Family & Children’s Center



Family & Children’s Center

Domestic Abuse Project Orientation Checklist

|Employee Name: | |Hire Date: | |

|Mentor Name(s): | |

|Please check/ initial each item upon completion – due by the end of employee orientation period. |

|Supervisor Responsibilities |Date Completed |

|Contact Mike Senn with new employee’s name, role and start date, for equipment purposes. | |

|Contact Senior Human Resources Specialist with new employee business cards and name plate request. | |

|Contact EHR Project Manager with employee information to assign Procentive role | |

|Contact Facilities Manager for key request | |

1. Sign Up For Required Live Training

| |Date Registered For |

|CPR/First Aid-to include infant CPR (to be completed within 3-6 months of hire date) | |

|Mental Health First Aid –Adult or Youth Focus (to be completed within 3-6 months of hire) | |

|Behavior Management Skills Training (to be completed within 3 months of hire date) | |

2. Complete During First Program Shift

| |Date Completed & Trainer’s |

| |Initials |

|Position Description - send to Senior Human Resources Specialist | |

|Complete Payroll Change Form/Emergency Contact Information & send to Senior Human Resources Specialist | |

|Time-Sheet Guidelines | |

|Schedules & Requesting Time Off | |

|Assign Mentor and Discuss Mentor Program | |

|Staff Introductions | |

|Tour Building | |

|Keys & Badge use | |

|Dress Code | |

|Staff Space and Office Equipment | |

|Mileage and Check Reimbursement Forms | |

|Use of EHR | |

|Phone Use | |

|Computer | |

|Mailboxes | |

|Copy Machine | |

|Supplies | |

|Duty to Report | |

|Team Meetings | |

|Peer Consultation Meetings | |

3. Agency Vehicles

| |Date Completed & Trainer’s |

| |Initials |

|Agency Vehicles Process /Key Locations/Policies | |

|Explain filling gas procedure for agency vehicles & receipts | |

4. Emergency Procedures

| |Date Completed & Trainer’s |

| |Initials |

|Fire | |

|Severe Weather | |

|Evacuation Plan | |

|First Aid Kits/Personal Protective Equipment | |

|Dangerous Situations | |

|AED Location | |

|Emergency Phone Numbers | |

|Mobil Crisis/EMHS/ Helpline- Viroqua | |

|Documentation for Staff or Client Injury | |

5. Trauma Informed Care

| |Date Completed & |

| |Trainer’s Initials |

|Review Agency Trauma Informed Care Philosophy | |

|Trauma Informed Care Practices | |

|TIC/Self-Care resources on Depot | |

|Self-Care Plan | |

6. Training

| |Date Completed & |

| |Trainer’s Initials |

|Complete Introduction to Trauma Informed Care | |

|CMS Fraud, Waste and Abuse Compliance Training (FCC-CMS-FWA-COMP) – Relias | |

|Training covering preventing & responding to bullying & harassment in all forms | |

I acknowledge that I have completed the above checklist and have been given the opportunity to ask any questions for further clarification. I understand and agree to follow program/department Policies and Procedures. I also acknowledge that I have been given a copy of and/or have access to the program/department Manual.

Employee Signature Date

Supervisor Signature Date

|After Employee Orientation Review is completed-please send the completed checklist along with the review to HR, to be placed in employee’s personnel file. |

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