Employee Name:
Job Classification:
Administrative Office:
Form must be signed and placed in the personnel file.
Hire Date:
Supervisor:
Please complete all sections no later than the first thirty days of employment.
HR
(covered during
New Hires ession)
Manager or
Designee
I. JOB SPECIFIC ORIENTATION (please Initial)
Shaded sections covered by HR
 Job Description Review
 Establish clear expectations
 Performance Expectations and Evaluation Process Review
 C-ICARE Practices
 Introduction to key colleagues
 Work Area Tour
 Staff Communication
 Chain of Command
 Organizational Chart
 Special Procedures
 Tour of commonly visited areas
 Other
II. ENVIRONMENT OF CARE / EMERGENCY MANAGEMENT / SECURITY
1.
Safety Management
 Review Office Safety Standards
 Body Mechanics and Ergonomic Evaluation (www.ergonomics.ucla.edu)
2.
Security Management
 How to report a crime
 Keys, Security Alarm, Panic Buttons
 Emergency Telephone Number List
3.
Hazardous Materials Management
 How to report a spill
 MSDS-Material Safety Data sheet
4.
Fire Prevention
 Fire Drills and Schedule of Fire Drills
 Steps to take in an event of a fire
 How to reporting a fire
 Fire Exits, Location of Fire Extinguishers and R.A.C.E.
1

5.
Utilities Management
 Procedures in the event of a malfunction of computer equipment and office equipment
6.
Medical Equipment Management (if applicable)
 Introduction for Office/Department Equipment
 Procedures for malfunction
7.
Emergency Management
 Location of Disaster Plan
 Location of Emergency Supplies/First Aid Kit
 Evacuation Procedures
III. PATIENT SAFETY & ERROR REDUCTION (if applicable)
 Patient Safety Plan
 National Patient Safety Goals
 Restraints Policy
 Medication Errors
 Event Reporting
 Infection Control
 Pain Management
IV. DEPARTMENTAL POLICIES AND PROCEDURES
 Personnel Contracts/Policies – Useful Websited
 Payroll System (OTR) ,Rules & Deadlines
 Communication Channels
 Organizational Chart
V. REQUIRED TRAINING
 Complete HIPAA Education and Training on-line module
 Review how HIPAA regulations apply to the position
 Complete Code of Conduct Training and Quiz on-line module
 Learning Management System (LMS) Training requiring UCLA Log-On ID
 Compliance Briefing: UC Ethical Values and Conduct
 Sexual Harassment Prevention Training for Supervisors (for Faculty,
Supervisors, MSP and equivalent)
VI. OTHER
Employee Signature
Reviewer Signature
Human Resources Representative Signature
Date
Date
Date
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