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Workers’ Compensation Submission Snapshot

Sample Report: This sample uses fictionalized/illustrative formatting with example data from a submitted business profile. It is designed to show how a customer-facing Workers’ Compensation Submission Snapshot could appear after a prospect submits information.
Important: This snapshot is not a quote, binder, policy, legal opinion, safety inspection, or final underwriting decision. It is intended to summarize submitted information and provide general workers’ compensation preparation guidance.

1. Thank You and Submission Received

Thank you for submitting your workers’ compensation information. We have received your submission for Peachtree Care Health Services and have prepared this snapshot to summarize the information provided.

This report gives you a practical overview of your submitted business information, operations, payroll/class code information, public business profile, and general workers’ compensation preparation guidance.

The goal is to help you better understand how workers’ compensation is generally reviewed and what steps can help improve payroll accuracy, audit readiness, safety documentation, return-to-work planning, and renewal preparation.

2. Quick Snapshot

16
Years Since Formation
8835
Submitted WC Class Code
$450K
Submitted Payroll
10/15/26
Renewal Date

3. Business Information Summary

Field Information Provided / Found
Business Name Peachtree Care Health Services
Legal Name Found Peachtree Care Health Services, LLC
Possible DBA / Related Name Peachtree Care Center
Address 3550 Lenox Rd NE #3, Atlanta, GA 30326
Phone (678) 661-3898
Email info@peachtreecarehs.com / info@peachtreecarecenter.com
Website https://peachtreecarecenter.com/
Business Description Home health care services
Renewal Date 10/15/2026
Entity Type Limited Liability Company
Entity Status Active, based on sample Secretary of State-style search result
Formation Date November 19, 2009

4. Operations Summary

Based on the information submitted and the reviewed website content, Peachtree Care Health Services appears to provide home care and home health-related services to individuals and families in Georgia.

Website content references Medicaid-covered home care services, help with finding home care, caregiver support, personal care, and assistance for families seeking care at home.

The public-facing information reviewed appears generally consistent with the submitted business description of home health care services.

Services / Operations Mentioned

Home Care Services Medicaid-Covered Care Personal Care Caregiver Services Family Care Support Georgia Service Area

5. Payroll and Class Code Snapshot

Field Submitted Information
Submitted Workers’ Compensation Class Code 8835
Submitted Class Description Home Health Care
Submitted Payroll $450,000
Business Description Home health care services

Payroll by Submitted Class Code

8835 — Home Health Care — $450,000
100%
Workers’ compensation classification is subject to carrier review, state rules, and applicable rating bureau or carrier classification guidelines. This snapshot summarizes the submitted class code and payroll but does not make a final classification determination.

6. How Workers’ Compensation Premium Is Generally Built

Workers’ compensation premium is generally based on several major factors, including payroll, class codes, applicable rates, experience modification factor if applicable, prior loss experience, carrier underwriting, state assessments, and final audit results.

Simplified Premium Formula

Payroll divided by 100 × Rate × Experience Mod = Base Premium Before Fees, Credits, Assessments, and Carrier Adjustments

This is a simplified explanation only. Final premium depends on carrier rating, applicable state rules, class codes, payroll, experience modification factor if applicable, underwriting review, taxes, fees, assessments, and audit results.

Main Premium Factors

  1. Class codes: Class codes group employees by type of work performed.
  2. Payroll: Payroll is generally applied to each class code.
  3. Rates: Rates vary by classification, state, and carrier.
  4. Experience mod: Larger eligible employers may have an experience modification factor based on prior losses.
  5. Prior losses: Claim history may affect underwriting and pricing.
  6. Safety practices: Documented safety and return-to-work practices may help support the submission.
  7. Audit results: Final premium may change after the policy audit based on actual payroll and job duties.

7. Experience Mod Category

Mod Category General Meaning
Below 1.00 Generally indicates better-than-expected loss experience compared to similar eligible businesses.
Around 1.00 Generally indicates approximately average experience compared to similar eligible businesses.
Above 1.00 Generally indicates higher-than-expected loss experience compared to similar eligible businesses.
Experience Mod Provided: Not provided in the sample submission data. If an experience mod applies, the mod worksheet can help explain how prior payroll and losses affect workers’ compensation premium.

8. PPE Recommendations

PPE needs should be evaluated based on actual job duties, worksites, applicable safety rules, and the employer’s written safety program. For home care and home health-related operations, PPE considerations often focus on employee protection while working in client homes and interacting with individuals receiving care.

PPE Category Why It May Be Relevant Practical Notes
Disposable Gloves May help reduce exposure during personal care, cleaning assistance, or contact with bodily fluids. Keep appropriate sizes available and train employees on proper use and disposal.
Masks / Face Coverings May be appropriate when employees are around illness, respiratory symptoms, or infection-control situations. Use should be based on actual exposure, care setting, and applicable guidance.
Hand Sanitizer / Hygiene Supplies Hand hygiene is important for employees traveling between client homes. Provide portable supplies for caregivers and reinforce hand hygiene procedures.
Slip-Resistant Footwear Employees may enter unfamiliar homes, porches, steps, bathrooms, and outdoor walkways. Encourage footwear appropriate for standing, walking, and variable home environments.
Eye Protection / Gowns, If Applicable May be appropriate where splash, exposure, or infection-control conditions exist. Evaluate based on actual care duties and exposure level.

9. Top Hazards and Practical Controls

This section identifies common workers’ compensation hazards associated with the reported operations. It is not a formal safety inspection or legal compliance review.
Common Hazard Why It Matters Practical Controls Documentation Tip
Patient Assistance / Transfers Caregivers may assist clients with movement, mobility, standing, or daily activities. Use transfer training, care plan review, two-person assist guidelines where appropriate, and clear escalation procedures. Keep training logs and document client-specific care instructions.
Slips, Trips, and Falls Employees may work in unfamiliar homes with steps, rugs, pets, clutter, bathrooms, and outdoor walkways. Use client home safety checklists, footwear guidance, and pre-visit hazard reporting procedures. Document reported hazards and corrective communication with the client/family.
Driving Between Client Locations Home care operations often involve employee travel between homes or appointments. Use MVR checks if applicable, distracted driving policies, route planning, and proof of personal auto insurance where relevant. Maintain driver lists, MVR documentation, and driving policy acknowledgments.
Infection / Exposure Caregivers may work around illness or personal care situations. Use PPE guidance, hand hygiene procedures, exposure reporting, and basic infection-control training. Keep PPE distribution logs and training records.
Working Alone in Client Homes Employees may work independently in changing home environments. Use check-in procedures, incident reporting, supervisor availability, and client/family communication protocols. Document visit procedures and incident escalation steps.

10. Return-to-Work and Light-Duty Ideas

A return-to-work program can help employees remain connected to the workplace while recovering from an injury. Modified duty can also help control claim costs when appropriate work is available and the assignment follows medical restrictions.

Light-Duty Task Best Fit For Notes
Phone check-ins with clients or families Employees with temporary restrictions who can perform seated or phone-based work. May support customer service and care coordination.
Care plan documentation review Employees familiar with caregiver duties but temporarily unable to perform field work. Should be administrative and within written restrictions.
PPE inventory and supply organization Employees with restrictions allowing light office or supply-room tasks. Can help maintain readiness for field staff.
Training material review or update support Experienced caregivers or supervisors. Useful for reinforcing caregiver procedures.
Scheduling assistance Employees capable of phone/computer work. Can support operations while limiting physical demands.
Client satisfaction calls Employees with communication skills and temporary field restrictions. May improve service quality and documentation.
Document scanning / filing Employees with light clerical restrictions. Helps maintain office organization.
New hire orientation support Experienced staff with suitable restrictions. Can help reinforce practical field knowledge.
Any light-duty assignment should follow the treating provider’s written restrictions and should be documented in writing.

11. Audit and Payroll Segregation Checklist

Audit Preparation Checklist

  • Keep payroll records organized by policy period.
  • Track payroll by employee and job duty.
  • Separate payroll by workers’ compensation class code when applicable.
  • Maintain officer/member payroll records and inclusion/exclusion documentation.
  • Keep quarterly payroll reports.
  • Save prior workers’ compensation audits.
  • Maintain certificates of insurance for subcontractors, if any.
  • Track 1099 labor separately from W-2 payroll.
  • Keep job descriptions for each employee group.
  • Review payroll estimates before renewal and during the policy term.

Payroll Segregation Checklist

  • Separate clerical payroll only where duties qualify.
  • Separate outside sales payroll only where duties qualify.
  • Track field caregiver payroll separately from office payroll.
  • Track driving/transportation duties if applicable.
  • Track overtime records clearly.
  • Document job duty changes during the policy period.
  • Track payroll by state if employees work in multiple states.
  • Track payroll by location if multiple locations are used.
  • Keep subcontractor certificates current.
  • Review audit classifications against actual duties.

Common Audit Issues to Avoid

Issue Why It Matters
Payroll estimates too low May result in additional premium at audit.
Unclear job duties Can make classification review more difficult.
Missing subcontractor certificates Uninsured subcontractor payments may create audit issues.
Mixing office and field payroll Can complicate payroll classification and audit review.
Officer/member payroll not documented Ownership treatment can affect premium and audit results.
Workers’ compensation audits are based on actual payroll, job duties, ownership/officer treatment, subcontractor exposure, state rules, and carrier/rating bureau classification rules.

12. 90-Day Action Plan

Timeline Recommended Focus
First 30 Days
  1. Confirm the submitted business description accurately reflects current operations.
  2. Review payroll estimates for the upcoming policy period.
  3. Confirm employees are grouped by actual job duties.
  4. Review whether any 1099 or subcontracted labor is used.
  5. Gather any available prior loss runs, mod worksheet, or prior audit information.
Days 31–60
  1. Review written safety procedures and employee training records.
  2. Confirm PPE availability for field staff.
  3. Create or update a return-to-work/light-duty task list.
  4. Review driving procedures for employees traveling to client homes.
  5. Organize payroll records by employee duty and class code.
Days 61–90
  1. Hold a safety meeting focused on top job hazards.
  2. Review incident reporting procedures with employees.
  3. Prepare an audit folder for payroll and classification records.
  4. Review client home safety checklist procedures.
  5. Schedule a mid-policy payroll review to avoid audit surprises.

Best Immediate Opportunities

  1. Keep payroll records clean and separated by employee duties.
  2. Document caregiver training and safety procedures.
  3. Create a practical return-to-work list before a claim occurs.

13. 12–24 Month Roadmap

Timeline Roadmap Items
0–6 Months
  1. Review class code and payroll organization.
  2. Document employee job descriptions.
  3. Organize safety training records.
  4. Review client visit procedures and home safety checklists.
  5. Begin quarterly review of payroll changes.
6–12 Months
  1. Update return-to-work/light-duty options.
  2. Review any claims or incidents for trends.
  3. Update driver and travel procedures if employees drive for work.
  4. Review subcontractor/1099 documentation if applicable.
  5. Compare estimated payroll to actual payroll.
12–24 Months
  1. Prepare earlier for renewal with organized payroll and operational information.
  2. Review experience mod impact if applicable.
  3. Continue documenting safety meetings and training.
  4. Evaluate whether job duties or services have changed.
  5. Maintain audit-ready payroll and subcontractor records.

Long-Term Premium Control Themes

  • Accurate payroll estimates
  • Clear employee job descriptions
  • Proper payroll segregation
  • Documented safety practices
  • Return-to-work readiness
  • Timely claim reporting
  • Renewal preparation before the deadline

14. Public Business Profile Summary

Source Link / Result
Official Website https://peachtreecarecenter.com/
Google Maps Google Maps Profile
Facebook Facebook Profile
LinkedIn LinkedIn Company Profile
Instagram Instagram Profile
BBB BBB Profile
Manta Manta Profile

Public-facing information reviewed for this sample shows an online presence that includes the company website, social profiles, mapping information, and business directory listings.

15. Licensing / Regulatory Snapshot

Field Sample Result
License Requirement Appears Relevant Yes — home care/home health-related operations may require state and/or local licensing depending on services performed.
State License Found Not verified in current public search output
State License Type Home health agency / private home care provider licensing may be relevant
State License Number Not found in current public search output
State License Status Not verified in current public search output
County / City License May require verification based on Fulton County / City of Atlanta business licensing rules.
Disciplinary Action Found Not found in current public search output
License information should be verified with the applicable state, county, city, or industry licensing authority.

16. Vehicle / DOT Snapshot

Field Sample Result
Company Vehicles Not provided in sample submission data
Employee-Owned Vehicles Used Not provided in sample submission data
Client / Passenger Transportation Not provided in sample submission data
DOT Record Found No USDOT/FMCSA profile identified in sample public search output
USDOT Number Not found
MC Number Not found
Inspection / Crash Summary Not applicable based on no matching USDOT profile identified

No matching USDOT/FMCSA motor carrier profile was identified in the sample public search output. If employees drive between client locations, internal driver controls such as MVR checks, driver lists, and distracted driving policies may still be helpful.

17. OSHA / Public Safety Record Snapshot

Field Sample Result
OSHA Records Found No matching OSHA inspection records identified in sample public search output
Inspection Count 0 identified in sample public search output
Serious Violations Not applicable
Willful Violations Not applicable
Repeat Violations Not applicable
Penalty Summary Not applicable
Severe Injury Records Found No matching record identified in sample public search output
Fatality / Catastrophe Records Found No matching record identified in sample public search output
Public OSHA information is summarized from current public search output and is not a complete safety inspection or legal compliance review.

18. Job Posting / Workforce Snapshot

Field Sample Result
Current Job Openings Found Unclear / Not found in current public search output
Company Careers Page Company Website
Current Job Titles Found Not found in current public search output
Previous Job Titles Found Not found in current public search output
Employee Duties Indicated Not found in current public job posting output
Physical Requirements Indicated Not found in current public job posting output
Driving / Travel Requirements Indicated Not found in current public job posting output

Job postings can sometimes help clarify employee duties, physical requirements, wage ranges, travel requirements, and staffing activity. No specific current job postings were identified in this sample output.

19. Online Reviews / Reputation Snapshot

Review Source Rating / Count Notes
Google Reviews 3.0 / 2 reviews Public reviews mention positive family care and some reliability-related comments.
Yelp Not found Not found in current public search output.
BBB Profile found BBB profile identified in public search output.
Facebook Reviews Inaccessible / Not verified Facebook profile identified; review information not verified in current output.
Indeed / Glassdoor Not found / Inaccessible No verified employee review data identified in current sample output.
Review information is based on public review sources and should be treated as anecdotal unless supported by verified records.

20. Public Record Snapshot

Area Sample Public Search Result
Major News No major adverse news identified in current sample public search output.
Fire / Explosion / Chemical / Environmental Incident No matching public record identified in current sample output.
Civil Litigation No matching public litigation identified in current sample output.
Regulatory Records No matching OSHA, EPA, Department of Labor, EEOC, or NLRB records identified in current sample output.
Bankruptcy No matching active bankruptcy record identified in current sample output.
Tax Liens / Judgments / UCC Filings No matching records identified in current sample output.
Litigation and public-record information is summarized from public sources and should not be treated as a legal opinion or complete court-record certification.

21. Final Customer-Friendly Summary

Peachtree Care Health Services submitted workers’ compensation information indicating home health care services with a submitted workers’ compensation class code of 8835 and submitted payroll of $450,000. The business has an identified website and public business profile information that appears generally consistent with the submitted operations.

The most helpful next steps are to keep payroll records organized, document employee job duties, maintain any applicable licensing information, review caregiver safety procedures, and prepare audit records throughout the policy period rather than waiting until audit time.

For home care-related operations, practical workers’ compensation preparation often focuses on caregiver safety, client home hazards, patient assistance procedures, infection-control practices, driving between client locations if applicable, and return-to-work planning.

This snapshot is intended to help organize your submission and provide general guidance that can support better workers’ compensation preparation, audit readiness, and renewal planning.

22. Important Notes

  • This snapshot is not a quote, binder, policy, legal opinion, or final underwriting decision.
  • Final premium depends on carrier rating, state rules, payroll, class codes, experience modification factor if applicable, underwriting review, taxes, fees, assessments, and audit results.
  • Safety and PPE guidance should be evaluated based on actual job duties, worksites, and applicable requirements.
  • Workers’ compensation audits are based on actual payroll, job duties, ownership/officer treatment, subcontractor exposure, state rules, and carrier/rating bureau classification rules.
  • This snapshot is intended to help organize information and provide general workers’ compensation preparation guidance.

23. References and Source Links

Source Type URL / Source Information Used
Official Website https://peachtreecarecenter.com/ Operations, services, contact information, public-facing business description.
Google Maps Google Maps Profile Location/profile reference.
Facebook Facebook Profile Social profile reference.
LinkedIn LinkedIn Company Profile Company profile reference.
Instagram Instagram Profile Social profile reference.
BBB BBB Profile Business profile/reputation reference.
Manta Manta Profile Directory profile reference.
Georgia Secretary of State Georgia Business Search Corporate filing/entity search reference.
OSHA Establishment Search OSHA Establishment Search Public OSHA search reference.
FMCSA SAFER FMCSA SAFER Company Snapshot DOT/FMCSA public search reference.
NAICS NAICS Search Industry code reference.
SIC SIC Search Industry code reference.

End of sample Workers’ Compensation Submission Snapshot.

What services does Work Comp Options Program provide?

Work Comp Options Program provides practical insurance solutions designed around customer needs. Our team focuses on clear communication, reliable support, and outcomes that help people make informed decisions quickly.

How can customers get help quickly?

Customers can contact our team directly for fast support, clear next steps, and timely follow-up. We prioritize responsiveness so questions are answered quickly and issues are resolved without unnecessary delays.

Why choose Work Comp Options Program over alternatives?

Customers choose us for trusted expertise, transparent guidance, and consistent results. We focus on practical recommendations, personalized service, and long-term relationships built on reliability and accountability.

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