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  • Employee Information Form

    Employee Information Form

    Step 1 of 6
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  • TB Questionnaire

    TB Questionnaire

    Step 2 of 6
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  • Competency Skills Checklist for Home Care Nurses

    Step 3 of 6
    Competency Skills Checklist for Home Care Nurses
  • The Registered Nurse and Licensed Practical Nurse is expected to be competent in the following areas. Please check the following areas in which you feel you have prior experience and competency and areas in which you need review. The Case Manager will review all areas with you pertaining to your particular assigned case and provide instruction in areas in which you require further review.
  • Please check for each skill on the list: Competent, never done, or needs review

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  • Agreements Section

    Step 4 of 6
    Agreements Section
  • Policy and Procedure Agreement

  • I have read, understand and agree to abide by the policies and procedures set forth by Abundant Life Home Health Agency, LLC.

    I also understand that I may view or copy any or all of Abundant Life Home Health Agency policy and procedure manual for review or retention.

    I also agree to adhere to all local, state and federal procedures regulated as precedent for the home health care industry for compliance in providing care to Agency clients as designated.

  • Infection Control

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

  • Employee Acknowledgement of Handbook

  • I acknowledge receipt of Abundant Life Home Health Agency, LLC 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.

  • Job Acceptance Statement

  • have been given a copy of my job description. I have read and agree to the terms specified in this description for the position I am applying for/currently hold. I further understand that this job description may be reviewed at any time and I will be provided with a revised copy should any revisions be made.

    I understand and agree with the above statement. I have had the opportunity to ask questions and have had my questions answered.

  • AGREEMENT TO ARBITRATE EMPLOYMENT CLAIMS

  • 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 Clearwater, Fl, 33761.


    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 determination of arbitrability of any claim.

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

  • COVID-19 Vaccine Policy and Procedures

  • I received and read a copy of Abundant Life Home Health Agency's COVID-19 VACCINE POLICIES AND PROCEDURES, dated February 3, 2023, and understand that it is my responsibility to be familiar with and abide by its terms. I understand that the information in this policy is intended to help Abundant Life Home Health Agency's employees to work together effectively on assigned job responsibilities. This policy is not promissory and does not set terms or conditions of employment or create an employment contract.

  • Agreement for E-Verify

  • I acknowledge that I have read and understood the information above. I understand my rights and the rights of the company to provide form I-9 to confirm that I am authorized to work in the US. 

  • In-service Documentation:

    Alzheimer’s Disease (AD) and Related Dementias
  • This document verifies that I have read and understand the literature prepared by the Florida Health Care Association with the assistance of the Alzheimer Resource Center of Tallahassee, Florida to meet statutory requirement of 400.4785 (1) (a) F.S.

  • HIPAA Training
    The in-service includes:
    Definition
    PHI
    Covered entities
    HIPAA specific policy to the agency
    Length of in-service: 1 hour

    Medical Device Reporting & MSDS Training
    The in-service includes:
    Hazard communication requirements of OSHA
    The presence of hazardous chemicals in the work area
    How to cope with emergency procedures (recognition, reporting, and evacuation)
    How to read and interpret labels and MSDS
    Medical device reporting policy and procedures
    Length of in-service: 1 hour

    AIDS/HIV/Bloodborne Pathogens Training
    The in-service includes:
    Definition
    Ability to identify at risk populations for HIV/AIDS
    Recognize new health concerns in HIV patients
    Recognize importance of infection control in the workplace
    Identify OSHA regulations regarding bloodborne pathogens
    Identify regulations regarding sharps safety and handling
    Length of in-service: 2 hour

  • I certify that I have attended the above listed in-service sessions. I have been given an opportunity to ask questions and have received clarification about the subject matter or policy/procedure involved. I understand how the materials presented apply to my work and agree to implement them to the best of my ability.

  • By signing this document, I agree to all terms and conditions above. This certifies that I have read and understood the policies for:  

    Policy and Procedure Agreement

    Infection Control

    Employee Acknowledgement of Handbook

    Job Acceptance Statement

    Agreement to Arbitrate Employment Claims

    COVID-19 Vaccine Policy and Procedures

    E-Verify Agreement 

    In-service Documentation: Alzheimer’s Disease (AD) and Related Dementias

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  • Other Agreements

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  • Competency Exam

    Competency Exam

    Step 6 of 6
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  • Orientation Checklist

    Orientation Checklist

    Step 7 of 7
  • For this step:

        The information you will need to complete this step is in the two documents listed below. Click the links below to view the pdf. Please read through the documents, and agree to the terms and conditions.

    Orientation Packet: Click Here

    Employee Handbook: Click Here

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