Employee Name	Social Security Number
Interviewed by	Date
Hired by	Hire Date

ALL EMPLOYEES: PRE-EMPLOYMENT PACKET

All documents due 1 week prior to beginning work. Be aware that background screening can take as long as 2 weeks to clear.

Complete and return with completed documentation so that this Pre-Employment Packet can be retained in the Employee file.
EMPLOYMENT DOCUMENTS	EMPLOYEE COMPLETED/ RETURNED TO SUPERVISOR	SUPERVISOR REVIEWED/

INITIALS
PRE-HIRE DOCUMENTATION: Provide all documentation to the office or supervisor 1 week prior to work.
Application (must show last 3 years of work and level of education)
References (3 verified work references)
I9 Form
Liability Clause (automobile insurance waiver)
Employee/Employment Contracts
Copies:

• Signature Page	• Driver License	• Social Security Card

• Car Insurance	• Diploma/Degree	• Transcripts
Signed and notarized:

• Affidavit of Good Moral Character

• Affidavit of a Position of Trust (Personal Support Day)
Local Law Enforcement Check
Background Screening (obtain Livescan Submission Form from supervisor)
Provider Certification (APD) - completed by Program Admin
Provider Verification - completed by Program Admin to check education/experience
Job Descriptions
TRAINING: You are required to complete required and company determined training and sign policies annually. The Program Administrator will remind you when these are due, but you MUST submit the required proof that you have completed required training and signed the policies by the date they are due. See the Program Administrator for training sources.
Meeting with Program Administrator

• Go over Policies

• Go over Client-Specific Training (related to specific clients, SP, IP, etc)

• Go over General Hire Training (documentation and training requirements)
PREHIRE Training (training completed prior to beginning work)

• Zero Tolerance

• Medication Administration/Validation 65G-7 (if client takes medications)

• Requirements for All Waiver Providers
PREHIRE SLC Training

• Pre-Service Training

• Introduction to Social Security Work Incentives
WITHIN 30 DAYS OF HIRE (complete within 30 days of hire)

• HIPAA

• Behavioral Emergency Procedures (Reactive Strategies 65G-8) (if client has behavior plan)
WITHIN 90 DAYS OF HIRE (complete within 90 days of hire)

• Direct Care Core Competency

• HIV/AIDS/Infection Control - obtain from Red Cross or other source

• CPR - obtain from Red Cross or other source

• First Aid - obtain from Red Cross or other source

• Overview of APD Waiver Provider Requirements (the same as in PREHIRE)
Other Training (As required - APD, Company, etc)

• General Hire Training

• Client-Specific Training

• DD & Ibudget Waiver Services & Limitations Handbook

• Waiver Services Agreement & Its Attachments

• Required Documentation

• Chapter 393.13 The Bill of Right of Persons with Developmental Disabilities

• Person-Centered Planning – What is PCP?

• Person-Centered Planning – The Process & Creating Goals

• Rights & Choices

• Emergency Preparedness

• Core Assurances

• Incident Reporting

FOR OFFICE USE ONLY
BACKGROUND CHECK	DATE COMPLETED	DATE RECEIVED	OK/NOT OK TO WORK
Local Law Check Received (County)
FDLE Letter Received (FBI - National)