The Administrator shall appoint a full-time employee as a “service director” to provide general supervision and direction of the professional services offered by the home health agency. The service director, who shall be a physician, registered nurse, or an alternate professional, who is sufficiently qualified by advance training to supervise this service, shall be available at all times during operating hours of the home health agency and shall participate in all activities related to the professional services provided, including the qualifications of personnel as related to their assigned duties. In his absence, he shall appoint a similarly qualified designee. The nursing services of the home health agencies shall be provided under the supervision and direction of a registered nurse who is qualified by having 2 to 3 years experience or education in community health nursing. There shall be periodic, on-site supervision of services provided by home health aides, with complete and accurate documentation maintained. Training Requirements for Home Health Aides. Aides shall receive a periodic, structured program of training and orientation which includes, at a minimum: The role of the home health aide as a member of the professional health services team; Instruction and supervised practice in personal care services of the sick at home, with major attention being given to personal hygiene and activities of daily living; Instruction in how to assist patients to achieve maximum self-reliance through re-learning and modifying activities of daily living; Principles of good nutrition; Meal planning, food purchasing, and preparation of meals, including special diets; General information on the processes of growth, development, and aging; Information on the emotional and physical problems accompanying illness; Principles and practices in maintaining a clean, health, and safe environment as well as a pleasant one that encourages morale building and self-help; Items requiring referral to the nurse supervisor in the home health agency, including changes in the patient's condition or family situation; Record-keeping, when applicable; Policies and objectives of the agency; Information concerning the duties and responsibilities of a home health aide; and Ethical behavior and confidentiality of information. Inservice education is required for all professionals including home health aides, on a quarterly basis. The subject matter, content, and attendance shall be documented for review during the survey process.