This is a notice to all potential Per Diem Independent Contractors of FLORIDA CONCIERGE HOME CARE that to inform that the Registry does not provide full time employment and cannot guarantee 40 hours of employment per week to any of our Per Diem Independent Contractors. Placement staggers and working hours vary day-to-day and week-to-week

When service begins between a Client and Per Diem Independent

Contractor, and the assignment has been accepted, the Registry expects the Per Diem Independent Contractor to show up for the case and complete the accepted hours. If a situation should arise that does not allow the Per Diem Independent Contractor to fulfill the commitment, the Registry expects a prompt notice to the office staff with sufficient time for it to provide a replacement. A no show or failure to notify the office of an absence is a reason for immediate termination.

The success of oursafety and health programs will only be achieved by the active leadership, direct participation, and enthusiastic support from all department heads, and case managers

Each member of FLORIDA CONCIERGE HOME CARE is obligated to observe safe practices and obey all safety rules, this direct personal involvement is the only way we can attain our goal of accident reduction and elimination.

I have read and fully understand and agree to the above statements.

It is the policy of FLORIDA CONCIERGE HOME CARE to provide a safe and healthful environment for all employees/caregivers/ contractors and visitors who are associated with our company

Safety and health programs dedicated to the elimination of accidents causes, will be emphasized and sponsored throughout the facility and department work safety rules, the investigation of accidents and the inspection of work procedures and facilities. These on-going programs eliminate unsafe work practices/conditions and to reduce the potential for accidents and personal injury.

It has been explained to me that I am being offered employment with the understanding that I have personal transportation at my disposal to be used for travel to and from patient assignments.

I further understand that I am responsible for maintaining automobile liability to include bodily injury and property damage.

Should I be unable to make patient visits assigned to be because of transportation problems, I will give FLORIDA CONCIERGE HOME CARE, a minimum of one working day or eight hours’ notice.

Failure to comply with the above may result in the immediate termination of my employment contract without further notice.

Office hours are from 9:00 am to 5:00 pm, Monday through Friday. Should an incident occur which requires immediate attention Per Diem Independent Contractor is required to notify the Registry as soon as possible. A 24-hour / 7-days a week answering systems is provided for this purpose.

By signing this agreement you are stating that you understand that any incident involving you or the client must be reported to FLORIDA CONCIERGE HOME CARE, immediately.

You also understand that proper documentation must be completed and submitted to the office in a timely manner. Nursing Notes are due Every Thursday.

Any other matter you are wishing to discuss with the Registry personnel, the calls should be placed during office hours.

It is the policy of this Registry that if a caregiver abandons a patient, the Per Diem Independent Contractor/caregiver will be immediately dismissed. The patient will be assigned another caregiver to continue care. The supervisor must contact the case manager to inform of the situation.

Leaving a patient before your shift is completed without the knowledge and approval of Florida Concierge Homecare is considered patient abandonment. The above mentioned actions will be taken.

I acknowledge that I have read and understood FLORIDA CONCIERGE HOME CARE , here in referred to as Registry, Confidentiality Policy, HIPAA regulations and the Privacy Statement. I acknowledge that during my employment/placement/volunteer/project work with Registry I may have access to confidential information.

I acknowledge that it is a term and condition of my work with Registry that I will at all times respect the privacy of clients and their families, students, volunteers and employees, and the confidential nature of the business of Registry. I will closely protect confidential information to prevent it being inappropriately accessed, used or disclosed either directly by me, or by virtue of my password to systems, or by permitting breaches in physical security to occur. If I become aware of any violation of confidentiality, or lose any record containing confidential information or any key or other item that could be used to violate confidentiality, I will notify my supervisor or another responsible Registry supervisor at the first reasonable opportunity. I understand that violations to confidentiality may include, but are not limited to:
- Accessing personal or organizational information that I do not require in order to properly carry out my duties;
- Using or disclosing personal/organizational information (verbally, through the computer system, or in hard copy) without proper authorization;

- Inappropriately sharing passwords, keys, codes or other identification devices without proper authorization.

I will only access, use, transfer or disclose private and confidential information as required by the duties of my position. I agree to cooperate with Registry in any audit or investigation relating to confidential information and to provide any records requested in connection with such audits or investigations. I understand and agree to abide by the conditions outlined in this agreement both during and after my employment or association with Registry. I understand that a violation of this agreement may result in disciplinary action that may include termination/dismissal from employment or association with Registry, or that I may be subject to civil or criminal liability.

I understand that no information is to be released without the written “Release of Information” consent signed by the patient or patient’s legal representative.

It is understood that breaks in the policies and procedures of Registry concerning confidentiality may result in immediate terminate without put further notice.

I voluntarily consent to and authorize FLORIDA CONCIERGE HOME CARE, here in referred to as Registry, and or their assigned agents, associates, or consumer reporting agencies to request and receive any criminal background reports, consumer reports, investigative consumer reports containing information as to my character, general reputation, personal characteristics and mode of living, or information concerning me as part of the pre-employment background review process. Reports requested may include any of the following: Law Enforcement Records, Criminal Records, Civil Records, Motor Vehicle/ Driving Records, Credential Verification, Employment Verifications, Past Employment Verifications, Education Verifications, Reference Checks, Military Service Verifications, and Consumer Credit Reports in accordance with the provisions of the Fair Credit Reporting Act and similar State laws.

I authorize any persons, organizations, companies, corporations, consumer reporting agencies, courts of law, licensing agencies, schools, and any current or past employer to furnish Registry and or their assigned agents, associates or consumer reporting agencies with any and all information concerning me. I further agree to release Registry and or their assigned agents, associates, or consumer reporting agencies and all persons and organizations providing information from any and all claims, liability and responsibility arising out of the release ofsuch information in connection with this research.

This authorization shall remain on file and shall serve as an ongoing authorization for Registry to procure criminal records, consumer reports, including investigative consumer reports, at any time during the contracting period. By signing below, I hereby release Registry, its employees, agents, and all persons, agencies and entities providing information or reports about me from any and all liability arising out of the release of any such information or reports.

I understand that if an adverse decision on my application for employment is made, based in whole or in part on information contained in any consumer report, I will be so informed. I will also be provided an opportunity to obtain a copy of that consumer report and to dispute any inaccurate or incomplete information.

I agree that a photocopy, facsimile, or other electronic forms of this information can be furnished to Registry, and that it will have the same authority and authenticity as the original. I also understand that any misrepresentation, falsification or omission of facts herein may be considered cause for rescinding and offer of employment, termination of employment, or denial of consideration for future employment.

If a Per Diem Independent Contractor/Employee refuses to take a periodic, random, post-accident, routine fitness for duty or reasonable suspicion Drug and/or Alcohol screen, he/she will be terminated from employment.

Any Per Diem Independent Contractor/Employee using, selling, purchasing, possessing, soliciting or distributing drugs and/or alcohol on duty or at company’s property, it will be terminated from the contract.

This company hereby states its policy relating to those individuals who test positive on a drug and/or alcohol screen to be as followed;

Any Per Diem Independent Contractor/Employee who tests positive on a Drug and/or Alcoholscreening will be terminated from their contract. If he/she is able to successfully obtain substance abuse treatment, at their own expense, and their contract is still available, he/she will be given one

(1) chance to be retired, upon a negative return-to-work Drug and/or Alcohol screen he/she will then undergo random Drug and/or Alcohol screensfor a period of (2) years as follow-up treatment. If he/she tests positive on any of their follow-up Drug and/or Alcoholscreens, he/she will be terminated from their employment.

POLICY:

The procedures of “University Isolation” as recommended by the Center for Disease Control will be carried out. “UNIVERSAL ISOLATION” precautions meansthat blood and body fluids precautionsshould be consistently used for all patients.

PROCEDURE:

1) Gloves should be worn for touching blood and body fluids, mucous membranes, or non-intact skin for all patients, for handling items orsurfacessoiled with blood or body fluids, and for performing venipuncture and other vascular access procedure.

2) Masks and protective eyewear or face shields should be worn during procedures that are likely to generate droplets of blood or other body fluidsto prevent exposure of mucous membranes of the mouth, nose, and eyes.

3) Gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids.

4) Hands and other skin surfaces should be washed immediately and thoroughly if contaminated. Hands should be washed immediately after removing gloves.

5) Needles should not be recapped, bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand.

6) Mouthpieces, resuscitation bags, or other ventilation devicesshould be available for use in areasin which the need for resuscitation is Predictable

7) Health-care workers who have exudative lesion or weeping dermatitisshould refrain from direct patient care and from handling patient-care equipment until the condition isresolved.