On-Site Orientation (To Be Completed and Faxed to the Office at 651-264-1002 Within 15

On-Site Orientation (to be completed and faxed to the office at 651-264-1002 within 15 days of hire):

_____Do not be alone with any client(s) at any time during 16 hours of shadowing.

_____ Do not answer the door or the telephone at the house during shadowing.

_____Do not drive any company vehicle until notified of approval by the agency’s insurance carrier

_____ Review all clients’ Risk Management Plans. Sign signature page on each.

_____ Review Maintenance Supervision Requirements policy

_____ Review each client’s Care Plan and sign signature page on each (at Class F programs)

_____ Review client ISPs and the plan to implement ISP objectives

_____ Review Clients complete files

_____ Review the Client Information/Protocols Book

_____ Locate the Fire Evacuation Plan and Severe Weather Shelter

_____Locate Fire Extinguisher(s)

_____ Locate emergency/power outage supplies: corded phone, flashlight, battery-powered radio

_____ Locate emergency phone List

_____ Identify the location of the first aid kit or first aid supplies

_____Locate and learn the operation procedure for ADT alarm system

_____ Review House Rules and Boundaries

_____ Understand the shoe procedure and the location of the shoe cabinet

_____Review the Medal Program and Ticket Program

_____Locate and discuss staff schedule

_____ Review payroll program on computer, identify location of payroll formsand where to keep completed Notation Forms and Time Edit Request Forms

_____Learn to check phone messages and emailand respond or pass on as appropriate

_____ Review the employee website, i.e. where to find necessary program forms, submit incident reports, complete online staff training

_____Become familiar with the staff book/communication book

_____Locate and discuss the Resident Counselor checklists

_____Identify where the keys are for the house are kept when not on your person (at the beginning or the end of your shift)

_____Learn how to submit incident reports and emergency use reports/submit test incident report

_____ Attend a Community Meeting

_____ Review the house schedule/calendar of upcoming events

_____ Identify clients’ laundry days and household chores

_____ Observe clients’ hygiene routines

_____ Become familiar with menu/meal planning and meal preparation

_____ Understand portion control requirements

_____ Discuss snack options

_____ Review all clients’ medication sheets and familiarize yourself with the medications and their uses

_____ Observe a complete medication pass

_____ Review med discrepancy form and submit one for practice

_____ Review Standing Orders Medication List for each client

_____ Identify location of standing order medications

_____ Administer medications while being observed; complete Medication Administration Observed Skills Checklist Form

_____Train on medical equipment

_____Med appointment procedures, referral forms

Record shifts worked shadowing/training with another staff person (Must shadow another staff for at least the first 16 hours of training):

Date ______Hours Worked______Signature of Staff Shadowed ______

Date ______Hours Worked ______Signature of Staff Shadowed ______

Total # onsite Training hours ______(must be at least 30 hours)

My signature below acknowledges that I have had all of the above listed training and have had opportunities to ask questions:

______

Employee SignaturePrinted NameDate

Zumbro House – Policies and Procedures

Please initial each policy below as you review.

______Non-Contract and Employment “At Will” Statement

______Welcome Letter

______Company Goals, Philosophy and Purpose

______Continuity of Policies – Right to Change or Discontinue

______Equal Opportunity Policy

______Recruitment

______Announcement of New Positions

______Transfer Policy

______Employee Selection and Development

______Staff Qualifications

______Staff Orientation

______Staff Training

______Staff Reliability

______Background Studies

______Sexual Harassment

______Drug Abuse/Alcohol Abuse

______Smoking

______Employment Classifications

______Employee Safety

______Employee Work Related Injury or Illness Reporting, Investigation, Prevention

______Return to Work after Serious Injury or Illness

______Performance Improvement

______Separation of Employment

______Grievance Procedure

______Employment Disputes

______Compensation

______Payroll Procedures

______Equal Pay

______Job Description

______Workday

______Pay Advances

______Overtime Compensation

______Rest Periods

______Performance Review

______Salary/Wage Administration

______Payroll Deductions

Employee Benefits

______Group Medical and Dental Insurance

______Paid Time Off (PTO)

______Holidays

______Leave of Absence and Military Leave

______Medical/Family Leave

______Bereavement Leave

______Jury Duty

______Voting

______Employee-Incurred Expenses and Reimbursement

______Travel Reimbursement

______Relocation of Current or New Employees

______Required Management Approval

Miscellaneous Policies

______Confidentiality of Company Information

______Confidentiality of Company Information – E-Mail

______Staff Reimbursement for Damaged or Stolen Property

______Conflict of Interest and Non-Compensation

______Gratuities to Government Employees or Officials

______Gratuities or Gifts from Clients/Legal Representatives

______Political Activities

______Employee Privacy

______Telephone

______Dress Code

______Visitors

Program Policies

______Admission and Service Initiation Policy

______Service Coordination and Continuity Policy

______Individual Rights Policy

______Individual Funds Management Policy

______Incident Response, Reporting, and Review Policy

______Emergency Response, Reporting, and Review Policy

______Emergency Use of Manual Restraint Policy

______Grievance Policy – Program

______Maltreatment of Vulnerable Adults Reporting and Internal Review Policy

______Maltreatment of Minors Reporting and Internal Review Policy

______Facility Health and Sanitation Policy

______Safe Medication Assistance and Administration Policy

______Healthy Living Policy

______Safe Transportation Policy

______Data Privacy Policy

______HIPAA Compliance Policy

______Record Keeping Policy - Program

______Quality Improvement Policy

______Temporary Service Suspension and Termination Policy

By signing below, I am indicating that I have read and understand the employee policies and procedures of Zumbro House, Inc., and have had the opportunity to have any questions answered. I am aware of how to access the employee policies and procedures.

______

Employee signature Printed NameDate

ZUMBRO HOUSE, INC.

Medication Administration Observed Skill Assessment – Site Specific

Staff members must demonstrate the ability to administer medications through an observed skill assessment. The skill assessment must be completed after the staff member has successfully completed the approved medication administration training and prior to staff members administering medications without supervision. Staff members are only required to have an observed skill assessment for the medication administration skills required for their job.

The skill assessment must document:

The skill(s) observed,
A determination of competency,
The date, signature and title of person observing the skill(s).

This is to indicate that______has successfully demonstrated the

(Staff Name)

Ability to administer medications at______on______.

(Name of Site) (Date)

CHECKLIST OF RESPONSIBILITIES AND SKILLSPassFail

Has observed at least one complete med pass at the site.______
Can explain the seven “rights” of medication administration.______
Can explain the purpose/action of each medication used at the site.______
Can explain the main side effects of each medication used at the site.______
Can identify available sources of information regarding side effects.______
Can identify location of the Health Care Procedures Manual.______
Can explain correct medication error reporting procedures.______
Can explain correct medication storage procedures.______
Can explain correct medication destruction procedures.______
Has demonstrated the CORRECT medication administration procedures for the following:

(Check all that apply)

____Oral____Vaginal

____Topical____Sublingual

____Eye Drops/Ointment ____Inhalers

____Nose Drops____Enteral Tubes

____Nasal Spray ____Transdermal Patches

____Rectal ____Nebulizer

____Other:______

Medical Equipment Training as Applicable:

____ Blood Pressure Cuff____ Glucometer

____ CPap____ Nebulizer

____ Other: ______

Comments:______

______

Signature and title of staff observing the skillsDate

Medication Administration Agreement

I have successfully completed an approved Medication Administration Training and have been observed administering medications at the site. I agree to follow all company policies and procedures for administering medications. By signing this agreement, I understand and accept the serious responsibility for administering medications to the consumers receiving services from this company.

______

Signature of StaffDate

Client Return Protocol

Upon a client’s return, all of their belongings and bags must be gone through before they go into their bedroom. This will ensure no contraband (illegal substances such as drugs or alcohol), inappropriate materials (pictures of triggers, magazines/books with sexual or violent content, etc.), or weapons are brought into the facility. Please go through any bags they come back with (overnight bags or shopping bags) and be sure they empty their pockets before going into their bedroom. Please collect any money, receipts, lighters, cigarettes, questionable pictures, etc.

Often times, family members give money to the clients as a gift and the clients do not think they should have to turn it in. Please let them know the money will be given to the LC and that the LC will discuss with the client how the money will be spent. Please ensure them we are not taking their money but holding on to it, to ensure it is used appropriately and does not get lost or stolen in the mean time. Same goes for clients contesting when an item is being confiscated. Let them know the LC will be informed and discuss it with them; the item will be given back if it is deemed appropriate.

1.)Client returns

2.)Guardian/family member signs in/out on Leave of Absence form

LOA form is for overnight visits only – it does not have to be filled out if a client leaves and comes back on the same day

3.)StaffTHROUGHLY go through any bags/belongings as well as the client’s pockets

4.)Client returns their belongings to their bedroom after the search is complete

*If any items of concern are found, remove from the client’s possession and lock in the staff office. Please notify the LC, immediately.

Please ensure this procedure is done exactly the same for every client, upon every return. If needed, explain to them this is protocol for everyone and is to ensure their safety. Please notify LC/PC with any concerns you may have or issues you may encounter. Thanks!

Staff Name: (PRINT): ______

Staff Signature______Date: ______

ADT Alarm Training

Alarm contacts have been placed on all exterior doors, bedroom windows, and in some houses, bathroom or other accessible windows. For the safety of the clients as well as the surrounding community, the alarm system must be armed at all times. There is a recording device within the system that will allow managers to review and pinpoint any spans of time that the alarm was disarmed for any reason. If the alarm is found to be disarmed, this will be considered a significant infraction of the Security Policy. The infraction will result in disciplinary action up to and including suspension or termination of employment.

Alarm Instructions

It is essential that the four-digit code remain confidential. Under no circumstances can it be shared with any individuals not employed by Zumbro House. Even more importantly, it cannot be discovered by the clients! For this reason, when staff are entering the code on the keypad, you must adhere to the following protocol:

Clients must remain at a distance of 10 feet from the keypad
Staff will place their body between the client and the keypad, to block any view
Before beginning to the enter the code, staff will look over their shoulder in both directions to ensure that no client is able to see the keypad
Staff will cover the keypad with one hand while entering the code with the other hand

If there is ever any suspicion that a client is aware of the code, contact a supervisor immediately – a plan will be developed to have the code changed by maintenance and to adjust supervision protocols until that change takes place.

Identify the primary door and all secondary doors (if applicable). WE SHOULD BE USING THE PRIMARY DOOR AT ALL TIMES. PLEASE AVOID USING THE SECONDARY DOOR AS MUCH AS POSSIBLE. The primary door is programmed under Zone 1 and is used when clients and staff enter and leave the building. Secondary doors are programmed under Zone 2 and should remain armed at all times and should only be used in emergency situations.

When you are leaving the building (even for a short period of time such as for a smoke break or activities in the yard):

Enter the Four-digit code, OFF, Four-digit code, AWAY (#2)

Once entered, you will have 30 seconds to get out of the building and the alarm will re-arm behind you.

When you are returning to the building, or coming onto your shift, enter the house and go right to the key pad:

Enter the Four-digit code, OFF, Four-digit code, AWAY (#2)

This sequence must be entered on the keypad within 30 seconds of entering the house.

At the beginning of every shift, staff must ensure that the secondary door is armed. To do this:

Enter the Four-digit code, *2. The panel should read ARMED AWAY.

If the panel reads DISARMED:

Enter the Four-digit code, *2, Four-digit code, AWAY (#2). This will arm all secondary doors.

To disarm the secondary door in an emergency situation ONLY:

Enter the Four-digit code, *2, Four-digit code, OFF.

Proceed with the steps outlined above to rearm the secondary door.

The panel should always show a Ready status. If the light does not indicate a Ready status, ensure all doors and windows are closed and attempt to re-arm the system. If the system continues to indicate a non-Ready status or if the word “CHECK” appears on the touchpad’s display, contact the supervisor immediately.

I have been trained on alarm protocols and have demonstrated my ability to complete the tasks outlined above.

______

Staff Signature Date

______

Printed Name

EZLabor Instructions

If you forget your password to EZLabor you need to immediately contact the Payroll Department to get the password reset and/or to get access rights restored (651-264-1008). If nobody is available, please leave your name and the number where you can be reached.

If you are prompted to enter a client name before logging in, the client name is ZumbroHouse.

Department

When transferring in you will need to change the department for which you are working. This allows the accounting department to allocate funds to each department/house. HOME is a nonexistent department so you will need to change this to whatever house you are working. If you are doing training such as EIS, CPR/First Aid, etc, you will choose 04-Training as the department.

If you are asked to work at a different location immediately following your time at one house, you may “transfer” to the other house once you arrive rather than “clock out” and then “transfer” in again. For instance, if you are working at Morris Park from 2-9pm and are asked to cover hours at Bossen from 6-10pm, you would not need to clock out from Morris Park and then transfer in when you get to Bossen. You can just transfer into the Bossen department once you get there. EZLabor will recognize this and will automatically clock you out from Morris Park and into Bossen. Then when you are done at Bossen you will simply clock out. However if you are working at Morris Park from 9am-4pm and are asked to work hours at Bossen from 7-10m, you would then clock out at Morris Park and then transfer in normally at Bossen. Just remember if there is no time between transferring to a new house (department) you do not need to clock out, just transfer in to the new location when you get there. This does not apply if you are simply taking clients to social skills at another house or something similar.

Please set your Pay Date Range to Current Pay Period. This will allow you to view your current timecard to be able to see errors and to be able to monitor hours in order to avoid overtime.

TERF (Time Edit Request Form)

The TERF is used when you miss a transfer in time or a clock out time. For instance, if the internet is down or you forget to transfer in or clock out, you would complete a TERF. The TERF can be found on the Zumbro House website under the Employees Only tab. The login for this is zumbro and the password is 4321. This can be accessed from any computer so the TERF can be completed from home if need be. A TERF needs to be submitted as soon as you notice an error on your timecard. If the internet is down and you are unable to access the website, please use the paper copy that is provided at the house and fax it the office. One missing punch will hold up all of payroll, so it is very important that all TERF’s get submitted immediately. All TERFs should be submitted no later than Monday at 5pm of payroll week (the Monday following the end of the pay period). Please do not wait to submit TERFs until that day. They should be submitted immediately to avoid confusion.

Falsifying or “padding” time on a TERF, or failing to complete a TERF as requested may be subject to disciplinary action. All TERF times are verified with camera checks for accuracy.

Timecard Notation Form

Timecard Notation Forms are found at the house. The form is to be used any time your transfer in and clock out times do not match the time in your schedule on EZLabor, whether approved or unapproved. On-call staff will need to do a Timecard Notation for each shift they work. The Timecard Notation Form needs to be put in the payroll binder at each house so the Lead Counselor can enter the information in the Note section of your timecard. The Lead Counselor will be auditing timecards at least once per week so it is very important that the Timecard Notation Forms be completed in a timely manner. If you notice that your time in EZLabor does not match the time you are regularly scheduled to work, you need to contact the Lead Counselor so this can be communicated to the Payroll Department and the schedule can be adjusted. Notations sent to the office will not be processed as this is a form for the Lead Counselor only.