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FACILITY ORIENTATION HSD 500 CHECKLIST
FACILITY:
EMPLOYEE NAME: DATE REPORTED TO FACILITY:
POSITION:
| TOPICS |
| BY |
| Completion Date |
| Initials |
(Supervisors/ Preceptors)
AGENCY OVERVIEW
| IHSC 101 (Mission/Vision/Values) |
| HSA/AHSA/PALMS/IPU |
| IHSC Orientation Guide |
| SUPERVISOR/IPU |
| ICE AFOD, DFOD, OIC/ Security Leadership (all roles) |
| HSA/AHSA |
| Other ICE /Custody Staff/stakeholders in the building |
| HSA/AHSA |
CHAIN OF COMMAND
| Department of Homeland Security |
| HSA/AHSA |
| Immigration & Customs Enforcement |
| HSA/AHSA |
| Organizational charts (ICE/ERO, IHSC, local facility) |
| HSA/AHSA/SUPERVISOR |
*FACILITY INFORMATION (Site Specific)
| Facility tour (introductions to facility leadership and stakeholders) |
| HSA/AHSA/CC/ |
SUPERVISOR
| Access to facility & parking |
| HSA/AHSA/CC/AA |
| Computer Access Request (complete form) |
| HSA/AHSA/CC/AA |
| Detainee/resident rules and regulations |
| HSA/AHSA/CC |
| Hours of operation |
| HSA/AHSA/CC |
| Badge / ID(s): facility, PIV |
| HSA/AHSA/CC/AA |
| Security (procedures and regulations) |
| HSA/AHSA/CC |
| Supervision of residents/detainees |
| HSA/AHSA/CC |
*PERSONNEL (**provide copies for on-site file)
| Awards (as applicable) |
| SUPERVISOR/CC |
| Professional education (CME/CEU) ** |
| SUPERVISOR/CC |
| Credentialing verification (certification, licensure, degree) ** |
| HQ Credentialing/ SUPERVISOR/CC/AA |
| Emergency Contact Information/ Emergency Recall Roster |
| HSA/AHSA/CC/AA |
| Employee Assistance Program (EAP) |
| SUPERVISOR/CC |
| Occupational health record (vaccines, declination statement) ** |
| FHPM/CC/AA |
| Employees' rights and responsibilities |
| SUPERVISOR/CC |
| Dress code/ wear of uniform (national policy) |
| SUPERVISOR/CC |
| Employee Grievance process |
| SUPERVISOR/CC |
| Government travel card PHS & GS (complete form) |
| SUPERVISOR |
| Outside activity form (federal employees only) (DHS G-843) |
| SUPERVISOR |
| Official travel (Concur) |
| SUPERVISOR |
| Leave policy (absence reporting time & attendance scheduling) |
| SUPERVISOR/CC |
| Performance review (COER, PWP, contractor) |
| SUPERVISOR/CC |
| TOPICS |
| BY |
| Completion Date |
| Initials (Supervisors/ Preceptors) |
Personnel policy manual
· GS
· PHS
· Contract-see employer personnel manual
SUPERVISOR/CC
| PHS Officers’ information |
| SUPERVISOR |
| Position Description** |
| SUPERVISOR |
| Privileging ** |
| SUPERVISOR/CC/HQ Credentialing/AA |
POLICIES AND PROCEDURES related to detainee/resident care
| Grievance process (National & local policy) |
| HSA/AHSA/NM/FHPM |
| IHSC National Policy |
| HSA/AHSA/FHPM |
| Local Operating Procedure Manual |
| HSA/AHSA/CC/FHPM |
Mandatory Report of Child Abuse and Neglect (Family Residential Facilities)
HSA/AHSA/CC
| MedPar process (payment authorization system) |
| MRT/Referral Coordinator/AA |
| Contact information for community resources used by facility |
| MRT/Referral Coordinator/AA |
| National Formulary |
| Pharmacist/APP |
| Nursing Guidelines |
| Nurse Manager |
| Quality Management Manual / Program |
| FHPM/HSA/AHSA |
| Clinical Practice Guidelines (providers only) |
| CD/ Staff Physician/APP |
| Protocols (vitals, blood sugars, etc.) |
| CD/ Staff Physician/NM |
| UpToDate (MLP’s physicians & psychiatrists)) |
| CD / Staff Physician |
ACCREDITATIONS (as applicable)
| American Correctional Association (ACA) |
| HSA/AHSA/FHPM/CC |
| Family Residential Standards (FRS) |
| HSA/AHSA/FHPM/CC |
| National Commission on Correctional Health Care (NCCHC) |
| HSA/AHSA/FHPM/CC |
| Performance Based National Detention Standards (PBNDS) |
| HSA/AHSA/FHPM/CC |
ADMINISTRATION
| After hours responsibilities (on-call) |
| SUPERVISOR/CC |
| Contract staff (COR & technical monitor roles), overtime |
| GTM/CC |
| Daily assignments |
| Discipline Lead/CC |
| Health care services scope |
| Discipline Lead/CC |
| Prohibition against providing legal advice or legal counsel |
| SUPERVISOR/CC |
| Meetings/ shift report: staff/job specific |
| SUPERVISOR/CC |
| NHSC loan repayment |
| HSA/AHSA/CC |
| Patient rights/confidentiality of patient info |
| SUPERVISOR/CC |
| DHS and ICE privacy policies |
| HSA/AHSA |
| Privacy Act Exemption |
| HSA/AHSA/CC |
| Telephone interpretation services |
| SUPERVISOR/CC |
| Telephone use and etiquette |
| SUPERVISOR/CC/AA |
| Continuation of Operations (COOP) Planning |
| HSA/AHSA/FHPM |
Revised March 2021 Facility Orientation HSD 500 Checklist
pg. 3 of 3 4
Date Initials (Supervisors/ Preceptors)
Use of office equipment:
· FAX
· Copy machines
· Printers
CC/AA/MRT
INFORMATION TECHNOLOGY
| Electronic health record guides |
| eCW Super User/MRT |
| Electronic health record support |
| eCW Super User/MRT |
| E-Mail access, internet, SharePoint, drives |
| SUPERVISOR/CC/AA |
| E-mail group access (as applicable) |
| SUPERVISOR/CC/AA |
| ICE Service Desk- (on-line & phone) |
| SUPERVISOR/CC/AA |
Public Health, Safety and Preparedness
| Environmental health | Directive 05-04 and related guide(s) |
| HSA/AHSA/CC/FHPM |
| All hazards emergency preparedness and response | Directive 03-05 and related guide(s) |
| HSA/AHSA/CC/ FHPM |
| Occupational health | Directive 05-02 and related guides |
| HSA/AHSA/CC/ FHPM |
| Safety and security | Directive 05-05 and related guides |
| HSA/AHSA/CC/ FHPM |
| Lock down/ tag out (water/electrical/oxygen shut-off) (nonfunctioning equipment) |
| HSA/AHSA/CC/ NM/FHPM |
| Public health, safety, and preparedness (PHSP) official guidance, tools, and resources |
| HSA/AHSA/CC/ NM/FHPM |
| Public Health, Safety, and Preparedness Administration activities & directives |
| HSA/AHSA/CC/ NM/FHPM |
| Public health actions for tuberculosis care | Directive 05-11, related guides, and OMs |
| HSA/AHSA/CC/NM/ FHPM/IPO |
| Infectious disease public health actions | Directive 05-06, related guides, and OMs |
| HSA/AHSA/CC/NM/ FHPM/IPO |
PRECEPTORS
Signature / initials Signature / initials name name
Signature / initials Signature / initials name name
HSA Signature Employee Signature name name