Employee Application

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Employment Date(employer complete)

Name(Required)

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Email:(Required)

Phone(Required)

(###) ###-####

Date of Birth:(Required)

Social Security #:(Required)

In Case of Emergency Notify:(Required)

Relationship:(Required)

Phone:(Required)

(###) ###-####

Do you currently attend school?(Required)

Yes

Are you presently employed?(Required)

Yes

May we contact your current employer?(Required)

Yes

Employer's Phone

Do you drive?(Required)

Yes

Do you have a valid driver's license?(Required)

Yes

Do you have experience in caring for children?(Required)

Yes

Explain:

Have you ever been convicted of a felony or have a criminal record? If yes please explain.(Required)

Yes

Explain & List Date of Conviction

Education(Required)

School Name

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Major/Specialties

Level or degree completed

Dates Attended

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Please list any additional experience, schooling, or special qualifications:

Employment(Required)

Name of Organization

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References(Required)

Full Name

Occupation/Relationship

Telephone

List three (3) persons not related to you, and who can furnish information about you. Do not repeat names of supervisors furnished in the employment record. Click the plus sign to add more education.

Applicant's Name(Required)

First Last

Date(Required)

MM slash DD slash YYYY

Name

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EmployeeHandbook

Orientation toChild Care Training Set Up

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New Staff Packet

PROCEDURES FOR IDENTIFYING CHILD ABUSE AND NEGLECT AND ACKNOWLEDGEMENT OF RESPONSIBILITY TO REPORT

Please read the following definition of an abused child, the signs of child abuse and neglect, and the requirements for reporting abuse or neglect as outlined in state law. Your signature affirms that you have read and understand the definition and know your responsibility.

DEFINITION OF ABUSED CHILD

Within South Dakota Codified Law (SDCL), the term custodian includes a child care provider. SDCL 26-8A-2 defines an abused or neglected child. The term abused or neglected child means a child:

(1) Whose parent, guardian, or custodian has abandoned the child or has subjected the child to mistreatment or abuse;

(2) Who lacks proper parental care through the actions or omissions of the child's parent, guardian, or custodian;

(3) Whose environment is injurious to the child's welfare;

(4) Whose parent, guardian, or custodian fails or refuses to provide proper or necessary subsistence, supervision, education, medical care, or any other care necessary for the child's health, guidance, or well-being;

(5) Who is homeless, without proper care, or not domiciled with the child's parent, guardian, or custodian through no fault of the child's parent, guardian, or custodian;

(6) Who is threatened with substantial harm;

(7) Who has sustained emotional harm or mental injury as indicated by an injury to the child's intellectual or psychological capacity evidenced by an observable and substantial impairment in the child's ability to function within the child's normal range of performance and behavior, with due regard to the child's culture;

(8) Who is subject to sexual abuse, sexual molestation, or sexual exploitation by the child's parent, guardian, custodian, or any other person responsible for the child's care;

(9) Who was subject to prenatal exposure to abusive use of alcohol, marijuana, or any controlled drug or substance not lawfully prescribed by a practitioner as authorized by chapters 22-42 and 34-20B; or

(10) Whose parent, guardian, or custodian knowingly exposes the child to an environment that is being used for the manufacture, use, or distribution of methamphetamines or any other unlawfully manufactured controlled drug or substance.

SIGNS OF ABUSE AND NEGLECT
Indicators of Physical Abuse:

• Unexplained bruises or welts.
• Unexplained burns.
• Unexplained fractures.
• Unexplained lacerations or abrasions.
• Child is wary of or suddenly frightened of caregiver or someone in the household.
• Child tells parents of injuries or abuse.
• Child shows behavior extremes – aggressiveness or withdrawal.

Indicators of Physical Neglect:

• Lack of consistent supervision.
• Unattended physical needs (i.e. diaper changes, bottle feedings, no meals or snacks).

Indicators of Emotional Abuse:

• Failure to thrive.
• Speech disorders.
• Habit disorders (i.e. sucking, rocking, biting).
• Extreme behaviors.

Indicators of Sexual Abuse:

• Difficulty walking or sitting.
• Pain or itching in genital area.
• Bruises or bleeding in external genitalia.
• Child tells parents of sexual contact by caregiver or someone in the household.

REPORTING POLICY

SDCL 26-8A-3 mandates all child care providers, who have reasonable cause to suspect that a child under the age of eighteen has been abused or neglected, report that suspicion to the Department of Social Services at 1-877-244-0864 or local Law Enforcement. Any person who intentionally fails to make the required report to one of these two entities is guilty of a Class 1 misdemeanor (a $2,000 fine and /or 1 year in jail).

ARSD 67:42:10:22 (licensed programs) and 67:42:14:14 (OST) Staff responsibility for reporting suspected incidents of child abuse or neglect states that the staff person, in addition to reporting the abuse to law enforcement or the Department of Social Services should report the incident to the executive director, the proprietor, or a designee. The executive director is then also responsible for reporting the incident and cooperating fully in the investigation.

In addition, ARSD 67:42:10:23 (licensed programs) and 67:42:14:16 (8) (OST) Center Procedures for handling suspected in-house child abuse requires the center to have written procedures for handling suspected in-house child abuse. The procedures include a means to assure the children are safe pending the outcome of the investigation. If a staff member/volunteer is involved, the program is required to have measures in place to evaluate the continued employability of the staff person.

ACKNOWLEDGEMENT STATEMENT

I have read the SDCL definition of abused child and reviewed the indicators of abuse and neglect. I understand the SDCL related to the reporting of child abuse and neglect. My signature affirms my responsibility to report to the Department of Social Services or Law Enforcement any time I suspect a child has been abused or neglected.

Staff Name(Required)

First Last

Staff Email Address(Required)

Date(Required)

MM slash DD slash YYYY

Name

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Staff Consents

Please check the box prior to each policy stating you understand and will abide by them:

Consent(Required)

Tardy: Staff must be on time for shifts so classrooms can stay within the state requirement ratio for teachers and children. You should arrive at your shift 5 minutes early. Do not clock in prior to 5 minutes early. If you are going to be late it is a requirement to call asap.(Required)

Consent(Required)

Clock Out: If you work longer than 6 hours you will get a 30 minute unpaid break where you can bring lunch and eat at the center. You cannot leave the center. You need to be available to come help if there is an emergency or need assistance. You are responsible to clock out at this time. If you ever need to stay after your scheduled out time it must be approved by the scheduling supervisor/director/owner. If it is not approved the software will automatically clock you out at your scheduled time. All cleaning needs to be done prior to your off time. If you need to communicate with other staff to balance out rooms to get done on time. You can not leave unless the classroom is in proper ratio for teachers and number of children.(Required)

Consent(Required)

Time off: You must submit a request off in HomeBase at least 2 weeks in advance in order to get time off. If something unexpected comes up, talk to the Director/Owner. If you have a late request off it will not be guaranteed. If you ask for time off and someone who is staffed in the same room as you asked for time off prior to you then you may be denied the time off request.(Required)

Consent(Required)

Sick: The only way you are excused from coming to work if you are sick is if you have a 100.4 degree fever, puking, diarrhea or a communicable disease. You will need to CALL to notify work you are sick 605-641-3367. Notify as soon as symptoms start no matter what hour of the day or night it is. You may be asked to turn in a doctor’s note. If you do not meet these criteria and still choose to stay home you will be asked to find your own coverage. If you can not find coverage it will be an unexcused absence.(Required)

Consent(Required)

Children Sick: If you have children it is your responsibility to have someone on back-up. I do understand this can be hard. If you are unable to find a backup babysitter, it is your responsibility to find a staff member to take your shift.(Required)

Consent(Required)

Uniform: You are provided with 2 shirts if you're full time and options to buy more. You can purchase more through alpine impressions website, search kids point and find all our apparel. You are required to wear those shirts during any of your shifts. The logo on the uniforms are always to be seen and there will be no sweatshirts over them. You can wear an unzipped sweatshirt if the logo is still visible. If you come to work wearing an improper uniform, you may be sent home to change or reminded to wear. When you are no longer working with us you will turn them in and then receive your last paycheck.(Required)

Consent(Required)

Uniform requirements: Uniform shirt with jeans, leggings, or yoga pants. No sweatpants or holy jeans are allowed. This is a professional institute and we want to show parents and anyone else who may come into our presence that we are professional and dedicated to the work that we do.(Required)

Consent(Required)

Phone Usage: You cannot use a phone for personal use at work. No Facebook, snapchat, txt, etc. Only can be used for voxer and brightwheel for work related things. This should only take a minute maximum. If you cannot follow this you will be asked to leave your phone in your car.(Required)

Consent(Required)

Phone Response: You are required to answer your phone in a timely manner when off. When you are off work it is your responsibility to listen to all voxer on the MustRead chat and try to catch up on the voxer for your room. Absolutely NO phone use for personal use unless on break or not with children.(Required)

Consent(Required)

Voxer: This is our communication system. It is a requirement to read all "Must Read" boxers. Check messages regularly because this is how we communicate.(Required)

Consent(Required)

CPR: If you resign within 6 months after Kids Point certified you with CPR you will have to pay back the fee of $70 by your termination then you will receive final paycheck and copy of CPR.(Required)

Consent(Required)

I have read over the employee handbook in addition to the above policies(different link) in full and I understand and agree to abide by all of the terms and regulations written. If I fail to follow all of the policies and procedures I understand that disciplinary action or possible termination could happen.(Required)

Signature(Required)

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Date(Required)

MM slash DD slash YYYY

Comments

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