PSW INFORMATION CHECKLIST STUDENT NAME: **IMPORTANT** Please have photocopies of the items listed below ready to hand in at the orientation session. Please do not submit originals. 1 copy of multiple items will be retained in your student file and all other copies are intended for your clinical and work placement file. The Orientation Session is offered at five locations: Location Date and Time Location Details Brockville Friday, December, 4, 2015 3:00-5:00 p.m. Cornwall & Morrisburg Wednesday, December 16, 2015 2:00-4:00 p.m. Gananoque Wednesday, December 2, 2015 3:00-5:00 p.m. Kemptville Friday, December 11, 2015 2:00-4:00 p.m. Vankleek Hill Monday, December 14, 2015 1:00-3:00 p.m. St. Mary Catholic High School 40 Central Avenue, Brockville, ON Cornwall Board Office (South Side Door B) 835 Campbell Street, Cornwall, ON St. Joseph Catholic School 235 Georgiana Street, Gananoque, ON St. Michael Catholic High School 2755 Hwy #43, Kemptville, ON St. Jude Catholic School 5355 Highway 34, Vankleek Hill, ON Provide 4 photocopies of a CURRENT VULNERABLE SECTOR SCREENING CHECK. THIS SCREENING MUST INDICATE NO CONVICTIONS (NEGATIVE) IN ORDER TO BE ADMITTED TO PROGRAM. Please contact your local Police Detachment for the fees and times of service. Provide 4 photocopies of your IMMUNIZATION RECORD. Needs to be completed to show proof of immunity for some placements. Please note that blood titres must accompany the immunization record. Provide 4 photocopies of the MEDICAL FORM COMPLETED & SIGNED BY YOUR DOCTOR. Provide 4 photocopies of PROOF OF CURRENT TWO STEP TB TEST. If step one-skin test-is positive, you must include a chest x-ray showing report of no active TB. See your doctor or call your health unit ASAP. Provide 4 photocopies of INFLUENZA VACCINE. Influenza vaccine is mandatory for clinical and co-op placements. Provide 1 photocopy of your CANADIAN BIRTH CERTIFICATE. Please note that if you are a non-canadian citizen, you will need to provide proof of Citizenship & Immigration Canada Documentation at the orientation session. A form Confirmation of Residency and Eligibility will be completed and signed confirming that the data on the form is accurate. It will be examined to verify eligibility by a school board official. Provide 1 photocopy of your PROOF OF RESIDENCY. This may include an Ontario driver's license, tax bill, or lease agreement. Provide 1 photocopy of your SECONDARY SCHOOL TRANSCRIPT. Note: If you have an IEP, please provide us with it, so we can support you accordingly. Provide 2 photocopies of A CURRENT RESUME OR A LIST OF JOBS YOU HELD ALONG WITH THE DATES EMPLOYED. REC D PAYMENT:. THE MATERIAL FEE OF $1100.00 IS DUE IN FULL PRIOR TO THE START OF THE PROGRAM.. IF YOU ARE SPONSORED BY AN ORGANIZATION - NOTIFICATION IS NEEDED FROM THE ORGANIZATION THAT THE FULL AMOUNT OF $1100.00 WILL BE PAID. PLEASE INCLUDE THE NAME OF CONTACT, TELEPHONE #, ETC. PLEASE " " THE NAME OF THE SPONSORING ORGANIZATION: ONTARIO WORKS EMPLOYMENT INSURANCE ONTARIO MINISTRY OF TRAINING SECOND CAREER STRATEGY ONTARIO DISABILITY SUPPORT PROGRAM JOB ZONE NAME OF CONTACT PERSON/REPRESENTATIVE: TEL. #: 613- EXT. FAX #: 613- Revised: October 28, 2015 Page 1 of 12
PERSONAL SUPPORT WORKER IMMUNIZATION & MEDICAL FORM PERSONAL INFORMATION: Student Name: Date of Birth: / / mm dd yyyy Address: City: Postal Code: Telephone #: Start Date: TO THE PHYSICIAN: The above named individual is planning to participate in the Personal Support Worker Program. The practical nature of this training program may require the individual to: Provide support and companionship to vulnerable clients of varying ages. Duties involved may include aspects of lifting, walking, standing, kneeling, bending, twisting requiring a full range of motion. PLEASE VERIFY THE FOLLOWING: Date: Given by: Signature: 1. Two Step TB (Mantoux) Test Negative Positive 2. If # 1 positive, Chest X-ray Negative Positive 3. Immunization against: (please note: blood titres must accompany the immunization record) DPT MMR Varicella Hep B 4. Flu Shot 5. General physical examination of the above named individual suggests that he/she is physically and mentally fit to perform above duties. Yes No 6. Other/Comments: Physician Signature: Dated: Name and Address of Physician: Revised: October 28, 2015 Page 2 of 12
November 2015 To Whom It May Concern: This letter is to confirm that has expressed interest in registering for the January 2016 Personal Support Worker Program with the Catholic District School Board of Eastern Ontario. The Brockville; Gananoque and Kemptville classes are scheduled to start on Monday, January 4, 2016; the Cornwall and Morrisburg classes are scheduled to start on Monday, January 11, 2016 and the Vankleek Hill class is scheduled to start on Monday, January 18, 2016. Placement and course ends in late June 2016. Please note: Each course will run based on sufficient enrollment. Conditional acceptance in the program depends on the student providing a current and negative Vulnerable Sector Screening Check and proof of current TB test, which she/he already has (please see PSW Information Checklist). In order for us to hold a position for her/him, we will require notification from your agency that the student will be sponsored for the full amount of the course ($1100.00) by the date indicated below (by student s choice of location). Location Date and Time Location Details Brockville Friday, December, 4, 2015 3:00-5:00 p.m. Cornwall & Wednesday, December 16, 2015 Morrisburg 2:00-4:00 p.m. Gananoque Wednesday, December 2, 2015 3:00-5:00 p.m. Kemptville Friday, December 11, 2015 2:00-4:00 p.m. Vankleek Hill Monday, December 14, 2015 1:00-3:00 p.m. Please find attached a copy of the program outline for your perusal. St. Mary Catholic High School 40 Central Avenue, Brockville, ON Cornwall Board Office (South Side Door B) 835 Campbell Street, Cornwall, ON St. Joseph Catholic School 235 Georgiana Street, Gananoque, ON St. Michael Catholic High School 2755 Hwy #43, Kemptville, ON St. Jude Catholic School 5355 Highway 34, Vankleek Hill, ON I trust that the information provided is sufficient. Should you have any other questions, or require additional information, please feel free to contact me at your earliest convenience. Regards, Kevin Dionne Coordinator of Continuing Education and Experiential Learning 1-800-443-4562 ext. 293 Please note: No classes on Family Day; Good Friday and Easter Monday. Revised: October 28, 2015 Page 3 of 12
To whom it may concern: The Catholic District School Board of Eastern Ontario s Personal Support Worker Program (PSW) begins in January 2016 and ends in late June 2016. The PSW is a full-time (36 hours per week) program. Lastly, if hired by the facility, a student may be paid for their co-op placement. Fees associated with the program are as follows: Item Cost Text Book/workbook (Mosby s Canadian) $135.00 First Aid/CPR $135.00 GPA Training $ 25.00 WHMIS $ 30.00 St. Peter Feeding Training $ 15.00 Mobility Training $ 70.00 Safe Food Handling Course $35.00 OLTCA Pin (registry list if they pass the course) presented at their graduation $ 16.00 Lab supplies per student $ 85.00 Component of facility rental $262.00 Equipment/Supplies Purchase, Replacement, and Repair $242.00 Restorative Therapy Training $ 50.00 Total Cost $1100.00 Additional costs the student needs to pay prior to entering the program or during the program include: Item Approximate Cost Scrub Uniforms (three required) $40 each Non-slip white shoes $75.00-$100.00 Misc Supplies $50.00-$75.00 Doctor s Note $0-$150.00 Hep B Immunization (three required) $25.00-$75.00 each TB (Mantoux) test $0-$25.00 Current Vulnerable Sector Screening Check $0-$50.00 Transcript $0-$20.00 Transportation Varies Parking fees Varies Revised: October 28, 2015 Page 4 of 12
PERSONAL SUPPORT WORKER PROGRAM (PSW) Program Outline This intensive training program is intended to provide individuals with the theoretical, clinical and practical knowledge and skill sets needed to perform personal support tasks, as a collaborative member of a client s health care/ support team. Whether applying these skills in the community and/or facility based setting, our program philosophy incorporates the principles of promoting client independence, dignity, safety and the delivery of compassionate care. The PSW Program is accredited through O.C.S.A. (Ontario Community Support Association) and sponsored by the Ministry of Education. This program follows the training standards set out by the MTCU (Ministry Training Colleges and Universities) and graduates must demonstrate competency in fourteen (14) vocational learning outcomes, (VLO) and essential employability skills (ESS) learning outcomes, divided between 7 program courses. Program Duration: 6 hours for the Orientation and Registration session, 330 hours of in-class instruction, 90 hours of supervised clinical workplace experience, 270 hours of coop workplace experience, and 7 senior secondary school credits towards the Ontario Secondary Diploma requirements. Program Courses: Health Care, Grade 11, College (TPJ3C 110 hours/1 credit) This course includes but is not limited to the training elements to have the student reliably demonstrate the ability to work within the personal support worker role in community, retirement homes, long-term care homes and/or hospital care settings; act responsibly and be accountable for one s own actions while recognizing the boundaries of knowledge and skills within the personal support worker role and participate as a member of the inter-professional care/service team. PSW modules included in this course: Orientation/Study Skills - 6hrs Roles and Responsibilities Interpersonal Skills Overview of the Canadian Health Care System Infection Control Mobility Individuality Introduction to Human Body Structures and Functions Optimal Support Health Care, Grade 12, College (TPJ4C 110 hours/1 credit) This course includes but is not limited to the training elements to have the student reliably demonstrate the ability to provide client-centred and client-directed care that is based on ethical principles, sensitive to diverse client and family values, beliefs and needs, and which follows the direction of the of care/service plan. Promote and maintain a safe and comfortable environment for clients, their families, self and other; assist clients across the lifespan with routine activities of daily living. Revised: October 28, 2015 Page 5 of 12
PSW modules included in the course: Personal Hygiene; Client Care Planning; Ongoing Conditions and Diseases; Rehabilitative Care; Assisting the Family; Core Elements of a Helping Relationship; Continuation of Human Body Structures and Functions; Safety of Client and Worker. Child Development and Gerontology, Grade 12, College (TOJ4C 110 hours/1 credit) This course includes but is not limited to the training elements to have the student reliably demonstrate the ability to identify and report situations of neglect and potential, alleged or witnessed actual incidents of abuse; assist in the provision of culturally relevant palliative and end-of-life care; and use identified approaches and best practices to support positive and safe behaviour in clients experiencing cognitive impairment, mental health challenges and /or responsive behaviors. PSW modules included in the course: Cognitive Impairment and Mental Health Issues; Continuation of Human Body Structures and Functions; Household Management and Meal Preparation; Assisting the Family; Assisting with Medications; End of Life Care; Responding to Abuse. Health Care: Support Services, Grade 12, Workplace. TPJ4E - Supervised Clinical (90 hours - 1 credit) Long Term Care Placement Part One. TPJ4EC Cooperative/Consolidation Placement (270 hours - 3 credits) Long Term Care Placement Part Two & Community Setting Placement (Minimum of 100 hours) These courses enable the student to develop the basic skills needed for careers in a range of health care support settings. Students will have the ability to reliably demonstrate the transfer of theoretical and laboratory learned skills and procedures while gaining an understanding of various employer policies and expectations while under the guidance of the clinical instructor and a PSW mentor. Note: Placements and course ends in late June 2016. Grading: Students must attain 70% in each credit course (80% in lab portion of program). Students who are at risk re: grades and/or attendance will be notified by the fourth week. Students who do not attain a passing grade of 70% in the theory component, cannot continue with the Clinical and Co-op Placements since a candidate needs to receive a minimum of 70% in order to obtain PSW Certification. In the case of not obtaining the required minimum of 70% in the theory component, the student will have to reapply and pay for the course again. Revised: October 28, 2015 Page 6 of 12
Upon successful completion of all components, students will receive an Ontario Long Term Care Association Pin and a Personal Support Worker Certificate. If a student does not finish the Co-op portion for a legitimate reason, they can complete it within the year, with a refresher of clinical skills. This will entail one week attendance of clinical, prior to starting Co-op placement. Attendance Policy: Since every day includes critical skill development and information, attendance is MANDATORY at all sessions. Being absent for more than 2 classes, without a medical note, may result in a failing grade. As well, lateness is unacceptable. Material Fee: The $1100.00 course fee covers the costs of: academic counseling, textbook, classroom and laboratory instruction, CPR and First Aid certificate, WHMIS training, Gentle Persuasion Approach (GPA) certification, St. Peter s Hospital Dining Feeding certification, Safe Food Handling certification, Ontario s Just Clean Your Hands certificate, Restorative Therapy Certification and Palliative Care Certification. All programs will offer these certificates and each individual program may offer other training as per their area. Each program will have guest speakers that may cover the following topics: ALS, Mental Health, Heart and Stroke, Diabetes, etc. Also, included in this fee is a name tag that you will be required to wear daily. The material fee of $1100.00 is due in full prior to the start of the program. We accept cash, money orders, and certified cheques. Please make cheques payable to: Catholic District School Board of Eastern Ontario. Late fees will not be accepted unless approved in advance by the Coordinator of Continuing Education. Refund Policy: If you withdraw within 10 business days from the start of the course, you are entitled to receive a full refund. If you withdraw between the first and fifth day of the start of the course, you will receive a $1000.00 refund. A refund will not be provided after the first week of class. Admission Requirements (A complete CDSBEO PSW package is needed for admission.) Be able to commute to classes and clinical/work placements. Have the fitness level necessary to perform the duties required of a PSW. Be nineteen years of age or older. Be an Ontario resident - provide 1 photocopy of proof of residency (please provide one of the following; driver s license, tax bill, lease agreement, cable bill, etc.). Provide 4 photocopies of a current vulnerable sector screening check. This screening must indicate no convictions. Provide 4 photocopies of your immunization record (needs to be completed to show proof of immunity for some placements; blood titres must accompany the immunization record). Provide 4 photocopies of your medical form completed and signed by your doctor. Provide 4 photocopies of proof of current Two Step TB test (if step one-skin test-is positive you must include a chest x-ray showing report of no active TB ). Provide 4 photocopies of influenza vaccine (influenza vaccine is mandatory for clinical and co-op placements). Revised: October 28, 2015 Page 7 of 12
Provide 1 photocopy of your Canadian Birth Certificate. Please note that if you are a non-canadian citizen, you will need to provide proof of Citizenship & Immigration Canada Documentation at the orientation session. A form Confirmation of Residency and Eligibility must be completed and signed confirming that the data on the form is accurate. It will be examined to verify eligibility by a school board official. Provide 1 photocopy of your Secondary School Transcript (note: if you have an IEP, please provide us with it, so we can guide you accordingly). Provide 2 photocopies of a current resume or a list of jobs you held along with dates you worked. NOTES: 1 photocopy of multiple items will be retained in your student file, two photocopies are intended for your clinical and work placement files, and the other one is for your files. All applicants must undergo a literacy assessment and interview and will be notified of acceptance into the program by phone. Students are required to purchase the following items (please ensure that you have these items for your first class) 2-4 sets of scrubs will be needed. The color will be determined at the orientation session. They are to be worn during for first day of class, when guest speakers visit, during clinical, at co-op placements and at graduation. 3-hole binder, 3-hole lined paper, small note pad and pen for work placement. Shoes Closed toe, closed heel, white nursing type shoe or white running shoe. Crocs or shoes with holes are not permitted to be worn. Revised: October 28, 2015 Page 8 of 12
CURRENT VULNERABLE SECTOR SCREENING CHECK (Please contact your local detachment; police service for the fees/times that they are available when a check can be completed. Please ask if they have a debit machine, if not you may need to pay cash). Sample provided below from the S. D. & G. O.P.P. Alexandria detachment regarding requirements. You will require: One (1) piece of PHOTO AND One (1) piece of NON-PHOTO Identification At least one piece of identification must include a photograph of the subject taken within the last five (5) years. Photo identification shall contain, at a minimum, the subject s full given name, surname, date of birth and gender. Examples of acceptable identification are: Acceptable Forms of Photo Identification: Driver s License BYID (Bring Your Identification, issued by the Liquor Control Board of Ontario (LCBO)) Military Employment Card Canadian Citizenship Card Indian Status Card Passport Permanent Resident Card PAL (Possession & Acquisition License issued by Chief Firearms Office) CNIB (Canadian National Institute for the Blind) Card Ontario Photo ID Card (issued by MTO) NEXUS Card FAST Pass Acceptable Forms of Non-Photo Identification: Birth Certificate Baptismal Certificate Hunting License Outdoors Card Canadian Blood Donor Card Immigration Papers Ontario Health Cards and Social Insurance Number (SIN) Cards as identification are NOT PERMITTED due to legislative restrictions. Revised: October 28, 2015 Page 9 of 12
Date: November 1, 2015 November 1, 2015 Revised: October 28, 2015 Page 10 of 12
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