Nursing Assistant Program Application Checklist for Adult Students

Transcription

1 Nursing Assistant Program Application Checklist for Adult Students Determine whether you need to take a reading assessment. Testing can be waived if you can provide documentation of any of the following: TABE (8), Accuplacer (55), or DRP (65) tests taken in the last year SAT minimum scores of 400 in English (taken in the past five (5) years) ACT minimum scores of 16 in English (taken in the past five (5) years) Associate degree or higher from an accredited college or university (in the United States) College transcripts with minimum English 960 with a "C" grade or better If you need to take the reading assessment, call (801) or (801) to schedule an appointment. Bring the $45 enrollment fee and picture ID when you come to test. Complete the online Admissions Application. Complete the online New Student Campus Orientation. Watch the program orientation video and fill out the verification form. Visit the Enrollment office to register. You must register by the 20th of the month prior to the month you want to begin classes (e.g. register by June 20th in order to start classes the first week of July). Be prepared to pay tuition and fees at the time of registration. Obtain your TB test and immunizations or immunization/test records. TB test must have been done within the past year. Flu shots are required during the flu season (typically October thru April). Students who do not have a current flu shot, will be required to wear a mask during their clinicals. Hepatitis B vaccine series is recommended due to potential for exposure to bloodborne pathogens. On the first day of class, turn in your TB test results, immunization records, and the 3 consent forms following this page.

2 Health Occupations Nursing Assistant Background Check Notification Students entering a Health Occupations Program at the Ogden-Weber Technical College are required to complete a background check. All Students must complete a Criminal Background Check application no later than the first day of class. Any misdemeanor or felony conviction that you have on your record may negatively impact your chances of completing the program and being placed at an externship site. An adverse finding on a criminal background check may also inhibit a student s ability to obtain employment and/or obtain certification/licensure in a health occupation. Many states including Utah, do not seal juvenile records. Any charge incurred in the last 7 years will show up on the background check. There will be no tuition or fee refund for students who are unable to complete the program due to their criminal record. Prospective students with a criminal record are strongly encouraged to contact the Program Coordinator prior to enrolling. In keeping with the program s due process policies, if a student disagrees with the accuracy of the information obtained, he/she may request a meeting with the Program Coordinator to discuss their concerns. I have read and understand the information presented above. Student Signature Parent Signature (if student is a minor) Revised 11/2017

3 OGDEN WEBER APPLIED TECHNOLOGY COLLEGE CONTRACT AGREEMENT FOR ON THE JOB TRAINING (OJT) This agreement is entered into this day of 20 between Ogden Weber Technology College, hereinafter referred to as COLLEGE, and, hereinafter referred to as STUDENT. NOW, THEREFORE, in accordance with the consideration provided herewith, it is agreed that: The WORKSITE will: Provide use of its facility for on the job training (OJT) also referred to as clinical to the student(s) to provide the same with practical experience and education beyond that which the COLLEGE is able to provide per specific student(s) curriculum requirements. Provide a healthy and safe work environment and proper staff to lead the student(s) throughout their OJT experience. Communicate to the coordinator of the program and instructor on-site of any unacceptable student behavior or other incidents. The COLLEGE will: Coordinate the arrangement between the WORKSITE and the student, and officially recognize the OJT received by the student(s). Provide necessary training to the student(s) prior to the student participation on any OJT. Provide an instructor to supervise the student(s) throughout and during the OJT. Recognize the importance of the onsite training and follow up with the administration of any misunderstanding or incidents. IT IS FURTHER AGREED THAT: The student is desirous of gaining said experience and education and recognize the clinical/ojt as hands on training. The student will not be paid nor provided other benefits by the WORKSITE or the COLLEGE during the training. The student will abide by all rules, procedures and policies of the WORKSITE now in effect, or placed in effect in the future, including those related to safety The student will abide by HIPAA laws and maintain patient confidentiality at all times. The student assumes all risk of personal injury and personal property loss in connection with or arising from the student s clinical training at the WORKSITE. The student waives and releases the COLLEGE and the WORKSITE for all damages or loss of personal property in connection with or arising from the student s clinical training at the WORKSITE. Both the WORKSITE and the COLLEGE shall be protected in accordance with the law (exclusive remedy) as it relates to claims for personal or property damage filed by the student. The WORKSITE will provide direct training and proper guidance to the student during the clinical. The student will be exclusively responsible for any damage caused by negligence on the student s part such as, but not limited to: property damage, equipment breakage, and physical harm to the WORKSITE property, its affiliates or third parties releasing the COLLEGE and the WORKSITE of any liability.

4 If the student is injured while on the WORKSITE premises, performing the normal tasks that are required of the position, the COLLEGE will provide assistance to the student. The student will NOT perform any task for which he or she was not trained, or if the task being asked to be performed by the student is not congruent with the way the student was trained, increasing the risk for unsafe performance. The COLLEGE will exercise reasonable care in selecting and forwarding student(s) to the WORKSITE for OJT training. By signing below all parties have read, understand, and agree to the terms of this agreement as written. Student signature Parent signature Ogden-Weber Technology College Representative signature *both pages of the OJT contract should go in the student s file

5 Hepatitis B Vaccine Declination I understand that occupational exposure to blood or other potentially infectious materials, may put me at risk of acquiring Hepatitis B virus, (HBV) infection. However, I decline Hepatitis B vaccination at this time. I understand that by declining this vaccine, I may be at risk of acquiring hepatitis B, a serious disease. I have previously completed Hepatitis B vaccination series I have just started the Hepatitis B vaccination series. Antibody testing reveals that I am immune to Hepatitis B For medical reasons, the Hepatitis B vaccine is contraindicated I am declining to have the Hepatitis B vaccination knowing that I have a chance to contract it at any time throughout this program. Yes No Yes No Yes No Yes No Yes No As a result of my decision to decline Hepatitis B vaccination, I hereby release Ogden-Weber Technology College, as well as any and all officers, directors, employees, agents or associates from any and all liability for any injury, illness, damage, claim or cause of action which arises or may arise in association with this decision and my work. Student Signature Parent or Guardian if younger than 18 years of age Students Printed Name / Parent or Guardian Name Printed Witness Medical Assisting, Dental Assisting, Certified Nurse Assisting, EMT, Surgical Technician 2007

6 Nursing Assistant Class Information All Students: All students must complete a Criminal Background Check application on the first day of class. Any felony or misdemeanor conviction that you have on your record may negatively impact your chances of completing the program and being placed at an externship site. There will be no tuition or fee refund for students who are unable to complete the program due to their criminal record. Prospective students with a criminal record are strongly encouraged to contact the Program Coordinator, Cherie Crezee, at to discuss their record prior to enrolling in the program. Please note, many states including Utah, do not seal juvenile records. Any charge incurred in the last 7 years will show up on the background check. Tuberculosis (TB)** test results indicating a negative reading must be provided within 2 weeks of your program start date. (Test can be completed at the Health Department, Workmed, or any Health Provider of your choice) Proof of current TB test results (within 1 year) acceptable..high School students must pay for the background check at time of enrollment. High School Students will have a Curriculum Packet provided at no cost and classroom access to all other items below marked with a single asterisk. Items without an asterisk will be your responsibility to purchase. You are strongly encouraged to purchase your own textbook, workbook, stethoscope, and blood pressure cuff for after school use. Adult students are responsible for all costs listed below: Approximate Associated Costs in addition to tuition and fees: Textbook* $46.00 o Hartman s Nursing Assistant Care Long Term Care, 3rd ed. ISBN Curriculum Packet* $19.25 Ceil Blue Scrubs $36.00 (required at end of course for clinical prep and clinicals) Stethoscope* $15.00 Blood Pressure Cuff* $25.00 TB testing** $20.00 (health provider of your choice) CPR Supplies $11.00 Flu shot during flu season $30.00 (health provider of your choice) Total $ High School Students are responsible for all costs listed below: Approximate Associated Costs: Background check fee $32.00 Ceil Blue Scrubs $36.00 (required at end of course for clinical prep and clinicals) TB testing** $20.00 (health provider of your choice) CPR Supplies $11.00 Flu shot during flu season $30.00 (health provider of your choice) Total $ Workbook Hartman s Nursing Assistant Care- Long Term Care, 3rd ed. is not required but is recommended for all students. ISBN (Updated January 2018)