Aging With Care INC
ORIENTATION PACKET
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EMPLOYMENT ACKNOWLEDGEMENT OF HANDBOOK

I acknowledge receipt of Aging With Care Inc. 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.

Employee Name *
Date *
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Employee Signature *
Aging With Care Inc. DRUG AND ALCOHOL POLICY
INFORMED CONSENT AND RELEASE OF LIABILITY


I authorize Aging With Care Inc. or Client Company (“Company”) to obtain a specimen of my urine for chemical analysis.  I understand that this analysis is to determine or exclude the presence of alcohol, drugs or other substances, in accordance with the Substance Abuse and drug Testing Policy of Company.  I understand that decisions regarding my continued employment may be made as a result of this analysis.  I understand that test results will be divulged only to authorized personnel.  I hereby consent to this test and release Company from any liability for decisions resulting from this test.


Employee/Applicant Signature *
Date

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Employee/Applicant Printed Name *
POLICY AND PROCEDURE AGREEMENT
Category:      All                                             Number:           2.008.1

Subject:             Policy and Procedure Agreement

Applies:     All Staff                                     Page:           1 of  1

I have read, understand and agree to abide by the policies
please print)and procedures set forth by Aging With Care Inc.  I also understand that I may view or copy any or all of Aging With Care Inc.’s policy and procedure manual for review or retention. I also agree to adhere to all local, state, and federal procedures regulated as a precedent for the home health care industry for compliance in providing care to Agency clients as designated.
Employee Signature and Date *
Administrative Signature and Date *
AGREEMENT TO ARBITRATE EMPLOYMENT CLAIMS
This Agreement to Arbitrate Employment Claims is made this the ______ day of ___________________, 20____, by and between Aging With Care Inc. (the “Company”) and _________________________ (the “Employee”), upon the following terms and conditions:( WRITE ADDING COMMAS) *
Conditions:
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 to Arbitrate 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 Lanham, Maryland 20706.

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 the determination of arbitrability of any claim.


6.   All costs and expenses of arbitration, except attorneys fees and expenses, shall be borne equally by the Employee and the Company. Each party agrees to pay their own attorneys 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.

8.    The parties shall utilize the discovery procedures provided for in the rules of arbitration for employment disputes of the American Arbitration Association. The parties agree that the arbitrators shall govern any discovery disputes.

9.    Either party may initiate the arbitration process by written demand with the arbitrators decision being final and binding on both parties. The arbitrator’s decision shall be entered in any court of competent jurisdiction.


Employee Name and Date *
Employee Signature and Date *
Administrative Signature and Date *
Conditions of Employment
Aging With Care Inc. is duly incorporated to provide employment contract services to clients.  The following conditions of employment exist between Aging With Care Inc. and the employee named below.

1.   Employee acknowledges and understands that Aging With Care Inc. will be responsible for payroll, withholding, and timely payment of all applicable employer and employee statutory employment taxes and insurance.  These include social security, state unemployment, disability (where applicable) and workers’ compensation.

2.   It is understood that employment is at the mutual consent of the employee and the employer.  Consequently, both employee and/or employer may terminate this employment relationship at any time, with or without cause or notice.  Employment is expressly at will.

3.   As an employer Aging With Care Inc. agrees to enter an employer relationship with the employee as outlined in the Employee Handbook, which the employee has received a copy.

This agreement embodies the entire employment agreement and understanding between Aging With Care Inc. as the employer, and the Employee, and there are no representations, warranties, terms, covenants, or conditions made by either of the parties except as herein expressly contained.

Employment Summary Signature Area

AGING WITH CARE INC.  - Hire Date *
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Employee Name *
Employee Signature and Date *
INFECTION CONTROL
ACKNOWLEDGEMENT OF THE REVIEW OF THE EXPOSURE CONTROL PLAN

I have read the Blood borne Pathogens Policy.  I understand and agree to comply with all provisions of the policy.

Employee Name *
Employee Signature and Date *
The following orientation topics will be used for full time, part-time and per diem workers
ORIENTATION PROGRAM *
YES
NO
Agency Mission Vision and plan and organizational chart
Types of care provided by the agency
Personnel policies, job descriptions and professional boundaries of all disciplines
Cultural diversity
Ethics, Conflict of Interest and Confidentiality of Patient information
Home safety (including Bathroom ,Electrical, Environment Fire and Hazards)
Emergency preparedness Plan/Actions to take in the event of a disaster
Row 8OSHA requirements, safety and infection control in the Home/Standard Precautions
Incidences and occurrences reporting
Identifying and reporting abuse neglect and exploitation
Policies and procedures
Training specific to job descriptions
Clients rights and grievance policy
Supervision and Evaluation
Safety issues in the home (including security and guns in the home )
Patient care responsibilities
Understanding and coping with Alzheimer’s Disease and dementia
Quality Assurance
ID badge Issued
Agency compliance
Print Name *
Title *
Signature *
Date *
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ORIENTATION CHECKLIST FOR CURRENT EMPLOYEES ASSIGNED TO  A NEW JOB CLASSIFICATION *
YES
NO
Review of all Agency policies and procedures
Review of federal and state regulations
Review confidentiality of patient /client information
Review contracts for all programs ,agencies and individuals
Review infection control, safety and disaster plan
Consult with and observe other staff in the same Job classification regarding patient/client job issues
Review implementation of patient /client goal and objectives
Ensuring safe and effective services to patient /clients families
Establishing and maintaining effective lines of communication practicing staff development
Establishing and maintaining effective lines of communication
Practicing staff development including orientation in service education and continuing education
Following job description in performance of duties
Implementing and evaluating patient/client care services
Participating in selected in service programs
Encouraging staff participation in problem solving
Performing other duties as assigned by the administrator
Print Name *
Title *
Employee Signature *
Date *
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