Attachment 12 - Facility Orientation Checklist - template.pdf

Revised March 2021 Facility Orientation HSD 500 Checklist pg. 1 of 3

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 Contraband HSA/AHSA/CC 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

SUPERVISOR/CC

Revised March 2021 Facility Orientation HSD 500 Checklist pg. 2 of 3

Performance review (COER, PWP, contractor) SUPERVISOR/CC

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 ICE policy HSA/AHSA 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

Revised March 2021 Facility Orientation HSD 500 Checklist pg. 3 of 3

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. 4 of 3

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)

NM/FHPM

Public health, safety, and preparedness (PHSP) official guidance, tools, and resources

Public Health, Safety, and Preparedness Administration activities & directives

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

HSA Signature Employee Signature