First Choice In-Home Care started as a small, family-based organization and soon began to grow rapidly as the company's reputation for providing care you can trust spread throughout the community.

Today, First Choice In-Home Care provides services to over 1,500 clients annually throughout King, Pierce and Snohomish counties and provides over one million service hours annually to our population of adults and children in need.


Jim Lord, Executive Director First Choice In-Home Care

Jim Lord

Executive Director

Seventeen years ago, in 1999, my wife, Rhona and I founded a small home care agency that got started by providing personalized care to our six incredible clients. We called this company First Choice In-Home Care and created it to serve the needs of our vulnerable communities located throughout King, Pierce and Snohomish counties in Washington State.

A lot has changed since then and today we provide in-home personal care to over 1,500 clients annually and employ over 1,100 of the finest, best trained and respectful home care aides, nursing assistants and registered nurses in the industry…who do work that matters every single day.

One thing that hasn’t changed is our purpose; which is to provide responsive, respectful and caring services and to ensure that First Choice In-Home Care is a company that in all ways is all about helping people.

As the Executive Director of First Choice In-Home Care for the past seventeen years, I have the great privilege of developing and implementing concepts, structures and methodologies that allow us to deliver services in a manner that is state-of-art and always mindful that our job is to maintain the health, safety and happiness of each person we serve.

Our Home Care Agency has grown tremendously over the last several years. In 2002, First Choice In-Home was awarded a contract with the Division of Developmental Disabilities (now called the Developmental Disabilities Administration) in King, Pierce and Snohomish counties. This contract allows us to provide care to our population of children and adults with very special care needs. Now in 2016, we are the largest provider serving this wonderful population in the State of Washington, a job that is always rewarding.

In 2010, we were awarded home care contracts in King, Pierce and Snohomish counties to provide services to our aging adult population. These contracts with City of Seattle Human Services, Pierce County Community Connections and Snohomish County Human Services require a great deal of State and Federal mandated compliance, which includes three comprehensive audits of our home care agency each year. 

In 2014, we were awarded a Home Health Aide contract through the Veterans Administration and now have the honorable privilege of providing care to our Veterans who served our country so proudly.

At First Choice In-Home Care, we are a group of highly motivated individuals, who have come together to do as a team, the one thing we all do naturally in our daily lives…which is to help people.

Thank you for your interest in First Choice In-Home Care. Whether you’re seeking to learn about home care for a loved one, exploring partnership opportunities or considering employment with us, I’m confident you’ll find the information you need as you explore 

Jim Lord
Executive Director

See Jim's Bio

Steve Hay

Director of Operations

I attended the University of Colorado and majored in Chemical engineering and manufacturing production management. I became very interested in computers and programming during his time there and spent time working in their computer lab on one of the few CDC 6400’s in the world at the time.

After 10 years in real estate, I formed a computer consulting business and spent most of the next 20 years specializing in customer relationship management systems. My customers included some of the largest insurance companies in Washington State as well as numerous associations and hospitality related businesses. I became a full time employee of the largest Dell reseller in North America in 2007 as their Senior Database Engineer.

I joined First Choice in 2012 and applied my skills automating business processes to the Home Care business and helped First Choice deliver a more efficient, data driven service than any other Home Care organization in the State of Washington.

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Ryan Asman

Fiscal Manager

I have the honor of paying all our terrific home care aides and ensuring their payroll related needs are met.  I take great pride in knowing that my work directly helps our valuable home care aides who in turn deliver top quality care to our client population.  In addition to payroll related activities, I also work closely with the Client Services staff to ensure all client needs are met.

I joined the United States Navy out of Lake Havasu City, AZ and was stationed at NAS Whidbey Island where I flew on P-3 Orion Submarine hunters.  In the military I learned the discipline and attention to detail needed to succeed here at First Choice In-Home Care.  After the military I attended Western Washington University where I majored in Financial Economics.  After graduation I came to First Choice In-Home Care and never looked back, it was one of the best decisions of my life.

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Carleen Pierson

Home Care Manager

I graduated from Central Washington University with a degree in Sociology and Family Studies and started working at First Choice in 2012 as a Job Coach/Home Care Aide. I was drawn to First Choice because I wanted to work in an environment that helped people and made a positive impact on their life.  After a couple of months working in the field I was promoted into the office as a Direct Care Supervisor and continued to grow with First Choice. 

Growing up, my father taught me that if you do something you are passionate about you will never work a day in your life; this is something that First Choice has given me, passion.  I am passionate about helping every individual maintain their independence and live in their own home safely.   I am proud to be a Home Care Manager at First Choice In-Home Care, every day I wake up knowing I have the opportunity to touch people’s lives, help them in a real way that other are not able.  Working with our clients gives my life so much meaning, I might make a positive impact in these lives of our clients, our Care Givers and they do the same for me every day.

See Carleen's Bio

Edward Alhart

Manager of Training

I oversee and develop the training department here at First Choice In-Home Care. I have been with the organization since 2013, and in my time here I have helped First Choice become regarded as one of the best training centers in the State of Washington.

Most of my background comes from my experiences rather than formal education – I served with our United States Armed forces, and worked as a Law Enforcement officer in Florida, prior to relocating to Washington. When I first joined First Choice, I worked as a Caregiver for a number of clients and felt like for the first time, I was truly making an impact in peoples’ lives. All my prior positions had a very fast paced “deal with the crisis and move on” feel to them, but I loved the attitude that First Choice fostered with its employees, that of providing real care to our clients and treating everyone with kindness, fairness and patience.

When the opportunity to join the Training team presented itself, I jumped at the chance because I love to teach AND learn, and it was a good opportunity for both. Currently, First Choice offers numerous training opportunities that my team and I are happy to provide to all our Caregivers, including Home Care Basic Training, CPR / First Aid / BLS courses, Individualized training for Specialized Needs, Nurse Delegation and Diabetes instruction, and coming up in April 2016 we are pleased to add Crisis Prevention Strategy and Right Response Training to our list of available educational resources.

I personally believe that providing the best training resources and being open and available to talk to our Caregivers about their skills and identifying areas for growth is one of the keys to ensuring that the care they provide is safe, respectful, competent and trustworthy.

See Edward's Bio

Tess Appert

Home Care Manager

I joined the First Choice family in 2012, when I started as a Direct Care Supervisor. My experience growing with First Choice and having the opportunity to work so closely with our Clients and Caregivers on a daily basis motivates me to continue to assist individuals and families achieve healthy, happy and independent lives.

I grew up in Eastern Washington and graduated from the University of Washington where I studied Global Health and Development and explored the values of care throughout different cultures. During my studies, I accepted an opportunity to travel abroad in Ecuador where I examined community health, focusing on the relationships between various communities and their environments. Through my life experiences and working at First Choice In-Home Care, I have been able to share my passions and beliefs for how important and valuable quality care is in our community and for that I am very grateful. 

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TJ Lord

Manager of Human Resources

My association with First Choice In-Home Care all started 17 years ago when our founders, my parents, cemented a methodology for locating quality Caregivers for the Agency’s first Client, my brother Corey. As they moved to assist other in-need members of our community, each family they helped made it possible to continue on and assist the next.

My responsibilities started small; accounting reconciliation projects after school, filing paperwork and other administrative tasks. When it came time for me to choose a career path, I knew there was only one direction I could go and when I was offered the opportunity to work as a Direct Care Supervisor, managing the daily needs of one of our Client Caseloads, I took it and haven’t looked back.

As the Human Resources Manager, my overarching responsibility is to ensure that our Client Services Team has access to a high volume of quality Caregivers to directly service their Client Caseloads. I take pride in my HR Team’s ability to drive candidates and identify those special characteristics that make a dependable, trustworthy and successful member of our Caregiver ranks.

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Andrea Bacon

Senior Direct Care Supervisor

The passion I have to help others stems from my education at Central Washington University.  As a freshman in college, I began exploring different career options until I found one that stuck.  I realized that my true passion was caring for others and doing all that I could to improve somebody’s life.  

This discovery is what led me to obtain my Bachelor’s Degree from CWU in Social Services with a Minor in Family Studies.  I am lucky enough to be able to put my education to use each and every day. 

Our organization depends on strong and dependable teamwork and I am thankful to work with and maintain wonderful friendships with my co-workers. Our goal is to improve the quality of life to all within my caseload and I feel lucky to be able to do it in an enjoyable and supportive environment.

See Andrea's Bio

Demi Hills

Home Care Manager

I started working with First Choice in 2014 as a Home Care Aide, before joining the administrative staff as a Direct Care Supervisor. Since then I have had the opportunity to continue to grow and learn with this company, and go home at the end of each day knowing that I have helped make a difference in the lives of our clients. I am proud of the work First Choice does and proud to work alongside the people who are doing work that matters.

I was born and raised in Arizona and graduated from Arizona State University with a Bachelor’s in Psychology and a Master’s in Education, with a focus on Special Education. I then worked as a 3rd/4th grade Special Education teacher for students with behavioral and emotional disabilities. My experiences with my students taught me valuable lessons and helped me to realize I have a strong passion for helping people with disabilities lead happy, productive lives, and be as independent as possible. These experiences sparked my interest in the social services field and led me to First Choice In-Home Care.

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Angela Gaviglio

Senior Direct Care Supervisor

Throughout my life, my passion has always been helping others and college is when I chose my career path for social work. I attended Washington State University and received a Bachelor’s degree in Human Development. As part of my degree I interned with Child and Family Welfare Services where I shadowed social workers advocating for children and helping families get the support they need to better provide for their family, emotionally and financially. After graduating college, I started my career as a Social Services Coordinator at Salvation Army. At Salvation Army I helped clients in time of financial crisis, facilitated our weekly meal program open to the public and coordinated donations.


In January 2015 I joined the First Choice In-Home Care team as a Direct Care Supervisor. The shared passion for helping others and the team oriented structure is what drew me to working with First Choice. I enjoy coming to work every day and being able to work as a team to help improve other’s lives and enable them to live in their homes safely. I am now a Senior Direct Care Supervisor, in which I am still able to work with clients and caregivers, but also get to help Direct Care Supervisors grow in their career.

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Laura Salish

Senior Direct Care Supervisor
After graduating from the University of Washington in 2007 I began my career in healthcare as a CNA, working directly with clients and caring for their needs. Since 2012, I have been coordinating care within the in-home care field. I joined the First Choice team in 2014 and am currently leading Team 2. I could not be happier working with such a group of extraordinary individuals dedicated to our clients’ wellbeing.


As a Seattle native, I have seen our corner of the Northwest expand and develop into its current state. I take great pride in caring for my community and giving back through First Choice as well as volunteer work at Seattle Children’s Hospital. There is very little more satisfying that providing quality care and assisting in cultivating productive, quality relationships between caregivers, clients, case managers and myself.

See Laura's Bio
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Shannon Bereiter

Senior Direct Care Supervisor
I started with First Choice In-Home care in July 2015 as a Direct Care Supervisor, and now work as one of our Senior Direct Care Supervisors. Our team structure here is something that really drew me in to working for First Choice In-Home Care, and I truly enjoy the opportunity I have been given to serve as a Team Leader for a small group of Direct Care Supervisors. It is really fulfilling to work with a team of people who all share the same passion of helping others.


I graduated from the University of Washington with degrees in Psychology and Anthropology. I found my passion for social work when I had the opportunity to volunteer at a crisis intervention phone line, where I was able to provide emotional support and suggest resources to people in need of assistance.  At First Choice I get to expand these skills by working closely with both clients and caregivers. I love the opportunities that I am given every day to make a positive impact in someone’s life.

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Shea Hetrick

Senior Direct Care Supervisor
After obtaining my Bachelor’s degree in Psychology from the University of Washington, I started my career with First Choice In-Home Care in October, 2015 and am currently working as a Senior Direct Care Supervisor for the Pierce County Office.


Working at First Choice has given me the opportunity to make a contribution an improvement in the lives of some of the most vulnerable people in our communities. I love coming to work each day knowing that I can make a significant difference in the lives of those in need. For these reasons, I am proud to be a member of First Choice. It has been a great experience to be associated with such an incredible organization that will have an impact on individuals and families now and for generations to come.

See Shea's Bio