WELCOME! - Providence Pa… · WELCOME! As the newest member ... 2. Accrues paid sick leave pursuant to the employer’s policy which satisfies or exceeds the accrual, carryover,

WELCOME!

As the newest member of our team, we want to ensure you have a smooth transition into yournew position and you have the best possible on boarding experience.

One of the first steps to getting you on your way, is to print out all the attached forms using thefollowing guidelines.

Print out all form(s) in this packet following these guidelines:

Do not print forms double sided

Print black and white (NO COLOR)

Ensure your printer has sufficient ink to make a quality print

Print on standard white paper – do not use glossy or cardstock

If you do not have access to a printer your local library, office supply store, or FedEx/Kinkos maybe able to assist you with printing these forms.

DON’T FORGET YOUR ID FOR VERIFICATION OF YOUR I9!You must complete the I9 online through the link that was sent to you by your RecruitmentCoordinator or your Human Resources contact prior to your first day.

If you did not receive the link to complete your I9 contact a Pre Boarding Specialist at 877.554.8484or your Human Resources contact immediately. This must be completed online prior to your firstday.

You MUST bring your I9 supporting documents with you on your first day unless youhave already presented them in person. Not bringing your ID with you could prevent

you from starting work.

FORM(S) ARE TO BE COMPLETEDAND SUBMITTED TO HUMANRESOURCESAT ORIENTATION/DAY 1

NOTICE TO EMPLOYEE Labor Code section 2810.5

EMPLOYEE

Employee Name:

Start Date:

EMPLOYER

Legal Name of Hiring Employer: Providence Health Systems Southern California

Is hiring employer a staffing agency/business (e.g., Temporary Services Agency; Employee Leasing Company; or Professional Employer Organization [PEO])? □ Yes □ No

Other Names Hiring Employer is "doing business as" (if applicable):

Physical Address of Hiring Employer’s Main Office:

Hiring Employer’s Mailing Address (if different than above), select from dropdown list below:

If the hiring employer is a staffing agency/business (above box checked "Yes"), the following is the other entity

for whom this employee will perform work:

Name:

Physical Address of Main Office:

WAGE INFORMATION

Rate(s) of Pay: Overtime Rate(s) of Pay: 1.5 times

Rate by (check box): □ Hour □ Shift □ Day □ Week □ Salary □ Piece rate □ Commission

Does a written agreement exist providing the rate(s) of pay? (check box) □ Yes □ No

If yes, are all rate(s) of pay and bases thereof contained in that written agreement? □ Yes □ No

Allowances, if any, claimed as part of minimum wage (including meal or lodging allowances): (If the employee has signed the acknowledgment of receipt below, it does not constitute a “voluntary written agreement” as required under the law between the employer and employee in order to credit any meals or lodging against the minimum wage. Any such voluntary written agreement must be evidenced by a separate document.)

Regular Payday: Friday Biweekly

DLSE-NTE (rev 12/2014) 07-Employment Letter

Employee ID

✔

20555 Earl St., Torrance, CA 90503

✔

✔

✔

WORKERS’ COMPENSATION

Insurance Carrier’s Name:

Address:

Telephone Number:

Policy No.:

□ Self-Insured (Labor Code 3700) and Certificate Number for Consent to Self-Insure:

PAID SICK LEAVEUnless exempt, the employee identified on this notice is entitled to minimum requirements for paid sick leave under state law which provides that an employee:

a. May accrue paid sick leave and may request and use up to 3 days or 24 hours of accrued paid sick leave per year;b. May not be terminated or retaliated against for using or requesting the use of accrued paid sick leave; andc. Has the right to file a complaint against an employer who retaliates or discriminates against an employee for

1. requesting or using accrued sick days;2. attempting to exercise the right to use accrued paid sick days;3. filing a complaint or alleging a violation of Article 1.5 section 245 et seq. of the California Labor Code;4. cooperating in an investigation or prosecution of an alleged violation of this Article or opposing any policy

or practice or act that is prohibited by Article 1.5 section 245 et seq. of the California Labor Code.

The following applies to the employee identified on this notice: (Check one box)

□ 1. Accrues paid sick leave only pursuant to the minimum requirements stated in Labor Code §245 et seq. with no other employer policy providing additional or different terms for accrual and use of paid sick leave.

□ 2. Accrues paid sick leave pursuant to the employer’s policy which satisfies or exceeds the accrual, carryover, and use requirements of Labor Code §246.

□ 3. Employer provides no less than 24 hours (or 3 days) of paid sick leave at the beginning of each 12-month period.

□ 4. The employee is exempt from paid sick leave protection by Labor Code §245.5. (State exemption and specific subsection for exemption):

ACKNOWLEDGMENT OF RECEIPT(Optional)

_________________________________ ______________________PRINT NAME of Employer representative) (PRINT NAME of Employee)

___________________________________ _______________________ (SIGNATURE of Employer representative) (SIGNATURE of Employee)

(Date)______________________________ (Date)__________________________

The employee’s signature on this notice merely constitutes acknowledgment of receipt.

Labor Code section 2810.5(b) requires that the employer notify you in writing of any changes to the information set forth in this Notice within seven calendar days after the time of the changes, unless one of the following applies: (a) All changes are reflected on a timely wage statement furnished in accordance with Labor Code section 226; (b) Notice of all changes is provided in another writing required by law within seven days of the changes.

Scan and email this document to: PHSImageNowHRCASTF @providence.org. DLSE-NTE (rev 12/2014)

Sedgwick CMS

P.O. Box 1442, Lexington, KY 40512-4514

1-714-258-5000

✔

For m

ore i

nfor

mat

ion,

cont

act D

FEH

toll

free a

t (8

00) 8

84-1

684

Sacr

amen

to ar

ea &

out

-of-s

tate

at (9

16) 4

78-7

200

TTY

num

ber a

t (80

0) 7

00-2

320

or v

isit o

ur W

eb si

te at

www

.dfe

h.ca

.gov

In a

ccor

danc

e with

the C

alifo

rnia

Gov

ernm

ent C

ode a

nd

ADA

requ

irem

ents,

this

publ

icatio

n ca

n be

mad

e ava

ilabl

e in

Bra

ille,

larg

e prin

t, co

mpu

ter d

isk, o

r tap

e cas

sette

as

a di

sabi

lity-

rela

ted

reas

onab

le ac

com

mod

atio

n fo

r an

indi

vidu

al w

ith a

disa

bilit

y. To

disc

uss h

ow to

rece

ive a

copy

of

this

publ

icatio

n in

an

alte

rnat

ive f

orm

at, p

lease

cont

act

DFE

H a

t the

num

bers

abo

ve.

Stat

e of C

alifo

rnia

Dep

artm

ent o

f Fai

r Em

ploy

men

t & H

ousin

g

DFE

H-1

85 (1

1/07

)

Th

e d

efi

nit

ion

of

sex

ua

l h

ara

ssm

en

t in

clu

de

s

ma

ny

fo

rms

of

off

en

siv

e b

eh

av

ior.

De

pa

rtm

en

t o

f F

air

Em

plo

ym

en

t a

nd

Ho

usi

ng

Se

xu

al

Ha

rass

me

nt

The

Fact

s Abo

ut S

exua

l Har

assm

ent

The F

air E

mpl

oym

ent a

nd H

ousin

g Act

(FEH

A)

defin

es se

xual

har

assm

ent a

s har

assm

ent

base

d on

sex

or o

f a se

xual

nat

ure;

gen

der

hara

ssm

ent;

and

hara

ssm

ent b

ased

on

preg

nan-

cy, c

hild

birt

h, o

r rel

ated

med

ical

con

ditio

ns.

The d

efini

tion

of se

xual

hara

ssm

ent i

nclu

des

man

y fo

rms o

f offe

nsiv

e beh

avio

r, in

clud

ing

hara

ssm

ent o

f a p

erso

n of

the

sam

e gen

der

as th

e har

asse

r. Th

e fol

low

ing

is a p

artia

l list

of

type

s of s

exua

l har

assm

ent:

• U

nwan

ted

sexu

al ad

vanc

es

• O

fferin

g em

ploy

men

t ben

efits

in

exch

ange

for s

exua

l fav

ors

• Ac

tual

or t

hrea

tene

d re

talia

tion

• Le

erin

g; m

akin

g se

xual

ges

ture

s; or

di

spla

ying

sexu

ally

sugg

estiv

e obj

ects,

pi

ctur

es, c

arto

ons,

or p

oste

rs

• M

akin

g or

usin

g de

roga

tory

com

men

ts,

epith

ets,

slurs

, or j

okes

• Se

xual

com

men

ts in

cludi

ng g

raph

ic co

m-

men

ts ab

out a

n in

divi

dual’

s bod

y; se

xu-

ally

deg

radi

ng w

ords

use

d to

des

crib

e an

indi

vidu

al; o

r sug

gesti

ve o

r obs

cene

lette

rs,

note

s, or

invi

tatio

ns

• Ph

ysic

al to

uchi

ng o

r ass

ault,

as w

ell as

im

pedi

ng o

r blo

ckin

g m

ovem

ents

such

as a

lead

, sup

ervi

sor,

man

ager

or a

gent

;

• th

e em

ploy

er h

ad n

o kn

owle

dge

of th

e

hara

ssm

ent;

• th

ere w

as a

prog

ram

to p

reve

nt h

aras

smen

t; an

d

• on

ce aw

are o

f any

har

assm

ent,

the e

mpl

oyer

to

ok im

med

iate

and

app

ropr

iate

cor

rect

ive

actio

n to

stop

the h

aras

smen

t.

Filin

g a

Com

plai

nt

Empl

oyee

s or j

ob ap

plica

nts w

ho b

eliev

e tha

t the

y ha

ve b

een

sexu

ally

har

asse

d m

ay fi

le a

com

plai

nt o

f di

scrim

inat

ion

with

DFE

H w

ithin

one

year

of t

he

hara

ssm

ent.

DFE

H se

rves

as a

neut

ral f

act-fi

nder

and

atte

mpt

s to

help

the p

artie

s vol

unta

rily

reso

lve d

isput

es.

If D

FEH

find

s suffi

cient

evid

ence

to es

tabl

ish th

at d

is-cr

imin

atio

n oc

curr

ed an

d se

ttlem

ent e

ffort

s fai

l, th

e D

epar

tmen

t may

file

a for

mal

accu

satio

n. Th

e acc

usa-

tion

will l

ead

to ei

ther

a pu

blic

hear

ing b

efor

e the

Fai

r Em

ploy

men

t and

Hou

sing

Com

miss

ion

or a

lawsu

it fil

ed b

y DFE

H o

n be

half

of th

e com

plai

ning

par

ty.

If th

e Com

miss

ion

finds

that

disc

rimin

atio

n ha

s oc-

curr

ed, i

t can

ord

er re

med

ies i

nclu

ding

:

• Fi

nes o

r dam

ages

for e

mot

iona

l dist

ress

fro

m ea

ch em

ploy

er o

r per

son

foun

d to

hav

e vi

olat

ed th

e law

• H

iring

or r

eins

tate

men

t

• Ba

ck p

ay o

r pro

mot

ion

• Ch

ange

s in

the p

olic

ies o

r pra

ctic

es o

f the

in

volv

ed em

ploy

er

Empl

oyee

s can

also

pur

sue t

he m

atte

r thr

ough

a

priv

ate

law

suit

in c

ivil

cour

t afte

r a c

ompl

aint

ha

s bee

n fil

ed w

ith D

FEH

and

a Rig

ht-to

-Sue

N

otic

e has

bee

n iss

ued.

For m

ore i

nfor

mat

ion,

see p

ublic

atio

n D

FEH

-159

“G

uide

for C

ompl

aina

nts a

nd R

espo

nden

ts.”

Th

e m

issi

on

of

the

De

pa

rtm

en

t o

f F

air

Em

plo

ym

en

t a

nd

Ho

usi

ng

is

to p

rote

ct

the

pe

op

le o

f

Ca

lifo

rnia

fro

m u

nla

wfu

l d

isc

rim

ina

tio

n i

n e

mp

loy

me

nt,

ho

usi

ng

an

d p

ub

lic

acc

om

mo

da

tio

ns,

an

d f

rom

the

pe

rpe

tra

tio

n o

f a

cts

of

ha

te v

iole

nce

.

Empl

oyer

s’ O

blig

atio

ns

All

empl

oyer

s mus

t tak

e the

follo

win

g ac

tions

ag

ains

t har

assm

ent:

• Ta

ke al

l rea

sona

ble s

teps

to p

reve

nt

disc

rim

inat

ion

and

hara

ssm

ent f

rom

oc

curr

ing.

If h

aras

smen

t doe

s occ

ur,

take

effec

tive a

ctio

n to

stop

any

furt

her

hara

ssm

ent a

nd to

corr

ect a

ny eff

ects

of

the h

aras

smen

t.

• D

evelo

p an

d im

plem

ent a

sexu

al h

aras

s-m

ent p

reve

ntio

n po

licy

with

a pr

oced

ure

for e

mpl

oyee

s to

mak

e com

plai

nts a

nd

for t

he em

ploy

er to

inve

stiga

te co

mpl

aint

s. Po

licie

s sho

uld

incl

ude p

rovi

sions

to:

• Fu

lly in

form

the c

ompl

aina

nt o

f hi

s/he

r rig

hts a

nd an

y ob

ligat

ions

to se

-cu

re th

ose r

ight

s.

• Fu

lly an

d eff

ectiv

ely in

vesti

gate

. The i

nves

-tig

atio

n m

ust b

e tho

roug

h, o

bjec

tive,

and

com

plet

e. A

nyon

e with

info

rmat

ion

re-

gard

ing

the m

atte

r sho

uld

be in

terv

iew

ed.

A d

eter

min

atio

n m

ust b

e mad

e and

the r

e-su

lts co

mm

unic

ated

to th

e co

mpl

aina

nt,

to th

e alle

ged

hara

sser

and,

as ap

prop

riate

, to

all o

ther

s dire

ctly

conc

erne

d.

• Ta

ke p

rom

pt an

d eff

ectiv

e cor

rect

ive

actio

n if

the h

aras

smen

t alle

gatio

ns ar

e pr

oven

. The e

mpl

oyer

mus

t tak

e app

ropr

i-at

e act

ion

to st

op th

e har

assm

ent a

nd e

n-su

re it

will

not

con

tinue

. The

empl

oyer

m

ust a

lso c

omm

unic

ate

to th

e com

-

plai

nant

that

actio

n ha

s bee

n ta

ken

to st

op th

e ha

rass

men

t fro

m re

curr

ing.

Fin

ally,

appr

opria

te

steps

mus

t be t

aken

to re

med

y the

com

plai

nant

’s da

mag

es, i

f any

.

• Po

st th

e Dep

artm

ent o

f Fai

r Em

ploy

men

t and

H

ousin

g (D

FEH

) em

ploy

men

t pos

ter (

DFE

H

- 162

) in

the

wor

kpla

ce (a

vaila

ble

thro

ugh

the

DFE

H p

ublic

atio

ns li

ne [9

16] 4

78-7

201

or

Web

site

).

• D

istrib

ute a

n in

form

atio

n sh

eet o

n se

xual

ha

rass

men

t to

all e

mpl

oyee

s. A

n em

ploy

er m

ay

eith

er d

istrib

ute t

his p

amph

let (

DFE

H 1

85)

or d

evel

op a

n eq

uiva

lent

doc

umen

t tha

t mee

ts

the r

equi

rem

ents

of G

over

nmen

t Cod

e sec

tion

1295

0(b)

. This

pam

phle

t may

be d

uplic

ated

in

any

quan

tity.

How

ever

, thi

s pam

phle

t is

not t

o be

use

d in

pla

ce o

f a se

xual

har

assm

ent

prev

entio

n po

licy,

whic

h al

l em

ploy

ers a

re

requ

ired

to h

ave.

• A

ll em

ploy

ees s

houl

d be

mad

e aw

are o

f the

se

rious

ness

of v

iolat

ions

of t

he se

xual

hara

ssm

ent

polic

y an

d m

ust b

e cau

tione

d ag

ainst

usin

g pe

er

pres

sure

to d

iscou

rage

har

assm

ent v

ictim

s fro

m co

mpl

aini

ng.

• Em

ploy

ers w

ho d

o bu

sines

s in

Calif

orni

a and

em

ploy

50

or m

ore p

art-t

ime o

r ful

l-tim

e em

ploy

ees m

ust p

rovi

de at

leas

t tw

o ho

urs o

f se

xual

har

assm

ent t

rain

ing

ever

y tw

o ye

ars

to ea

ch su

perv

isory

empl

oyee

and

to al

l new

su

perv

isory

empl

oyee

s with

in si

x m

onth

s of

thei

r ass

umpt

ion

of a

supe

rviso

ry p

ositi

on.

• A

pro

gram

to el

imin

ate s

exua

l har

assm

ent f

rom

th

e wor

kpla

ce is

not

onl

y re

quire

d by

law,

but

is

the m

ost p

ract

ical w

ay fo

r an

empl

oyer

to

avoi

d or

lim

it lia

bilit

y if

hara

ssm

ent s

houl

d oc

cur d

espi

te p

reve

ntiv

e effo

rts.

Empl

oyer

Lia

bilit

y

All e

mpl

oyer

s, re

gard

less o

f the

num

ber o

f em

ploy

ees,

are c

over

ed b

y the

har

assm

ent s

ectio

n of

the F

EHA

. Em

ploy

ers a

re g

ener

ally

liab

le fo

r har

assm

ent b

y th

eir su

perv

isors

or a

gent

s. H

aras

sers

, inc

ludi

ng b

oth

supe

rviso

ry an

d no

n-su

perv

isory

per

sonn

el, m

ay b

e he

ld p

erso

nally

liab

le fo

r har

assin

g an

empl

oyee

or

cow

orke

r or f

or ai

ding

and

abet

ting

hara

ssm

ent.

Add

ition

ally

, the

law

requ

ires

em

ploy

ers t

o ta

ke

“all

reas

onab

le ste

ps to

pre

vent

har

assm

ent f

rom

oc

curr

ing.

” If a

n em

ploy

er h

as fa

iled

to ta

ke su

ch

prev

entiv

e mea

sure

s, th

at em

ploy

er ca

n be

hel

d li-

able

for t

he h

aras

smen

t. A

vic

tim m

ay b

e ent

itled

to

dam

ages

, eve

n th

ough

no

empl

oym

ent o

ppor

tuni

ty

has b

een

deni

ed an

d th

ere i

s no

actu

al lo

ss o

f pay

or

bene

fits.

In ad

ditio

n, if

an em

ploy

er k

now

s or s

houl

d ha

ve

know

n th

at a

non-

empl

oyee

(e.g

. clie

nt o

r cus

tom

-er

) has

sexu

ally

har

asse

d an

empl

oyee

, app

lican

t, or

pe

rson

pro

vidi

ng se

rvice

s for

the e

mpl

oyer

and

fails

to

take

imm

edia

te a

nd a

ppro

pria

te co

rrec

tive a

c-tio

n, th

e em

ploy

er m

ay b

e hel

d lia

ble f

or th

e act

ions

of

the n

on-e

mpl

oyee

.

An

empl

oyer

mig

ht av

oid

liabi

lity

if

• th

e har

asse

r is n

ot in

a po

sitio

n of

auth

ority

,

***** YOU DO NOT NEED TO PRINT THESE PAGES *****


Post Hire Things I need to do within 2 weeks of starting my new job!

Once you have received your Lawson Log in information from your manager.Log into Lawson/ProvConnect Employee Self Service (ESS) and review and:

Input my Emergency Contact information

W4 deductions

Direct Deposit Information

My address and phone number (review for accuracy)

Print out and/or review the Payroll Calendar

Input my Emergency Contact Information:

Log into LawsonEmployee Self Service (ESS)

1

Select Emergency Contacts

Select “Add”Complete informationSelect “Update”

2



W4 Exemptions (Tax Withholding):

2

3

Update yourexemptions,

marital status oradditionalamount


1

4



Direct Deposit – (Entering Bank Information):

2Click “Add” to enter yournew bank information

Follow Add Account Instructions:

Enter your new bank information

Click “update” when completed

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Employee ID

New Caregiver Orientation Checklist

Providence Overview Mission System Goals Code of Conduct Core Values Ethical & Religious Directives Fraud and Abuse History of Providence Workplace Violence Infection Prevention Diversity Service Excellence Abuse Criteria and Reporting Spiritual Care Process Improvement Suicide Awareness Foundation HIPAA ProvConnect/Lawson Vision Providence Integrity Operating Principles Compliance and Ethnics Safety and Security Parking Human Resources Security Sexual Harassment Mgmt of Aggressive Behavior Non-Retaliation Environment of care Caregiver Benefits Safety and Disaster Preparedness Reporting of Safety Concerns Agreement as to the Terms of Employment and Acknowledgement I acknowledge that I understand all Providence Health and Services Southern California (PHSSC) employment policies are available on the intranet under Policies and Procedures. I agree to read and comply with all of these policies. I understand that if I do not have direct access to a computer in my immediate work area that I can use a workstation located in my unit or in the Medical Library. I can also, at any time, request a copy of any employment policy from my supervisor. New situations develop constantly and I understand that my employer reserves the right, in its sole and absolute discretion, to change, supplement, or rescind all or any part of the practices, procedures, or benefits described in the Human Resources Polices as it deems that circumstances require. I further understand and agree that my employment is entered into voluntarily and I am free to resign at any time. Similarly, Providence Health and Services CA is free to terminate my employment for any reason at any time, with or without cause. I acknowledge and understand that no representative or agent of my employer (other than the Chief Executive Officer in a written agreement signed by the Chief Executive Officer) has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. I further understand and agree that this acknowledgement constitutes a fully integrated agreement as to the terms of my employment and the ability of my employer to terminate, discipline, demote at will. Terms and conditions of represented employees’ employment are governed by the applicable Collective Bargaining Agreement. I agree to observe and abide by all the terms and conditions for employment contained within the employer’s policies

I have received orientation on the topics listed above as applicable to me at (Print facility name)

Caregiver Name (please print) Caregiver Signature Date

HR NOTE EMAIL ADDRESS: Once Caregiver has completed and signed this form email to:

[email protected]

Documents

WELCOME! - Providence Pa… · WELCOME! As the newest member ... 2. Accrues paid sick leave pursuant to the employer’s policy which satisfies or exceeds the accrual, carryover,