Please read this checklist and instructions prior to completing the enclosed paperwork. These forms must be completed by you, as the Managing Employer. Initial the line in the “Completed” column as each item is finished and keep this checklist for your files. The Enrollment Packet is divided up between materials that should be returned to PossAbilities and staff training materials for staff to keep. If you have questions, please contact the PossAbilities FSE Director at 507-281-6116.

Initial When Completed

______1.Application- Have your support worker complete. Return to PossAbilities.

______2.Personnel Action Form. Your support worker signs this form. Return to PossAbilities.

______3.Support Worker Information Sheet-to be completed by you. Fill out completely.

No blank spaces. Return form to PossAbilities.

______4.Personal Support Worker Job Description. Have your staff review and sign.

Return form to PossAbilities. (A copy for the staff to keep is located in the training materials.)

______5.Driving Permission - If this support worker will be driving during their working hours, you

you must make a written request to PossAbilities for its permission and obtain a copy of your support worker’s vehicle insurance card. PossAbilities will check the worker’s DMV record and you will be notified in writing as to our decision. This can take anywhere from a day to a week after receiving your packet. NO DRIVING DURING WORKING HOURS IS PERMITTED WITHOUT THIS! Return the form and vehicle insurance card to PossAbilities.

______6.Consumer Bill of Rights. Have your support worker review and sign the form. Return

Form to PossAbilities.

______7.Personal Support/Respite Worker Training Verification. You and your staff sign this form

after staff has completed reading the policies and procedures training materials packet. Return Form to PossAbilities.

______8.Personal Support/Respite Worker on the Job Training Verification. You and your

support worker sign after you have gone through and provided on the job training. The One Page Profile, CSSP Addendum, and Individual Abuse Prevention Plan completed by PossAbilities after intake are also tools to use when completing on the job training. Return Form to PossAbilities.

______9.Personal Support/Respite Worker Medication Administration Training Verification. You

and your support worker sign after you have gone through and provided training if your support worker will be providing medication administration or assistance while working. Return form to PossAbilities if medication administration is applicable.

______10.Packet of training materials. This packet contains the following policies and the

associated forms for staff to review and keep for future reference:

Data Privacy and HIPAA information.

Incident Reporting Policy and Procedures.

Emergency Use of Manual Restraint Policy and Procedures.

Admissions Policy.

Grievance Policy and Procedures.

Temporary Service Suspension/Service Termination Policy and Procedures.

Participant Funds and Property Policy and Procedures.

Universal Precautions/ Blood Borne Pathogens information.

Safe Transportation Policy and Procedures.

Reporting Maltreatment of Minors and Reporting Maltreatment of Vulnerable Adults information.

Basic First Aid materials.

Drug and Alcohol policy.

Job Description.

Calendar of time card due dates and paydays

______11.Person Centered Thinking/Planning Training. Your staff must either complete this training

online or in person at PossAbilities (1808 3rd Avenue SE Rochester, MN 55904). If your staff will be completing the training online, they must email the FSE Director at and a link will be provided for the training via email. If your staff will be completing the training at PossAbilities, they must contact the FSE Director at 507-281-6116 or via the email listed above to schedule the training. Training is offered once per month at PossAbilities. If your staff have completed Person Centered Thinking/Planning through other employment, they may send verification of completion and will not be required to complete it again.