Staff of the Month Nomination

Staff of the Month Nomination


Team Member Name: Month:

Nominated By: Date Submitted:

It is vital to the success of our agency that we have team members that share our values and behave in alignment with those values. PCL's Staff of the Month nominees will exemplify excellent character and credibility by exhibiting integrity, positive intent, capability, showing results, respect, straight talk, a willingness to improve, and accountability of themselves and others. They behave with humility, an abundance mentality, tenacity, and levity. They partner with people to lead the lives they want, based on their unique preferences, dreams, and needs in their home, at work, and in their communities.

Criteria for Eligibility (all criteria must be met to be eligible) / Verified By:
 Certifications current
 No medication errors in the last 90 days
 No known performance concerns in the last 6 months
 No Plan for Success in the last 6 months
 No more than 1 verified unfavorable “How is my Driving” Report in the last 6 months
 Has successfully completed introductory period with PCL
 No “at fault” accidents (as determined by PCL) in the last 12 months
 No unexcused absences (i.e. team meetings, training, shift, etc.) in the last 12 months /  HR/Supervisor:

 HR:
 HR:
 HR:
 HR:


  • Complete this form (both sides) and submit to your Area Director by the 15th of the month.
  • The team member’s eligibility will be verified by Human Resources.
  • The Area Director will bring eligible nominations to the Guidance Team meeting for voting.

Please provide one story of how the nominee exemplifies PCL’s mission and values and Board Directives: PCL is a Great Provider of Person Centered Services, Great Place to Work, Great Community Partner, and Great Steward of Our Resources.
Expand the horizons and enhance the quality of life of those we support.
The people served by PCL are valued members of their communities.
We value:
 Flexibility, diversity, and dignity
 Ongoing education and support to families, employees, and communities
 Safe, secure, and quality environments in which to live, work, and play
 Continuous creative support as directed and defined by those we serve
 People with disabilities being an integral member of their community
 Physical, emotional, and spiritual well-being
 Opportunities and choices for each individual to become responsibly and effectively interdependent
 Mutual respect and understanding
PCL’s Board Directives
If the nominee works a shift in a home that is not an awake overnight please answer the following question: What is one story of how the team member is helping the person(s) they support to build non-paid relationships with friends and/or family.
If the nominee works a shift in a home as an awake overnight or is not in a Direct Support Professional, please provide one story of how they exemplify one of PCL’s Board Directives.