In consideration for Abundant Life HHA evaluating my application for employment, I give permission for Abundant Life HHA to contact the person(s) named below in order to complete a reference check. I release Abundant Life HHA and the persons named below from all liability in connection with seeking information and providing information concerning my employment history. I specifically indemnify Abundant Life and the person(s) named below from any and all claims of libel or slander arising out of the completion of the Reference Check Form.
FOR OFFICE USE ONLY
Company Being Contacted:
I hereby authorize Abundant Life Home Health Agency, LLC (Employer) to initiate credit entries and to initiate, if necessary,debit entries and adjustments for any credit entries in error to my account as follows:
at the financial institution(s) as indicated. I further authorize the financial institution named in this authorization form to credit and/or debit such account(s). I understand that this authorization remains in effect until the “Employer” receives from me, in writing, notification to terminate the authorization in such a time and a manner as to afford the “Employer” and my financial institution a reasonable time to act upon it. I acknowledge that I have been informed that it will take a reasonable amount of time (up to 15 business days) to complete the initial set up for my bank and particular account and that all paychecks prior to the full implementation will be delivered to me as fully negotiable paychecks.
For this step:
The informatio you will need to complete this step is in the two documents listed below. Click the links below to view the pdf. Please read through the documents, and agree to the terms and conditions.
Orientation Packet: Click Here
Employee Handbook: Click Here
I have read, understand and agree to abide by the policies and procedures set forth by Abundant Life Home Health Agency, LLC.
I also understand that I may view or copy any or all of Abundant Life Home Health Agency policy and procedure manual for review or retention.
I also agree to adhere to all local, state and federal procedures regulated as precedent for the home health care industry for compliance in providing care to Agency clients as designated.
I have read the Blood Borne Pathogens Policy. I understand and agree to comply with all provisions of the policy.
I acknowledge receipt of Abundant Life Home Health Agency, LLC Employee Handbook. In consideration of my employment I agree to read and abide by the rules and the policies of this handbook. Since the information, policies, and benefits described in this booklet may be subject to change, I understand and agree that any such change can be made unilaterally by the company in its sole and absolute discretion, and that material changes will be made known to employees through the usual methods of communication within a reasonable period of time.
have been given a copy of my job description. I have read and agree to the terms specified in this description for the position I am applying for/currently hold. I further understand that this job description may be reviewed at any time and I will be provided with a revised copy should any revisions be made.
I understand and agree with the above statement. I have had the opportunity to ask questions and have had my questions answered.
1. Employee is employed by Company on an at-will basis. Employee is not subject to the terms of any individual written employment contract or collective bargaining agreement between Employee and the Company. This Agreement toArbitrate Employment Claims agreement and the Conditions of Employment are the only written agreements between the Employee and the Company and except as expressly set forth herein, is intended to modify the employee-at-will relationship between the Employee and the Company to require arbitration of all employment disputes under the Federal Arbitration Act. Both parties waive the right to a judge or jury trial, except as provided in the Federal Arbitration Act.
2. In consideration of the continued employment relations between Employee and the Company, the Employee and the Company agree that any legal or equitable claims or disputes arising out of, or in connection with the Employee’s employment status, continued employment, terms and conditions of continued employment, employment-related disciplinary action, or the termination of employment, including related claims against other officers, employees or agents of the Company, will be settled by binding arbitration. Claims that are subject to arbitration include, without limitation, those arising under Title VII of the Civil Rights Act of 1964, the Age Discrimination and Employment Act, the Older Workers Benefit Protection Act, the Americans with Disabilities Act, the Employment Retirement Income Security Act, the Fair Labor Standards Act, or any federal law, or any civil rights, human rights, labor or employment law, rule, regulation or decision of any other state in the United States, or any other jurisdiction or country. This Agreement is intended to apply to claims involving Employee, Company and Company’s customers. The parties agree that Company’s customers are third party beneficiaries of this Agreement.
3. Except as modified by this Agreement, the arbitration will be conducted in accordance with the rules of the American Arbitration Association, and shall be conducted in the City of Clearwater, Fl, 33761.
4. The arbitration procedure and results shall be equally binding on the Employee and the Company.
5. In the event that a mutually binding arbitrator cannot be selected by both parties, each party shall select an arbitrator and the two arbitrators shall select a third arbitrator and the matter shall be heard by a panel of the three arbitrators. Decisions will be by majority vote of the arbitrators. The arbitrator(s) shall have exclusive jurisdiction to interpret and enforce this agreement, including determination of arbitrability of any claim.
6. All costs and expenses of arbitration, except attorney’s fees and expenses, shall be borne equally by the Employee and the Company. Each party agrees to pay their own attorney’s fees and expenses and waives any claim against the other party.
7. Except as expressly modified herein, all damages available at law or in equity shall be available to the parties. The arbitrators shall issue a written opinion that summarizes the issue in dispute, describes the awards, and explains the reasons for the outcome.
This document verifies that I have read and understand the literature prepared by the Florida Health Care Association with the assistance of the Alzheimer Resource Center of Tallahassee, Florida to meet statutory requirement of 400.4785 (1) (a) F.S.
HIPAA TrainingThe in-service includes:DefinitionPHICovered entitiesHIPAA specific policy to the agencyLength of in-service: 1 hour
Medical Device Reporting & MSDS TrainingThe in-service includes:Hazard communication requirements of OSHAThe presence of hazardous chemicals in the work areaHow to cope with emergency procedures (recognition, reporting, and evacuation)How to read and interpret labels and MSDSMedical device reporting policy and proceduresLength of in-service: 1 hour
AIDS/HIV/Bloodborne Pathogens TrainingThe in-service includes:DefinitionAbility to identify at risk populations for HIV/AIDSRecognize new health concerns in HIV patientsRecognize importance of infection control in the workplaceIdentify OSHA regulations regarding bloodborne pathogensIdentify regulations regarding sharps safety and handlingLength of in-service: 2 hour
I certify that I have attended the above listed in-service sessions. I have been given an opportunity to ask questions and have received clarification about the subject matter or policy/procedure involved. I understand how the materials presented apply to my work and agree to implement them to the best of my ability.
I understand as a condition of my employment with Abundant Life Home Health Agency, that I am at all times, to provide a device connected to my internet network. I further understand that this expense will not be reimbursed by the Agency. I must bring with me a tablet, laptop computer and/or cell phone that has the capability to connect to my internet service every shift I work.
I have been advised that all notes, communications and schedules will be provided and completed through ERSP (a web based electronic medical record).
If at any time during my employment, I am not able to maintain a device with internet access, I understand I would no longer meet the terms/condition of employment and would be terminated from my position with the company.
By signing below, I agree, at all times during my assigned working shifts, I will provide for myself a mobile device with my own internet connection.
DRUG-FREE WORKPLACE POLICY ACKNOWLEDGEMENTI hereby acknowledge that I have received and read the Abundant Life Home Health Agency Drug-Free Workplace Policy, a summary of the drugs which may alter or affect a drug test and a list of local Employee Assistance Programs and drug and alcohol treatment programs. I have had an opportunity to have all aspects of this material fully explained. I also understand that I must abide by the policy as a condition of initial and/or continued employment, and any violation may result in disciplinary action up to and including discharge.
Further, I understand that during my employment I may be required to submit to testing for the presence of drugs or alcohol. I understand that submission to such testing is a condition of employment with the Company and disciplinary action up to and including discharge may result if:
I also understand that if I am injured in the course and scope of my employment and test positive or refuse to be tested, I forfeit my eligibility for medical and indemnity benefits under the Workers' Compensation Act upon exhaustion of the remedies provided in Florida Statute 440.102(5).
I ALSO UNDERSTAND THAT THE DRUG-FREE WORKPLACE POLICY AND RELATED DOCUMENTS ARE NOT INTENDED TO CONSTITUTE A CONTRACT BETWEEN THE COMPANY AND ME.