Background Screening Forms  
  Care Provider Background Screening Application (Lake City & Palatka)
09/07/16
  Criminal History Acknowledgement (IG/BSU-003)
09/07/16
  Livescan Employee Memo (Gainesville)
04/15/18
  Livescan Employee Memo (Lake City)
04/15/18
  Livescan Employee Memo (Palatka)
04/15/18
  Meridian Behavioral Background Consent Form (Gainesville)
09/07/16
  Privacy Policy Acknowledgement Form
09/07/16
  Request for Live Scan Background Screening Employee
02/11/18
  Request for Live Scan Background Screening Volunteer
02/11/18
  Request for Re-Screening (Five-Year) Check (IG/BSU-005)
04/10/15
 

Annual Affidavit of Compliance with Good Moral Character Standards (IG/BSU-006)

04/17/06
  DJJ Annual Affidavit of Background Screening
12/20/13
  DCF Annual Affidavit of Background Screening
07/01/07
  Related Operating Procedure:
   

"Background Screening, P-1025"
, or
click here to be redirected to Operating Procedures

1/3/14
   
Family Medical Leave Forms  
  Request for Leave of Absence
02/06/09
  Employer Response/Notice of Eligibility for Family Medical Leave
02/06/09
  Designation
01/08/10
  Certification of Health Care Provider for Employee’s Serious Health Condition
01/08/10
  Certification of Health Care Provider for Family Member’s Serious Health Condition
02/06/09
  Certification of Qualifying Exigency for Military Family Leave
02/06/09
  Certification of Health Care Provides for Serious Injury or Illness of Covered Service Member for Military Family Leave
02/06/09
  Return to work
01/08/10
   

New Hire Orientation Forms

 
 

Acknowledgment Forms:

 
   

Auto Insurance / Driver's License

06/14/07
   

Attestation of the requirements of Section 504 of the Rehabilitation Act, Fact Sheet Title II of the ADA, Auxiliary Aids Policy and Plan for Participants or Companions and Potential Participants or Companions with Disabilities, Roles and Responsibilities of the Single Point of Contact and DCF ADA/504 Coordinator

02/02/11
   

Benefits - Part-time Employees

11/12/14
   

Benefits - Full-time Employees

11/12/14
   

Bloodborne Pathogen Exposure Control Program

02/25/07
   

Confidentiality - CDS Employee or Volunteer/Intern

07/11/08
    Data Security on Mobile Devices - DCF
03/31/09
   

Drug Free Workplace Program

06/18/07
   

Employee Handbook

6/28/18
    Hepatitis B
09/6/07
   

HIPAA Training

01/25/17
   

Musculoskeletal Disorders

02/21/17
   

New Hire Orientation & Benefits Training

3/6/14
   

Pre-Employment Drug Testing

05/27/09
    PREA Prison Rape Elimination Act Acknowledgement
05/05/16
   

Reminder Slip

01/24/17
   

Responsibility to Report Child, Adult ... Abuse and Neglect ...

02/21/17
   

Retirement Plan Summary Description

06/18/07
   

Personnel Responsibilities in the Use of Information Technology Resources

3/31/09
   

Support to the Deaf and Hard of Hearing Training - DCF

03/17/18
    Transcript Request
10/13/13
    Urinalysis Screen
06/18/07
   

Workman's Comp Procedures

12/15/14
 

Government Form

    Florida New Hire Reporting Form
3/5/14
    I-9: Employment Eligibility Verification
02/21/17
    W4: Employee's Withholding Allowance Certificate
01/02/17
  Miscellaneous Forms
    Corporate Compliance Letter
08/18/08
    Issue Problem Identification Form
3/17/14
    Cultural Competency / Cultural Diversity
01/06/09
    Directions to LabCorp 3 Locations
3/17/14
    Domestic Partner Registration Form
10/16/13
    Domestic Partner Termination Form
10/16/13
    Enrollment Form 13-14
9/27/13
    Notification of COBRA Continuation Rights
11/4/15
    Person and Family Centered Planning
01/06/09
    Rights of Participants
07/14/08
    VALIC Letter
9/27/13
    Staff Emergency Contact Information - CDS
01/06/09
    Your Rights Under Section 504 of the Rehabilitation Act
01/31/11
    Your Rights Under the Americans with Disabilities Act
01/31/11
   

Personnel File:

 
  Personnel File Order of Contents
02/03/11
   

Selection Tools:

 
 

Application for Employment (click here for PDF version)

04/16/15
 

Interview Summary Forms:

 
   

Coordinator/Supervisor

11/30/09
   

Counselor/Case Manager CINS/FINS

11/30/09
    Data Systems Analyst
02/08/16
    Fiscal Clerk
02/08/16
   

House Manager/Cook

11/30/09
    Information Systems Specialist
02/08/16
    Nurse (RN)
08/26/15
   

Prevention Specialist

11/30/09
   

Prevention Specialist (Reichert House-Family Liaision)

11/30/09
   

Resource Development Coordinator

11/30/09
   

Youth Care Worker (Interview Packet):

 
      Cover Letter
6/14/07
     

Unusual Event Report Form

6/14/07
     

Youth Care Worker Interview Summary

6/14/07
     

Youth Care Worker Job Description

02/17/16
 

Notice of Personnel Action

03/18/16
 

Personal Reference Form

05/07/07
 

Professional Reference Form

05/07/07
 

Pre-Interview Questionnaire

05/07/07
 

Resume/Application Checklist

06/09/07
 

"Thank you" letter wording - Applicants not interviewed
    (copy and paste into appropriate Program Letterhead)

02/22/07
  "Thank you" letter wording - Applicants interviewed
    (copy and paste into appropriate Program Letterhead)
02/22/07
   
Staff Recognition:  
 

Esprit de Corps Nomination

5/25/10
   
Staff Training:  
 

Clinical Supervision - Group

7/15/2015
  Clinical Supervision - Individual
7/15/2015
  Clinical Supervision Log
09/22/08
  Staff Development/Training Plan
11/15/10
  Supervision and Utilization Tracking Note
09/22/08
  Training Documentation Log
09/22/08
  Training Documentation Log - CARF Modules
11/15/10
  Training Documentation Log - Group
02/18/09
         
Volunteer / Intern Forms:  
  Acknowledgment Forms:  
   

Volunteer/Intern Handbook and NASW Code of Ethics

11/08/17
    Orientation
5/07/15
  Service Agreement
07/01/08