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  • Personal

    Personal Insurance

    We offer insurance for individuals and families, including customized coverage, to fit your lifestyle.
    View All
    Homeowners
    Disability Insurance
    Vacation Rental
    Secondary Home
    Builders Risk
    Condo
    Marine
    Flood
    Life
    • Homeowners
    • Disability Insurance
    • Vacation Rental
    • Secondary Home
    • Builders Risk
    • Condo
    • Marine
    • Flood
    • Life
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    Shield Insurance

    5602 Trompeter Gade
    St. Thomas, U.S. Virgin Islands 00802
    Phone: 340-201-1349
    Fax: 888-843-1915

    M – F, 9:00am – 5:00pm

    Get DirectionsGet Directions
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Adult Foster Care Insurance Quote

Adult Foster Care Insurance QuoteArabia Karaawi2024-08-12T10:41:10-04:00

Step 1 of 11

9%
Contact Name
Mailing Address
Same as Physical Address?
Physical Address
Organization Type?

Current Insurance Information

Do you currently have insurance?
MM slash DD slash YYYY
Have you had any claims in the last 5 years?
Does your current insurance program include?
MM slash DD slash YYYY
Is it?
MM slash DD slash YYYY

General Information

Are all facilities licensed through the state?
Has your license ever been suspended, revoked, or placed under conditional status OR claims of negligence?
MM slash DD slash YYYY
Any violations noted?
Are counseling services offered for any of the following?
Check all that apply.
Do you operate any other locations not included on this application?
Is insurance in place at these other locations?

Property Details

Facility Information

Resident unauthorized leave prevention?
Check all that apply.
Does a physician screen clients prior to admission?
Are residents responsible for their own basic personal care?
Example: Bathing, dressing, eating, restroom aide.
Do you allow physical restraint?
Resident Rooms
Inspection Freq.
By Who
How often?
Is there a written plan for supervising staff when interacting with clients on and off premises?
Are security cameras monitoring operations and residents?
Are resident's door ever locked from the outside?
Are residents allowed to cook their own meals?
How?
Is there a pool?
Who uses the pool?
Check all that apply.
Is the pool fenced with a self-locking gate?
Is there a diving board?
Is there trained staff on water safety?

Management Practices

Do you have sign in/out procedures for?
Check all that apply.
What is your client to staff ratio?
Day
Night

Abuse Prevention

Do you run criminal background checks, including sex/child abuse related crimes, before an employment offer?
This includes employees and volunteers.
Do you have a crisis plan for dealing with an incident of abuse?
Is there formal training on child/sexual abuse?
Are closed door one-on-one meetings prohibited?
Have any incidents resulted in an allegation of sexual abuse?
Was the case taken to trial?

Human Resources

Aprox. how many FT and PT employees two years ago?
Full Time
Part Time
Employee changes over the past twelve (12) months?
Left
Let Go
Laid Off
Demoted
Anticipated Employee changes over the past twelve (12) months?
Reductions
Layoffs
Demotions
Do you have written job descriptions for each employee?
Is drug testing conducted?
Do you train and require all staff to report incidents, in writing, and do you investigate each incident?

Workers Compensation

Which of the following contracted services are utilized?
Are there written agreements with those contractors?
Do you collect certificates of insurance from your contractors?

Financials

Annual Revenue:
Current Fiscal Year
Previous Fiscal Year
Annual Budget:
Current Fiscal Year
Previous Fiscal Year
Total Assets:
Current Fiscal Year
Previous Fiscal Year
Net Assets / Fund Balance:
Current Fiscal Year
Previous Fiscal Year
Do you offer a retirement plan?
Plan Details
Name
Established
Assets
Type
Participants
Administrator
Do you file a Form 5500 each year?
Request a copy of most recent filing.
Is your organization more than 25% owned by private equity?
Any mergers or operations under another name in the last five (5) years?

Vehicles and Transportation

Are all vehicles registered to the organization?
Do employees or volunteers use their personal vehicles for business?
How many use their own vehicles for business use?
Full Time - Driving over 20 hours per week Part Time - Driving up to 20 hours per week
Full Time
Part Time
Volunteers
Do you run MVRs on employees?
Do you require employees and volunteers to carry and show evidence of personal auto insurance?
Do you provide transportation services?
Do vehicles equipped for wheelchairs have tie-down belts?
Do you have a formal maintenance and safety training program in place?
Does Applicant utilize GPS fleet telematics devices?
Fleet Telematics Utilized

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Shield Insurance

5602 Trompeter Gade
St. Thomas, U.S. Virgin Islands 00802
Phone: 340-201-1349
Fax: 888-843-1915
Email: bia@shieldvi.com

Mailing Address

PO Box 305166
St. Thomas, VI 00803

Office Hours:
M – F, 9:00am – 5:00pm

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