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Employee Manual Personnel Policies and Procedures

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URGENT, Inc. Urban Renewal Greater Enhancement National Team

Employee Manual OFFICE LOCATION: OVERTOWN/CULMER SERVICE CENTER 1600 NW 3RD AVE. BLDG D MIAMI, FL 33136

MAILING ADDRES: P.O. Box 013047 Miami, Florida 33101

CONTACT US: (305) 576-3084 PHONE (866) 811-7778 FAX OFFICE@URGENTINC.ORG WWW.URGENTINC.ORG

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About Urgent, Inc. is a 501 (c) 3 Community Based Organization founded in 1994. Vision: All people have the social, economic and educational resources to thrive Mission: To Empower young minds to help transform their communities Guiding Principal: To promote shared leadership through empowerment, education and civic engagement to promote collective well-being Core Values: Compassion, Innovation, Learning, Patience, Reciprocity, Responsibility and Teamwork

Value Statements 

Innovation- We strengthen existing and initiate new opportunities to enhance constituent learning and development. We are creative in delivering value to whom we serve. We anticipate change and capitalize on the many opportunities that arise.

Responsibility- We assume complete responsibility for our behavior and hold ourselves accountable for our actions. We operate from an ethical frame of reference. We behave with honesty and fairness, promoting justice, admitting errors, and acting in alignment with our asserted mission, vision and values.

Compassion- We approach our work with an understanding of our areas of influence, cognizant that the work we do individually and agency-wide impacts others within the organization and in the broader community. We act with kindness, heart and understanding to develop sincere rapport with our multiple constituencies and keep them at the center of our work.

Teamwork- We utilize teamwork and cooperation in our work. We achieve synergy and positive overall results through partnerships, teamwork, and cooperation. We are reliable and work together and effectively to provide high quality programs and services.

Reciprocity- We believe all people have strengths and assets in which they can contribute to the sustainable growth and development of their community. We aim to act together to achieve those goals.

Patience- We acknowledge that our success will come through patience. We will work to developed by being constantly aware of our levels of tension, our breathing, and being able to speak and work with people in a habitually calm voice and composed manner.

Learning- We are committed to continuous learning to increase our capacity to apply collective knowledge to solve problems and achieve strategic goals iii

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Current Programs CRA Summer Youth Employment Program Rites of Passage Prevention Program Intergenerational Project Youth Empowerment After School Program Youth Empowerment Summer Camp

Board of Directors Dennis Horton, Chairperson Marcos Lapcuic Patrick Williams, PhD Jacqueline Ledon, Atty

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Table of Contents

Page OFFICE LOCATION:.................................................................................................................................ii MAILING ADDRES:..................................................................................................................................ii CONTACT US: ...........................................................................................................................................ii Current Programs .....................................................................................................................................iv Board of Directors .....................................................................................................................................iv Introduction ................................................................................................................................................ 1 At-Will Employment ................................................................................................................................. 1 Mandatory Background Screening.......................................................................................................... 1 Equal Employment Opportunity............................................................................................................. 1 Policy Against Harassment ...................................................................................................................... 3 Grievance Procedure ................................................................................................................................. 4 Purpose and Scope ................................................................................................................................. 4 Procedure................................................................................................................................................. 4 Filing of Complaint ......................................................................................................................... 4 Investigation .................................................................................................................................... 4 Appeal............................................................................................................................................... 5 Non-Retaliation ............................................................................................................................... 5 Hours of Work, Overtime and Pay Day ................................................................................................. 5 Hours of Work ........................................................................................................................................ 5 Overtime Definition and Pay Rates ..................................................................................................... 5 Pay Period................................................................................................................................................ 5 Place and Time for Payment of Wages................................................................................................ 6 Payment on Resignation of Termination ............................................................................................ 6 v

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Performance and Pay Review............................................................................................................... 6 Employee Benefits...................................................................................................................................... 6 Health Insrance....................................................................................................................................... 6 Worker’s Compensation Insurance...................................................................................................... 6 Holidays, Vacation, Sick Leave and Leaves of Absence....................................................................... 7 Holidays................................................................................................................................................... 7 Weekends and Vacations ...................................................................................................................... 7 Eligibility ................................................................................................................................................. 7 Vacation Policy ....................................................................................................................................... 7 Accrual of Vacation Time ...................................................................................................................... 7 Part-time and Temporary Employees ................................................................................................. 7 Pay in Lieu of Vacation.......................................................................................................................... 7 Vacation Accrual During Leaves of Absence ..................................................................................... 7 Vacation Pay on Termination ............................................................................................................... 8 Vacation Approval ................................................................................................................................. 8 Vacation Scheduling .............................................................................................................................. 8 Vacation Use............................................................................................................................................ 8 Holidays Occurring During Vacation ................................................................................................. 8 Vacation for Family Care and Medical Leave Purpose..................................................................... 8 Personal Leave ........................................................................................................................................ 8 Eligibility .......................................................................................................................................... 8 Use..................................................................................................................................................... 8 Leaves of Absence .................................................................................................................................. 9 Family Care and Medical Leave........................................................................................................... 9 Eligibility .......................................................................................................................................... 9 vi

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Legally Required Leaves of Absence............................................................................................ 9 Workplace Rules and Procedures............................................................................................................ 9 Rules of Conduct and Discipline.......................................................................................................... 9 Policy................................................................................................................................................. 9 Job Performance ............................................................................................................................ 10 Misconduct..................................................................................................................................... 10 Attendance ..................................................................................................................................... 11 Discipline Procedure..................................................................................................................... 11 Personnel Records ................................................................................................................................ 11 Conflicts of Interest .............................................................................................................................. 11 Security and Confidential Information ............................................................................................. 12 Proprietary and Confidential Information........................................................................................ 13 Obligations on Termination ................................................................................................................ 13 Technology Use and Privacy .............................................................................................................. 13 Technology Resources Definition ............................................................................................... 14 Authorization................................................................................................................................. 14 Use................................................................................................................................................... 14 Improper Use ........................................................................................................................................ 14 Prohibition Against Harassing, Discriminatory and Defamatory Use.................................. 14 Prohibition Against Violating Copyright Laws........................................................................ 15 Other Prohibited Uses .................................................................................................................. 15 Access To Technology Resources....................................................................................................... 15 Privacy ............................................................................................................................................ 15 Passwords....................................................................................................................................... 15 Data Collection .............................................................................................................................. 16 vii

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Deleted Information...................................................................................................................... 16 The Internet and Online Services................................................................................................ 16 Confidentiality............................................................................................................................... 17 Monitoring ..................................................................................................................................... 17 Software Use .................................................................................................................................. 17 Confidential Information ............................................................................................................. 18 Security ........................................................................................................................................... 18 Audits ............................................................................................................................................. 18 Drug-Free Workplace .......................................................................................................................... 18 Purpose of Guideline .................................................................................................................... 18 Employee Cooperation................................................................................................................. 19 Definitions ...................................................................................................................................... 19 Prohibited Conduct....................................................................................................................... 19 Alcohol............................................................................................................................................ 20 Illegal Drugs................................................................................................................................... 20 Legal Drugs.................................................................................................................................... 20 Disciplinary Action ....................................................................................................................... 20 Effect of Criminal Conviction...................................................................................................... 21 Effect of Discharge on Eligibility for Rehire.............................................................................. 21 Criminal Convictions.................................................................................................................... 21 Use of Legal Drugs........................................................................................................................ 21 Customary Use of Over-the-Counter Drugs ............................................................................. 22 Off-the-Job Conduct...................................................................................................................... 22 Authorized Use of Alcohol .......................................................................................................... 22 Confidentiality............................................................................................................................... 22 viii

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Inspections and Searches on Company Premises..................................................................... 22 Purpose of the Guideline ................................................................................................................. 22 Definitions.......................................................................................................................................... 22 Inspections and Searches ............................................................................................................. 23 Access to Company Property ...................................................................................................... 23 Inspections and Searches for Prohibited Materials .................................................................. 23 Disciplinary Action ....................................................................................................................... 24 Termination ........................................................................................................................................... 24 Voluntary Termination................................................................................................................. 24 Involuntary Termination.............................................................................................................. 24 Termination Due to Reorganizations, Economics, or Lack of Work...................................... 24 Workplace Safety ..................................................................................................................................... 25 Policy...................................................................................................................................................... 25 Safety Rules ........................................................................................................................................... 25 Corporal Punishment........................................................................................................................... 25 Miscellaneous ........................................................................................................................................... 26 Open Door Policy ................................................................................................................................. 26 Lobbying-Political and Sectarian Activities...................................................................................... 26 Travel and Expense Accounts............................................................................................................. 27 Exit Interview........................................................................................................................................ 27 Violence in the Workplace .................................................................................................................. 27 Workplace Violence Defined....................................................................................................... 27 Reporting........................................................................................................................................ 28 Investigation .................................................................................................................................. 28 Corrective Action and Discipline................................................................................................ 28 ix

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Arbitration ............................................................................................................................................. 28 Hiring-Nepotism .................................................................................................................................. 28

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URGENT Inc. Employee Manual

Introduction This manual is intended to outline and explain URGENT Inc.’s personnel policies. This employee manual should be regarded as a set of guidelines only. It is not a contract. Neither the policies in this manual, nor any other written or verbal communication by a company officer, manager or supervisor are intended to create a contract of employment or a warranty of benefits. The policies in this manual may be amended, modified, deleted or otherwise changed by URGENT without prior notice. This manual supersedes and replaces all prior employee manuals, handbooks, policies or procedures. If you have any questions about any of the policies or procedures in this manual, please consult the Vice President.

At-Will Employment Under Florida law, employment contracts which do not specify a definite term of employment are terminable "at will." In other words, an employee can quit or be fired at anytime for any reason, other than those proscribed by law (e.g., race, sex, handicap, age, etc.). Accordingly, URGENT has an “atwill” employment policy, which means that the term of employment is for no definite period and may be terminated by the employee or by URGENT at any time and for any reason, with or without cause or advance notice.

Mandatory Background Screening In accordance with Sections 943.0542, 984.01, Chapter 435, 402, 39.001, and 1012.465 Florida Statutes, and pursuant to the requirements of Paragraph R. Background Screening, URGENT required all direct service employees to submit to a Level II back ground screening with the Florida Dept. of Law Enforcement prior to hiring. Current must be rescreened every 5 years.

Equal Employment Opportunity Our company is committed to the principals of Equal Employment Opportunity and is committed to making employment decisions based on merit and value. We are committed to complying with all Federal, State, and local laws providing Equal Employment Opportunities, as well as all laws related to terms and conditions of employment. We desire to keep a work environment which is free of harassment or discrimination because of sex, race, religion, color, national origin, sexual orientation, physical or mental disability, marital status, age or any other status protected by Federal, State or local laws. We value diversity and are willing to employ men and women of all ethnic and racial groups, ranging in age from the teens to the sixties and older, and representing a broad spectrum of religions and national origins. The company will make every reasonable effort to accommodate those physical or mental limitations of an otherwise qualified employee, unless undue hardship would result for the company.

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Just as the company bears a responsibility towards this policy, each of us must clearly communicate our disinterest in, or offense taken to, any perceived verbal or physical discrimination or harassment. We are all responsible for upholding this Equal Employment Opportunity policy and commitment. Equal Employment Opportunity laws afford each one of us the chance to succeed or fail based on individual merit. Prohibited sexual harassment is defined as follows: “Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitutes sexual harassment when (1) submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment (2) submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individual or (3) such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile or offensive work environment. Our company will not tolerate any form of discrimination or harassment! Any employee who feels that he or she has witnessed, or been subject to, any form of discrimination or harassment should immediately notify their supervisor, personnel administrator or other manager at the company. We will promptly investigate any claim and take appropriate action. We will seek to impose appropriate sanctions against any person found to be in violation of this policy. Such sanctions may include, but are not limited to, reprimand, suspension, demotion, transfer and discharge. Our company prohibits retaliation against any employee who brings forth any complaint or assists in the investigation of any complaint. If you feel we have not resolved your complaint, and after you have followed the company grievance procedure, you can complain to the EEOC, or State Fair Employment Office found in the local phone book. It is URGENT’s policy to provide equal employment opportunity for all applicants and employees. URGENT does not unlawfully discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions), national origin, ancestry, age, physical disability, mental disability, medical condition, family care status, veteran status, marital status, or sexual orientation. URGENT also makes reasonable accommodations for disabled employees. Finally, URGENT prohibits the harassment of any individual on any of the bases listed above. For information about the types of conduct that constitute impermissible harassment and URGENT’s internal procedures for addressing harassment complaints, please refer to the Policy Against Harassment below.

This non-discrimination policy applies to all areas of employment including recruitment, hiring, training, promotion, compensation, benefits, transfer, and social and recreational programs. It is the responsibility of every manager and employee to conscientiously follow this policy. Any employee having any questions regarding this policy should discuss them with the Vice President of Operations. 2


Policy Against Harassment URGENT is committed to providing a workplace free of sexual harassment (which includes harassment based on gender, pregnancy, childbirth, or related medical conditions), as well as harassment based on such factors as race, color, religion, national origin, ancestry, age, physical disability, mental disability, medical condition, marital status, sexual orientation, family care or medical leave status, or veteran status. URGENT strongly disapproves of and will not tolerate harassment of employees by managers, supervisors, or co-workers. Similarly, URGENT will not tolerate harassment by its employees of non-employees with whom URGENT employees have a business, service, or professional relationship. Harassment includes verbal, physical, and visual conduct that creates an intimidating, offensive, or hostile working environment or that interferes with work performance. Such conduct constitutes harassment when (1) submission to the conduct is made either an explicit or implicit condition of employment; (2) submission to or rejection of the conduct is used as the basis for an employment decision; or (3) the harassment interferes with an employee’s work performance or creates an intimidating, hostile, or offensive work environment. Harassing conduct can take many forms and includes], but is not limited to, the following: slurs, jokes, statements, gestures, assault, impeding or blocking another’s movement or otherwise physically interfering with normal work, pictures, drawings, or cartoons based upon an employee’s sex, race, color, national origin, religion, age, physical disability, mental disability, medical condition, ancestry, marital status, sexual orientation, family care or medical leave status, or veteran status. Sexually harassing conduct in particular includes all of these prohibited actions as well as other unwelcome conduct such as requests for sexual favors, conversation containing sexual comments, and unwelcome sexual advances. Any incident of harassment, including work-related harassment by any Company personnel or any other person, should be reported promptly to the employee’s supervisor or manager (or to any other member of management) or to Vice President of Operations, who is responsible for investigating the matter. Managers who receive complaints or who observe harassing conduct should inform Vice President of Operations immediately. URGENT emphasizes that an employee is not required to complain first to his or her supervisor if that supervisor is the individual who is harassing the employee. Every reported complaint of harassment will be investigated thoroughly, promptly, and in a confidential manner. In addition, URGENT will not tolerate retaliation against any employee for cooperating in an investigation or for making a complaint to Vice President of Operations or any other manager. In the case of Company employees, if harassment is established, URGENT will discipline the offender. Disciplinary action for a violation of this policy can range from verbal or written warnings up to and including immediate termination, depending upon the circumstances. With regard to acts of

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harassment by customers or vendors, corrective action will be taken after consultation with the appropriate management personnel.

Grievance Procedure Purpose and Scope Urgent, Inc. wishes to provide a comfortable, productive, legal and ethical work environment. To this end, the company wants you to bring any grievances you have about the work place to the attention of your supervisor and, if necessary, to upper level management. In light of these concerns we have instituted the following grievance procedure: If you feel that there is inappropriate conduct or activity on the part of the company, management, its employees, vendors, customers, or any other persons or entities related to the company, we request that you bring this concern to the immediate attention of your supervisor. Please try to approach your supervisor at a time and place that will allow the supervisor to properly listen to your concerns. If you have discussed this matter with your supervisor previously and you do not believe that you have received a sufficient response, we request that you present your concerns to your supervisor in writing. Please indicate what the problem is, those persons involved in the problem, and any suggested solution you may have to the problem. If you do not receive a sufficient response to your written complaint within three (3) working days from providing it to your supervisor, or if your supervisor is the problem, you should contact the next level of supervision (The President), and so on. If you consider the matter an emergency, legal, ethical or safety issue, use your best judgment to expedite the complaint process. The company may have a conference with you and your supervisor or with both of you individually. If the matter is not resolved after that conference, and you believe it still merits attention, it is requested that you immediately place your concerns in writing and bring the matter forward to the Board of Directors. It is the purpose of this grievance procedure to help maintain a positive work environment with respect and responsibility towards each other. The grievance procedure is also intended to avoid unnecessary employee claims and company legal exposure. The company cannot promise that your specific grievance or complaint will result in the action you request or that you will be satisfied with the outcome of the grievance procedure.

Procedure Filing of Complaint Employees should file written complaints with the Vice President of Operations as soon as possible after the events that give rise to the employees’ work-related concerns. The written complaint should set forth in detail the bases for the employee’s complaint. Investigation The Vice President of Operations dates and logs all written complaints and sends the employee an acknowledgment that the complaint is under review. 4


The Vice President of Operations or his/her/its designee investigates the complaint, meeting separately with the employee and with others who either are named in the complaint or who may have knowledge of the facts set forth in the complaint. URGENT will attempt to treat all internal complaints and their investigation as confidential, recognizing, however, that in the course of investigating and resolving internal complaints some dissemination of information to others may be appropriate. On completion of the investigation, the Vice President of Operations orally reports its findings and conclusions to the employee. If the complaint is resolved to the employee’s satisfaction, the terms of the resolution should be recorded and signed by both the employee and the Vice President of Operations. Appeal If the complaint is not resolved to the employee’s satisfaction, the employee may submit a written request for review of the complaint to the President. On completion of the appeal review, the employee should receive an oral explanation of the conclusion reached and the reasons for that conclusion. Decisions resulting from appeal reviews by the President will be final. Non-Retaliation If an employee has filed a complaint in good faith, the employee should not be disciplined or otherwise penalized because of the complaint, regardless of whether or not the complaint is sustained. If it appears that the complaint was not filed in good faith, approval of the Vice President of Operations should be obtained before taking any action.

Hours of Work, Overtime and Pay Day Hours of Work Work hours vary. For full time employees, schedules may vary between an 8-12 hour work day, with one half hour, unpaid, for lunch, with two ten-minute paid break periods for each full workday, one in mid-morning and one in mid-afternoon. URGENT reserves the right to modify employees' starting and quitting times and the number of hours worked. Overtime Pay

Overtime Definition and Pay Rates URGENT will pay overtime consistent with applicable federal and state law and regulations. However, ALL over-time must be pre-approved. Exempt employees do not earn overtime, but accumulate comp time to be used when submitted for approval.

Pay Period All employees are responsible for completing a time sheet for each pay period. Time sheets must be signed by the employees immediate supervisor. The supervisor is responsible for submitting time sheets to the Finance Officer. Each pay period begins on the 1st and 16th of every month. 5


Place and Time for Payment of Wages Salaried employees will be paid by check or direct deposit on the 15th or last day of the month for the current pay period. Hourly employees will be paid by check or direct deposit on the 15th or last day of the month for the previous pay period. If a regular payday falls on a holiday or weekend every effort will be made to have paychecks/direct deposit ready for distribution on the day before. However, we reserve the right to distribute checks/direct deposits on the next business day.

Payment on Resignation of Termination If an employee resigns, his or her paycheck will be available on the next scheduled payday. His or her paycheck will be mailed by regular mail to his or her last known address. The employee’s final paycheck will include payment for all wages due and not previously paid and for accrued but unused vacation time, minus authorized deductions.

Performance and Pay Review URGENT is a meritocracy. Compensation and benefits are tied directly to performance. Employees receive performance reviews once a year, with the exception of a four-month review at the end of your probationary period. The purpose of the review is to evaluate your current level of performance, to examine the progress you have made since the last review, and to establish goals for your next review. Additionally, your reporting supervisor will review and discuss your salary range and your position within that range during your performance reviews. When you are promoted to a higher-level position, you may be eligible for an increase as dictated by the salary range of that position and funding availability.

Employee Benefits Health Insrance URGENT currently offers health insurance for Full time employees meeting the criteria set forth by the health insurance provider and Board of Directors of Urgent, Inc. Prior to the beginning of coverage full time employees must have successfully completed their probationary period. Other criteria may be instituted as needed.

Worker’s Compensation Insurance URGENT carries workers’ compensation when required by law to protect employees who are injured on the job. This insurance provides medical, surgical, and hospital treatment in addition to payment for loss of earnings that result from work-related injuries.

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Holidays, Vacation, Sick Leave and Leaves of Absence Holidays All full-time employees who have completed their probationary period receive time off with pay at their normal base rate. URGENT observes the following standard holidays: Presidents' Day, Independence Day, Thanksgiving, Labor Day, Memorial Day and Christmas Day through New Years Day are paid due to office closure.

Weekends and Vacations Holidays falling on a Saturday or Sunday are normally observed on the preceding Friday or the following Monday, respectively. All Fridays following a Thursday Holiday are paid holidays. Holidays that occur during an employee’s vacation are not to be counted as vacation days taken.

Eligibility Part-time and temporary employees and contractors are ineligible for holiday benefits. All employees are ineligible for holiday benefits that accrue while on leave of absence.

Vacation Policy URGENT provides vacation benefits to eligible employees to enable them to take paid time off for rest and recreation. URGENT believes this time is valuable for employees in order to enhance their productivity and to make their work experience with URGENT personally satisfying. URGENT also provides long-service employees with additional vacation benefits as years of service are accumulated.

Accrual of Vacation Time All regular full-time employees who have completed four (4) months of continuous service, measured from the date of hire, are eligible for vacation benefits. ‘‘Continuous service’’ is defined as service that is uninterrupted by termination of employment and subsequent rehire by URGENT or a break in service that has been bridged. Vacation accrues up to a maximum of 5 days per year for employees first two years of service, one day a year is added per year up to a maximum of 15 vacation days per year.

Part-time and Temporary Employees Part-time employees do not accrue vacation benefits. No part-time employee regardless of status receives holiday pay or personal days.

Pay in Lieu of Vacation No employee will receive pay in lieu of vacation except on the termination of his or her employment, as described below, unless the employee has deferred his or her vacation at URGENT‘s request.

Vacation Accrual During Leaves of Absence No vacation accrues during an unpaid leave of absence or while on disability salary continuation. Vacation accruals recommence when the employee returns to work.

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Vacation Pay on Termination On termination of employment, the employee is paid all accrued but unused vacation at the employee’s base rate of pay at the time of his or her termination.

Vacation Approval All vacations must be approved at least 6 weeks in advance.

Vacation Scheduling Scheduling of vacations is to be done in a manner consistent with URGENT’s operational requirements. Employees must submit vacation requests at least six weeks prior to the commencement of a vacation period to their immediate supervisor for approval. In the event that two or more employees have requested vacations covering the same period and may not be absent simultaneously, preference shall be give to the employee with the greater length of service. Subject to supervisor approval, an employee may otherwise schedule and take vacation at any time once it has accrued.

Vacation Use All vacation days should be taken not later than the calendar year immediately following the year in which they accrue, unless prior approval is obtained from the supervisor.

Holidays Occurring During Vacation If an observed Company holiday (see guideline entitled “Holidays”) occurs during an employee’s scheduled vacation, no deduction from accrued vacation will be made for the holiday period. An employee may add to his or her vacation period by adding to or using the holiday period in place of accrued vacation time.

Vacation for Family Care and Medical Leave Purpose Employees who request family care or medical leave pursuant to URGENT's Family Care and Medical Leave policy must apply any available accrued vacation pay to their family or medical leave.

Personal Leave In order to help prevent loss of earnings caused by accident or illness, or by other emergencies, URGENT has established paid personal leave. Eligibility All regular full-time employees are eligible for 3 days personal leave per calendar year. Regular part-time employees are ineligible for personal leave. Employees cannot use personal leave during their introductory periods. Temporary employees are ineligible to earn or receive personal leave benefits. Use Up to employee’s discretion.

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Leaves of Absence At which time URGENT meets the federal guidelines for complying with the (A) Family and Medical Leave Act of 1993; (B) disability leave as required to reasonably accommodate employees with a qualified disability under the Americans with Disabilities Act (“ADA”) or with a workplace injury; and (C) federal guidelines will be followed. Employees having any questions regarding this policy should contact the Vice President of Operations.

Family Care and Medical Leave Eligibility To be eligible for family care and medical leave, an employee must (1) have worked for URGENT for at least twelve months prior to the date on which the leave is to commence; and (2) have worked at least 1,250 hours in the twelve (12) months preceding the leave. However, employees who work at a location where URGENT employs fewer than 50 persons within 75miles are not eligible for family care and medical leave. Legally Required Leaves of Absence Employees will be granted a leave of absence as required by law for the purpose of fulfilling any required legal or military obligation (e.g., jury duty, appearance as a witness in a legal proceeding, military reserve duty, appearance at school by a parent when requested pursuant to the Education Code, or performance of emergency duty by a volunteer firefighter). Employees are required to provide reasonable advance notice of any need for such leave and are expected to return to work each day or portion of the day that they are not selected for jury duty or called as a witness. For non-exempt employees, this leave will be unpaid. For exempt employees, salary during leave will be offset by any amounts received as jury or witness fees or as military pay, and no salary will be paid for workweeks in which no Company work is performed. Employees who do not have sufficient time outside of their regular working hours to vote in a statewide election may request time off to vote. If possible, employees should make their request at least two days in advance of the election. Up to two hours of paid time off will be provided, at the beginning or end of the employee’s regular shift, whichever will allow the most free time for voting and the least time off work.

Workplace Rules and Procedures Rules of Conduct and Discipline Policy Employees are expected to observe certain standards of job performance and good conduct. When performance or conduct does not meet Company standards, URGENT will endeavor when it deems appropriate to provide the employee a reasonable opportunity to correct the 9


deficiency. If, however, the employee fails to make the correction, he or she will be subject to discipline including termination. The rules set forth below are intended to provide employees with fair notice of what is expected of them. Necessarily, however, such rules cannot identify every type of unacceptable conduct and performance. Therefore, employees should be aware that conduct not specifically listed below but which adversely affects or is otherwise detrimental to the interests of URGENT, other employees, or customers, may also result in disciplinary action. Nothing in these rules is intended to modify the at-will nature of your employment with the company. Job Performance Employees may be disciplined for poor job performance, including but not limited to the following:  Unsatisfactory work quality or quantity;  Poor attitude (for example, rudeness or lack of cooperation);  Excessive absenteeism, tardiness, or abuse of break and lunch privileges;  Failure to follow instructions or Company procedures; or  Failure to follow established safety regulations.

Misconduct Employees may be disciplined for misconduct, including but not limited to the following:  Insubordination;  Dishonesty;  Theft;  Discourtesy;  Misusing or destroying Company property or the property of another on Company premises;  Violating conflict of interest rules;  Disclosing or using confidential or proprietary information without authorization;  Falsifying or altering Company records, including the application for employment;  Interfering with the work performance of others;  Altercations;  Harassing, including sexually harassing, employees or customers;  Being under the influence of, manufacturing, dispensing, distributing, using, or possessing alcohol or illegal or controlled substances on Company property or while conducting Company business;  Gambling on Company premises or while conducting Company business;  Sleeping on the job or leaving the job without authorization;  Possessing a firearm or other dangerous weapon on Company property or while conducting Company business; or 10


 Being convicted of a crime that indicates unfitness for the job or raises a threat to the safety or well-being of URGENT, its employees, customers, or property; or  Failing to report to URGENT, within five days, any conviction under any criminal drug statute for a violation occurring in the workplace].

Attendance In addition to the general rules stated above, employees may be disciplined for failing to observe the following specific requirements relating to attendance:  Reporting to work on time, observing the time limits for rest and lunch periods, and obtaining approval to leave work early; and  Notifying the supervisor in advance of anticipated tardiness or absence.

Discipline Procedure Except as set forth below, an oral warning and a written warning ordinarily will precede discharge for poor performance. URGENT reserves the right to proceed directly to a written warning or to termination for misconduct or performance deficiency, without resort to prior disciplinary steps, when URGENT deems such action appropriate. Nothing in these rules is intended to modify the atwill nature of your employment with the company.

Personnel Records The information in the employee’s personnel file is permanent and confidential, and must be kept upto-date. The employee should inform the Personnel Manager immediately whenever there are changes in personal data such as address, telephone number, marital status, number of dependents, and person(s) to notify in case of emergency. The employee has the right to inspect his or her personnel file at reasonable times at a reasonable place, and on reasonable notice. In addition, employees have the right to request copies of all employmentrelated documents that they have signed. An employee may inspect only his or her own personnel file and only in the presence of the Personnel Manager. Personnel files are the property of URGENT and may not be removed from URGENT’s premises without written authorization from the Personnel Manager.

Conflicts of Interest Employees are expected to devote their best efforts and attention to the full-time performance of their jobs. They are expected to use good judgment, to adhere to high ethical standards, and to avoid situations that create an actual or potential conflict between the employee’s personal interests and the interests of URGENT. A conflict of interest exists when the employee’s loyalties or actions are divided between URGENT’s interests and those of another, such as a competitor, supplier, or customer. Both the fact and the appearance of a conflict of interest should be avoided. Employees unsure as to 11


whether a certain transaction, activity, or relationship constitutes a conflict of interest should discuss it with their immediate supervisor or the Personnel Manager for clarification. The President must approve any exceptions to this guideline in writing. While it is not feasible to describe all possible conflicts of interest that could develop, some of the more common conflicts, from which employees should refrain, include the following:     

   

Accepting personal gifts or entertainment from competitors, customers, suppliers, or potential suppliers; Working for a competitor, supplier, or customer; Engaging in self-employment in competition with URGENT; Using proprietary or confidential Company information for personal gain or to URGENT’s detriment; Having a direct or indirect financial interest in or relationship with a competitor, customer, or supplier, except that ownership of less than one percent (1%) of the publicly traded stock of a corporation will not be considered a conflict; Developing a personal relationship with a subordinate employee of URGENT that might interfere with the exercise of impartial judgment in decisions affecting URGENT or any employees of URGENT. Using Company assets or labor for personal use; Acquiring any interest in property or assets of any kind for the purpose of selling or leasing it to URGENT; Committing URGENT to give its financial or other support to any outside activity or organization; If an employee or someone with whom an employee has a close relationship (a family member or close companion) has a financial or employment relationship with a competitor, customer, supplier, or potential supplier, the employee must disclose this fact in writing to the Personnel Department. Employees should be aware that if they enter into a personal relationship with a subordinate employee or with an employee of a competitor, supplier, or customer, a conflict of interest may exist, which requires full disclosure to URGENT.

Part-time employees may engage in outside employment, provided that they disclose such employment and get approval from their immediate supervisor. Failure to adhere to this guideline, including failure to disclose any conflicts or to seek an exception, will result in discipline, up to and including termination of employment.

Security and Confidential Information The security of employees, employee property, and Company property is of vital importance to URGENT. All employees share responsibility to ensure that proper security is maintained.

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Proprietary and Confidential Information Company property includes not only tangible property, like desks and typewriters, but also intangible property such as information. Of particular importance are proprietary information and confidential information. Proprietary information includes all information obtained by Company employees during the course of their work. This Manual, for example, contains proprietary information. Confidential information is any Company information that is not known generally to the public or the industry. Customer lists, customer files, personnel files, client files, program manuals, grant proposals, computer records, financial and marketing data, process descriptions, research plans, formulas, and trade secrets are examples of confidential information. Given the nature of URGENT’s business, protecting proprietary and confidential information is of vital concern to URGENT. This information is one of the most important assets of URGENT. It enhances URGENT’s opportunities for future growth, and indirectly adds to the job security of all employees. Employees must not use or disclose any proprietary or confidential information that they obtain during employment with URGENT, except as required by their jobs. This obligation remains even after an employee’s employment relationship with URGENT ends. If an employee is in a position that gives him or her access to particularly sensitive information, the employee may be required to sign a written nondisclosure agreement. In addition, all employees must observe good security practices. They are expected to keep proprietary and confidential information secure from outside visitors and all other persons who do not have a legitimate reason to see or use such information. Company rules regarding document control, restricted access to areas of the facility, and other such procedures must be strictly observed by each employee. Failure to adhere to Company policies regarding proprietary and confidential information will be considered grounds for discipline, including dismissal. In addition to observing this policy, you will be asked to sign a written nondisclosure agreement.

Obligations on Termination On termination of employment, whether voluntary or involuntary, all Company documents and other tangible Company property in the employee’s possessions or control must be returned to URGENT.

Technology Use and Privacy URGENT provides various Technology Resources to authorized employees to assist them in performing their job duties for URGENT. Each employee has a responsibility to use URGENT’s Technology Resources in a manner that increases productivity, enhances URGENT’s public image, and is respectful of other employees. Failure to follow URGENT’s policies regarding its Technology Resources may lead to disciplinary measures, up to and including termination of employment. Moreover, URGENT reserves the right to advise appropriate legal authorities of any violation of law by an employee.

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Technology Resources Definition Technology Resources consist of all electronic devices, software, and means of electronic communication including, but not limited to, the following: personal computers and workstations; lap-top computers; mini and mainframe computers; computer hardware such as disk drives and tape drives; peripheral equipment such as printers, modems, fax machines, and copiers; computer software applications and associated files and data, including software that grants access to external services, such as the Internet; electronic mail; telephones; cellular phones; pagers; and voicemail systems. Authorization Access to URGENT‘s Technology Resources is within the sole discretion of URGENT. Generally, employees are given access to URGENT’s various technologies based on their job functions. Only employees whose job performance will benefit from the use of URGENT’s Technology Resources will be given access to the necessary technology. Additionally, employees must successfully complete Company-approved training before being given access to URGENT’s Technology Resources. Use URGENT’s Technology Resources are to be used by employees only for the purpose of conducting Company business. Employees may, however, use URGENT’s Technology Resources for the following incidental personal uses so long as such use does not interfere with the employee's duties, is not done for pecuniary gain, does not conflict with URGENT’s business, and does not violate any Company policy:    

To send and receive necessary and occasional personal communications; To prepare and store incidental personal data (such as personal calendars, personal address lists, and similar incidental personal data) in a reasonable manner; To use the telephone system for brief and necessary personal calls; and To access the Internet for brief personal searches and inquiries during meal times or other breaks, or outside of work hours, provided that employees adhere to all other usage policies.

URGENT assumes no liability for loss, damage, destruction, alteration, disclosure, or misuse of any personal data or communications transmitted over or stored on URGENT’s Technology Resources. URGENT accepts no responsibility or liability for the loss or non-delivery of any personal electronic mail or voicemail communications or any personal data stored on any Company property. URGENT strongly discourages employees from storing any personal data on any of URGENT’s Technology Resources.

Improper Use Prohibition Against Harassing, Discriminatory and Defamatory Use URGENT is aware that employees use electronic mail for correspondence that is less formal than written memoranda. Employees must take care, however, not to let informality 14


degenerate into improper use. As set forth more fully in URGENT’s “Policy Against Harassment,” URGENT does not tolerate discrimination or harassment based on gender, pregnancy, childbirth (or related medical conditions), race, color, religion, national origin, ancestry, age, physical disability, mental disability, medical condition, marital status, sexual orientation, family care or medical leave status, veteran status, or any other status protected by state and federal laws. Under no circumstances may employees use URGENT’s Technology Resources to transmit, receive, or store any information that is discriminatory, harassing, or defamatory in any way (e.g., sexually-explicit or racial messages, jokes, cartoons). Prohibition Against Violating Copyright Laws Employees must not use URGENT’s Technology Resources to copy, retrieve, forward or send copyrighted materials unless the employee has the author’s permission or is accessing a single copy only for the employee’s reference. Other Prohibited Uses Employees may not use any of URGENT’s Technology Resources for any illegal purpose, violation of any Company policy, in a manner contrary to the best interests of URGENT, in any way that discloses confidential or proprietary information of URGENT or third parties, or for personal or pecuniary gain.

Access To Technology Resources All messages sent and received, including personal messages, and all data and information stored on URGENT’s electronic-mail system, voicemail system, or computer systems are Company property regardless of the content. As such, URGENT reserves the right to access all of its Technology Resources including its computers, voicemail, and electronic-mail systems, at any time, in its sole discretion. Privacy Although URGENT does not wish to examine personal information of its employees, on occasion, URGENT may need to access its Technology Resources including computer files, electronic-mail messages, and voicemail messages. Employees should understand, therefore, that they have no right of privacy with respect to any messages or information created or maintained on URGENT’s Technology Resources, including personal information or messages. URGENT may, at its discretion, inspect all files or messages on its Technology Resources at any time for any reason. URGENT may also monitor its Technology Resources at any time in order to determine compliance with its policies, for purposes of legal proceedings, to investigate misconduct, to locate information, or for any other business purpose. Passwords Certain of URGENT’s Technology Resources can be accessed only by entering a password. Passwords are intended to prevent unauthorized access to information. Passwords do not confer any right of privacy upon any employee of URGENT. Thus, even though employees may maintain passwords for accessing Technology Resources, employees must not expect 15


that any information maintained on Technology Resources, including electronic-mail and voicemail messages, are private. Employees are expected to maintain their passwords as confidential. Employees must not share passwords and must not access coworkers’ systems without express authorization. Data Collection The best way to guarantee the privacy of personal information is not to store or transmit it on URGENT’s Technology Resources. To ensure that employees understand the extent to which information is collected and stored, below are examples of information currently maintained by URGENT. URGENT may, however, in its sole discretion, and at any time, alter the amount and type of information that it retains. 

Telephone Use and Voicemail: Records are kept of all calls made from and to a given telephone extension. Although voicemail is password protected, an authorized administrator can reset the password and listen to voicemail messages.

Electronic Mail: Electronic mail is backed-up and archived. Although electronic mail is password protected, an authorized administrator can reset the password and read electronic mail.

Desktop Facsimile Use: Copies of all facsimile transmissions sent and received are maintained in the facsimile server.

Document Use: Each document stored on Company computers has a history, which shows which users have accessed the document for any purpose.

Internet Use: Internet sites visited, the number of times visited, and the total time connected to each site is recorded and periodically monitored.

Deleted Information Deleting or erasing information, documents, or messages maintained on URGENT’s Technology Resources is, in most cases, ineffective. All employees should understand that any information kept on URGENT’s Technology Resources may be electronically recalled or recreated regardless of whether it may have been “deleted” or “erased” by an employee. Because URGENT periodically backs-up all files and messages, and because of the way in which computers re-use file storage space, files and messages may exist that are thought to have been deleted or erased. Therefore, employees who delete or erase information or messages should not assume that such information or messages are confidential. The Internet and Online Services URGENT provides authorized employees access to on-line services such as the Internet. URGENT expects that employees will use these services in a responsible way and for business-related purposes only. Under no circumstances are employees permitted to use URGENT’s Technology Resources to access, download, or contribute to the following: 16


        

gross, indecent, or sexually-oriented materials; sports sites; job-search sites; entertainment sites; gambling sites; games, humor; illegal drug-oriented sites; personal pages of individuals; and politically-oriented sites or sites devoted to influencing the course of legislation or public policy.

Additionally, employees must not sign “guest books” at Web sites or post messages to Internet news groups or discussion groups at Web sites. These actions will generate junk electronic mail and may expose URGENT to liability or unwanted attention because of comments that employees may make. URGENT strongly encourages employees who wish to access the Internet for non-work-related activities to get their own personal Internet access accounts. Confidentiality Some of the information to which URGENT has access is confidential. Employees should avoid sending confidential information over the Internet, except when absolutely necessary. Employees also should verify electronic mail addresses before transmitting any messages. Monitoring URGENT monitors both the amount of time spent using on-line services and the sites visited by individual employees. URGENT reserves the right to limit such access by any means available to it, including revoking access altogether. Software Use  License Restrictions All software in use on URGENT’s Technology Resources is officially licensed software. No software is to be installed or used that has not been duly paid for and licensed appropriately for the use to which it is being put. No employee may load any software on URGENT’s computers, by any means of transmission, unless authorized in advance. Authorization for loading software onto URGENT’s computers should not be given until the software to be loaded has been thoroughly scanned for viruses. 

Software for Home Use

URGENT endeavors to license its software so that it may be used on portable computers and home computers in addition to office computers. Before transferring or copying any software from a Company Technology Resource to another computer, employees must request permission and receive written authorization from the Vice President of Operations. 17


Confidential Information URGENT is very sensitive to the issue of protection of trade secrets and other confidential and proprietary information of both URGENT and third parties (“Confidential Information”). Therefore, employees are expected to use good judgment and to adhere to the highest ethical standards when using or transmitting Confidential Information on URGENT’s Technology Resources. Confidential Information should not be accessed through URGENT’s Technology Resources in the presence of unauthorized individuals. Similarly, Confidential Information should not be left visible or unattended. Moreover, any Confidential Information transmitted via Technology Resources should be marked with the following legend: “This message contains confidential information. Unless you are the addressee (or authorized to receive for the addressee), you may not copy, use, or distribute this information. If you have received this message in error, please call 888-205-8690 or return it promptly by mail.” Security URGENT has installed a variety of programs and devices to ensure the safety and security of URGENT’s Technology Resources. Any employee found tampering or disabling any of URGENT’s security devices will be subject to discipline up to and including termination. Audits URGENT may perform auditing activity or monitoring to determine compliance with these policies. Audits of software and data stored on URGENT’s Technology Resources may be conducted without warning at any time.

Drug-Free Workplace Purpose of Guideline It is the intent of URGENT to maintain a workplace that is free of drugs and alcohol and to discourage drug and alcohol abuse by its employees. URGENT has a vital interest in maintaining safe and efficient working conditions for its employees. Substance abuse is incompatible with health, safety, efficiency, and success at URGENT. Employees who are under the influence of a drug or alcohol on the job compromise URGENT’s interests, endanger their own health and safety and the health and safety of others, and can cause a number of other work-related problems, including absenteeism and tardiness, substandard job performance, increased workloads for co-workers, behavior that disrupts other employees, delays in the completion of jobs, inferior quality in products or service, and disruption of customer relations. To further its interest in avoiding accidents, to promote and maintain safe and efficient working conditions for its employees, and to protect its business, property, equipment, and operations, URGENT has established this Guideline concerning the use of alcohol and drugs. As a condition of continued employment with URGENT, each employee must abide by this Guideline. 18


Employee Cooperation Early detection of substance-abuse problems benefits everyone. For example, it benefits the employee with the substance-abuse problem because it gives him or her the opportunity to correct the problem before it leads to serious harm to the employee or others; it benefits the employee's co-workers who otherwise might have to carry an extra burden by ‘‘covering’’ for the substance abuser or who otherwise might be exposed to serious injury; and it benefits URGENT because it gives URGENT an opportunity to prevent accidents and avoid the performance problems and other losses associated with substance abuse. Accordingly, all employees should understand that co-workers with substance-abuse problems should be encouraged to seek assistance. Definitions For purposes of this Guideline: “Illegal drugs or other controlled substances” means any drug or substance that (a) is not legally obtainable; or (b) is legally obtainable but has not been legally obtained; or (c) has been legally obtained but is being sold or distributed unlawfully. “Legal drug” means any drug, including any prescription drug or over-the-counter drug, that has been legally obtained and that is not unlawfully sold or distributed. “Abuse of any legal drug” means the use of any legal drug (a) for any purpose other than the purpose for which it was prescribed or manufactured; or (b) in a quantity, frequency, or manner that is contrary to the instructions or recommendations of the prescribing physician or manufacturer. “Reasonable suspicion” includes a suspicion that is based on specific personal observations such as an employee’s manner, disposition, muscular movement, appearance, behavior, speech or breath odor; information provided to management by an employee, by law enforcement officials by a security service, or by other persons believed to be reliable; or a suspicion that is based on other surrounding circumstances. “Possession” means that an employee has the substance on his or her person or otherwise under his or her control. Prohibited Conduct The prohibitions of this section apply whenever the interests of URGENT may be adversely affected, including any time the employee is:  On Company premises;  Conducting or performing Company business, regardless of location;  Operating or responsible for the operation, custody, or care of Company equipment or other property; or  Responsible for the safety of others. 19


Alcohol The following acts are prohibited and subject an employee to discharge:  The unauthorized use, possession, purchase, sale, manufacture, distribution, transportation, or dispensation of alcohol; or  Being under the influence of alcohol.

Illegal Drugs The following acts are prohibited and subject an employee to discharge:  The use, possession, purchase, sale, manufacture, distribution, transportation, or dispensation of any illegal drug or other controlled substance; or  Being under the influence of any illegal drug or other controlled substance.

Legal Drugs The following acts are prohibited and subject an employee to discharge:  The abuse of any legal drug;  The purchase, sale, manufacture, distribution, transportation, dispensation, or possession of any legal prescription drug in a manner inconsistent with law; or  Working while impaired by the use of a legal drug whenever such impairment might:  Endanger the safety of the employee or some other person;  Pose a risk of significant damage to Company property or equipment; or  Substantially interfere with the employee’s job performance or the efficient operation of URGENT’s business or equipment.

Disciplinary Action A first violation of this Guideline will result in immediate discharge, whenever the prohibited conduct:     

Caused injury to the employee or any other person, or, in the sole opinion of management, endangered the safety of the employee or any other person; Resulted in significant damage to Company property or equipment, or, in the sole opinion of management, posed a risk of significant damage; Involved the sale or manufacture of illegal drugs or other controlled substances; Involved in the possession, distribution, or dispensation of illegal drugs or other controlled substances or alcohol in a quantity greater than for personal use; Involved an employee who had not completed the introductory period or was a casual, seasonal, or temporary employee; 20


Involved the failure of an employee to report a criminal conviction, as required by below.

Effect of Criminal Conviction An employee who is convicted under a criminal drug statute for a violation occurring in the workplace or during any Company-related activity or event will be deemed to have violated this Guideline.

Effect of Discharge on Eligibility for Rehire Employees who are discharged for a violation of this Guideline will not be eligible for rehire by URGENT.

Criminal Convictions Employees are required by this Guideline to notify URGENT of any conviction under a criminal drug statute for a violation occurring in the workplace or during any Companyrelated activity or event, not later than five days after any such conviction. When required by federal law, URGENT will notify any federal agency with which it has a contract of any employee who has been convicted under a criminal drug statute for a violation occurring in the workplace.

Use of Legal Drugs URGENT recognizes that employees may, from time to time, be prescribed legal drugs that, when taken as prescribed or according to the manufacturer’s instructions, may result in their impairment. Employees may not work while impaired by the use of legal drugs if the impairment might endanger the employee or someone else, pose a risk of significant damage to Company property, or substantially interfere with the employee’s job performance. If an employee is so impaired by the appropriate use of legal drugs, he or she may not report to work. To accommodate the absence, the employee may use accrued sick leave, or vacation time. The employee may also contact Vice President of Operations to determine whether or not he or she qualifies for an unpaid leave of absence, such as family care or medical leave. Nothing in this Guideline is intended to sanction or encourage the use of accrued sick leave or vacation time to accommodate absences due to the abuse of legal drugs. Further, nothing in this Guideline is intended to diminish URGENT’s commitment to employ and reasonably accommodate qualified disabled individuals. URGENT will reasonably accommodate qualified disabled employees who must take legal drugs because of their disability and who, because of their appropriate use of such drugs, cannot perform the essential functions of their positions adequately or safely.

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Customary Use of Over-the-Counter Drugs Nothing in this Guideline is intended to prohibit the customary and ordinary purchase, sale, use, possession, or dispensation of over-the-counter drugs, so long as that activity does not violate any law or result in an employee being impaired by the use of such drugs in violation of this Guideline.

Off-the-Job Conduct This Guideline is not intended to regulate off-the-job conduct, so long as the employee’s offthe-job use of alcohol or drugs does not result in the employee being under the influence of or impaired by the use of alcohol or drugs in violation of this Guideline.

Authorized Use of Alcohol URGENT may provide alcohol for consumption at certain events such as social functions. The consumption of alcohol at these events does not violate this policy.

Confidentiality Disclosures made by employees to the Vice President of Operations concerning their use of legal drugs will be treated confidentially and will not be revealed to managers or supervisors unless there is an important work-related reason to do so in order to determine whether it is advisable for the employee to continue working. Disclosures made by employees to Vice President of Operations concerning their participation in any drug or alcohol rehabilitation program will be treated confidentially.

Inspections and Searches on Company Premises Purpose of the Guideline

URGENT believes that maintaining a workplace that is free of drugs, alcohol, and other harmful materials is vital to the health and safety of its employees and to the success of URGENT’s business. URGENT also intends to protect against the unauthorized use or removal of Company property. In addition, URGENT intends to assure its access at all times to Company premises and Company property, equipment, records, documents, and files. Accordingly, URGENT has established this Guideline concerning inspections and searches, on Company premises. This Guideline applies to all employees of URGENT.

Definitions

For purposes of this Guideline: “Prohibited materials” means firearms or other weapons; explosives and/or hazardous materials or articles; illegal drugs or other controlled substances as defined in URGENT’s Drug-Free Workplace Guideline; drug-related paraphernalia; and alcoholic beverages or Company property that an employee is not authorized to have in his or her possession. 22


“Company property” includes all documents, records, software, and files relating to URGENT’s business; and all equipment, hardware, and other property of any kind, whether owned, leased, rented, or used by URGENT. “Company premises” includes all premises and locations owned or leased by URGENT or under the control of URGENT, including parking lots, lockers, and storage areas. “Reasonable suspicion” includes a suspicion that is based on specific personal observations such as an employee’s manner, disposition, muscular movement, appearance, behavior, speech or breath odor; information provided to management by an employee, by law enforcement officials, by a security service, or by other persons believed to be reliable; or a suspicion that is based on other surrounding circumstances. “Possession” means that an employee has the substance or company property on his or her person or otherwise under his or her control.

Inspections and Searches Access to Company Property In order to ensure access at all times to Company property, and because employees properly in possession of Company property or information related to company business may not always be available to produce the property or information when needed in the ordinary course of URGENT’s business, URGENT reserves the right to conduct a routine inspection or search at any time for Company property on Company premises. URGENT reserves the right to access information and communications stored on company technology resources, at all times. Routine searches or inspections for Company property may include an employee’s office, desk, file cabinet, closet, computer files, voice mail, or similar places where employees may store Company property or Company-related information. Because even a routine search for Company property might result in the discovery of an employee’s personal possessions, all employees are encouraged to refrain from bringing into the workplace any item of personal property that they do not wish to reveal to URGENT.

Inspections and Searches for Prohibited Materials  Inspections or searches for prohibited materials in or on Company premises also will be conducted whenever URGENT has reasonable suspicion that a particular employee or employees may be in possession of such materials in violation of this Guideline.  Inspections or searches for prohibited materials may be conducted by an independent security service or by URGENT with its own personnel. In all cases, a member of management should be present.  Inspections or searches for prohibited materials may include an employee’s office, desk, file cabinet, closet, or other locations where employees may place personal possessions, including, but not limited to, employee lockers and vehicles, when on company premises, and/or other items of personal property worn or carried while on company premises.  Employees who refuse to cooperate during an inspection or search will not be forcibly detained or searched. They will be informed, however, that URGENT will base any 23


disciplinary decision on the information that is available, including their refusal to consent to the search as well as the information that gave rise to a reasonable suspicion that the employee was in possession of prohibited materials, if applicable, and that their failure or refusal to cooperate could deprive URGENT of information that may clear them of suspicion. In addition, URGENT reserves the right to take appropriate action to prevent the unauthorized removal from Company premises of Company property.

Disciplinary Action  Employees who are found to be in possession of prohibited materials in violation of this Guideline or have used Company property in an unauthorized manner and/or are found to be in violation of other URGENT policies and guidelines will be subject to discipline, up to and including discharge, regardless of URGENT’s reason for conducting the search or inspection.  If an employee refuses to cooperate with a search or inspection that is based on reasonable suspicion that the employee is in possession of prohibited materials, URGENT may take that refusal into consideration in determining appropriate disciplinary action. Discipline will be based on all available information, including the information giving rise to the reasonable suspicion. It is therefore to the employee’s advantage to cooperate with the search or inspection whenever prohibited material are present.

Termination Voluntary Termination URGENT will consider an employee to have voluntarily terminated his or her employment if an employee does any of the following:  Elects to resign from URGENT;  Fails to return from an approved leave of absence on the date specified by URGENT; or  Fails to report for work without notice to URGENT for three consecutive days. Involuntary Termination An employee may be terminated involuntarily for reasons that include poor performance, misconduct, or other violations of URGENT’s rules of conduct, as set forth below. Notwithstanding this list of rules, URGENT reserves the right to discharge with or without cause and with or without prior notice. Termination Due to Reorganizations, Economics, or Lack of Work From time to time, URGENT may need to terminate an employee as a consequence of reorganizations, job eliminations, end of grant contracts, economic downturns in business, or lack of work. Should URGENT consider such terminations necessary, URGENT will attempt to provide all affected employees with advance notice when practical. 24


Workplace Safety Policy URGENT is committed to providing and maintaining a healthy and safe work environment for all employees. Accordingly, URGENT has instituted an Injury and Illness Prevention Program designed to protect the health and safety of all personnel. Every employee will receive a copy of URGENT’s General Safety Rules and will receive health and safety training as part of the Injury and Illness Prevention Program. A complete copy of the Injury and Illness Prevention Program is kept by Vice President of Operations and is available for your review. You are required to know and comply with URGENT’s General Safety Rules and to follow safe and healthy work practices at all times. You also are required to report immediately to your supervisor any potential health or safety hazards, and all injuries or accidents. First aid supplies are located Office Supply Closet. The location of the nearest doctor and/or medical facility is posted Office Supply Closet.

Safety Rules Safety is to be given primary importance in every aspect of planning and performing all URGENT activities. We want to protect you against industrial injury and illness, as well as minimize the potential loss of production. Please report all injuries (no matter how slight) to your manager immediately, as well as anything that needs repair or is a safety hazard. Below are some general safety rules. Your manager or department head may post other safety procedures in your department or work area:         

Avoid overloading electrical outlets with too many machines. Use flammable items, such as cleaning fluids, with caution. Walk – don’t run. Report to your manager if you or a co-worker becomes ill or is injured. Ask for assistance when lifting heavy objects or moving heavy furniture. Keep cabinet doors and file and desk drawers closed when not in use. Sit firmly and squarely in chairs that roll or tilt. Avoid “horseplay” or practical jokes. Start work on any machine only after safety procedures and requirements have been explained (and you understand them).

Remember, failure to adhere to these rules will be considered serious infractions of safety rules and will result in disciplinary actions.

Corporal Punishment In summary, it is the policy of the agency to prohibit corporal punishment by all employees in the routine performance of their duties towards any client; and to comply with appropriate laws governing child abuse and neglect. We are obligated and must respond to suspected or known child abuse or 25


sexual abuse whether it occurs inside or outside of the program. Each person within the agency must report child abuse and neglect in accordance with the provisions of applicable state or local law. Florida law requires reporting by any adult working with children. This is designed for use when a series of incidents / reports / staff observations result in suspicion of neglect or abuse.

Miscellaneous Open Door Policy URGENT has an Open Door Policy that encourages employee participation in decisions affecting them and their daily professional responsibilities. Employees who have job-related concerns or complaints are encouraged to talk them over with their supervisor or any other management representative with whom they feel comfortable. URGENT believes that employee concerns are best addressed through this type of informal and open communication. Employees are encouraged to raise work-related concerns with their immediate supervisor, or with a supervisor or other management representative of their choice, as soon as possible after the events that cause the concern. Employees are further encouraged to pursue discussion of their work-related concerns until the matter is fully resolved. Although URGENT cannot guarantee that in each instance the employee will be satisfied with the result, URGENT will attempt in each instance to explain the result to the employee if the employee is not satisfied. URGENT will also attempt to keep all such expressions of concern, the results of its investigation, and the terms of the resolution confidential. However, in the course of investigating and resolving the matter, some dissemination of information to others may be appropriate. Employees who conclude that their work-related concerns should be brought to the attention of URGENT by written complaint and formal investigation may avail themselves of the “Internal Complaint Review’ procedure set forth in this Manual.

Lobbying-Political and Sectarian Activities The Company is not allowed to support or oppose any candidate for political office, not even for nonpartisan local offices such as school boards or library boards. This prohibition includes the publishing or distribution of statements. This is an absolute prohibition, with no requirement that the activity be substantial. The Company complies with the provisions of Section 216.347, Florida Statutes, which prohibit the expenditures of contract funds for the purposes of lobbying the Legislature, a judicial branch or state agency. The Company is however, allowed to engage in voter education activities. Such activities must be conducted in a non-partisan manner and may include: * public forums and public debates during a campaign in which all legally qualified candidates are 26


invited; a broad range of issues are covered; questions are prepared and presented by an independent panel; and each candidate receives equal time. * a compilation of voting records of public officials, if it involves a wide range of issues, contains no editorial opinions, and it does not imply approval or disapproval of any individual's voting record. The agency may also organize public forums, lectures, and debates on controversial social, political, and international questions, even if the speakers are frequently controversial, as long as the company adopts an unbiased position.

Travel and Expense Accounts URGENT will reimburse employees for meals and transportation during out of town trainings and conferences up to a maximum of $50/per day. Mileage will be reimbursed at .48 cents per mile. You may obtain mileage expense reports from the Vice President of Operations.

Exit Interview Employees who leave URGENT for any reason may be asked to participate in an exit interview. This interview is intended to permit terminating employees the opportunity to communicate their views regarding their work with URGENT, including job duties, job training, job supervision, and job benefits. At the time of the interview, employees are expected to return all Company-furnished property, such as uniforms, tools, equipment, I.D. cards, keys, credit cards, documents, and handbooks. Arrangements for clearing any outstanding debts with URGENT and for receiving final pay also will be made at this time.

Violence in the Workplace URGENT recognizes that workplace violence is a growing concern among employers and employees across the country. URGENT is committed to providing a safe, violence-free workplace and strictly prohibits employees, consultants, customers, visitors, or anyone else on Company premises or engaging in a Company-related activity from behaving in a violent or threatening manner. As part of this policy, URGENT seeks to prevent workplace violence before it begins and reserves the right to deal with behavior that suggests a propensity towards violence even prior to any violent behavior occurring. URGENT believes that prevention of workplace violence begins with recognition and awareness of potential early warning signs and has established procedures for responding to any situation that presents the possibility of violence. More information is available from Vice President of Operations. Workplace Violence Defined Workplace violence includes:  Threats of any kind;  Threatening, physically aggressive, or violent behavior, such as intimidation of or attempts to instill fear in others; 27


 Other behavior that suggests a propensity toward violence, which can include belligerent speech, excessive arguing or swearing, sabotage, or threats of sabotage of Company property, or a demonstrated pattern of refusal to follow Company policies and procedures;  Defacing Company property or causing physical damage to the facilities; or  With the exception of security personnel, bringing weapons or firearms of any kind on Company premises, in Company parking lots, or while conducting Company business.

Reporting If any employee observes or becomes aware of any of the above-listed actions or behavior by an employee, customer, consultant, visitor, or anyone else, he or she should notify Vice President of Operations immediately. Further, employees should notify Vice President of Operations if any restraining order is in effect, or if a potentially violent non-work related situation exists that could result in violence in the workplace.

Investigation All reports of workplace violence will be taken seriously and will be investigated promptly and thoroughly. In appropriate circumstances, URGENT will inform the reporting individual of the results of the investigation. To the extent possible, URGENT will maintain the confidentiality of the reporting employee and of the investigation but may need to disclose results in appropriate circumstances, for example, in order to protect individual safety. URGENT will not tolerate retaliation against any employee who reports workplace violence.

Corrective Action and Discipline If URGENT determines that workplace violence has occurred, URGENT will take appropriate corrective action and will impose discipline on offending employees. The appropriate discipline will depend on the particular facts but may include written or oral warnings, probation, reassignment of responsibilities, suspension, or termination. If the violent behavior is that of a non-employee, URGENT will take appropriate corrective action in an attempt to ensure that such behavior is not repeated. Under certain circumstances, URGENT may forego disciplinary action on the condition that the employee takes a medical leave of absence. In addition, URGENT may request that the employee participate in counseling, either voluntarily or as a condition of continued employment.

Arbitration URGENT strongly believes in and endorses expeditious, non-judicial resolution of employment disputes. All employees are therefore asked to sign a separate arbitration agreement, submitting any potential employment disputes to arbitration.

Hiring-Nepotism Persons who are members of the same household as an employee of the Corporation or persons who are members of the same immediate family as the Corporation may consider an employee for 28


employment provided the individual possesses all the qualifications for employment. ***

29


2011

Engage. Educate. Activate A 501 ( c ) 3 Organization

Continuity of Operation Plan Last Modified 3/11

1


CONTINUITY OF OPERATIONS PLAN

Administrative Guidebook

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 (ph) 866-811-7778 (fax) office@urgentinc.org www.urgentinc.org

Last Modified 3/11

2


INTRODUCTION

4

AGENCY CONTACTS

4

PRINCIPAL ADDRESS ALTERNATE ADDRESS PRINCIPAL CONTACTS CRISIS MANAGER CASE MANGER(S) ALTERNATE CRISIS MANAGER EMERGENCY CONTACTS INSURANCE PROVIDER PRIMARY FUNDERS PROGRAM LOCATIONS

4 4 4 4 4 4 4 4 4 5

MISSION ESSENTIAL FUNCTIONS

6

LOGISTICS

6

OFFICE CONDITION DEMOGRAPHICS CLIENT ASSISTANCE

6 6 6

EDUCATION AND TRAINING

6

CLIENTS STAFF

6 7

LEADERSHIP

7

NOTIFICATION PROCEDURES ALTERNATE OFFICE OPERATIONS

7 7 7 7

DISASTER PROCEEDURES

7

STORAGE OF AGENCY DOCUMENTS

7 7

VOLUNTEER ASSISTANCE

7

Last Modified 3/11

3


INTRODUCTION The purpose of the Continuity of Operation Plan (COOP) is to guide staff in planning the continuity of organizational, operational and business functions should disruptions occur due to natural disasters, man-made causes (unintentional and deliberate actions), or technological failures. This "all-hazards" planning focuses on the actions necessary to continue mission-essential and other functions, rather than on why the disruption occurred.

AGENCY CONTACTS Principal Address

Culmer Service Center 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 (ph) 305-576-2089 (fax) 866-811-7778 (E-fax) Email- office@urgentinc.org URL: www.urgentinc.org

Alternate Address

Gibson Charter School 1682 NW 4th Ave. Miami, FL 33136

Principal Contacts

Henry Crespo, President 305-984-0067 cell hcrespo@urgentinc.org

Crisis Manager

Saliha Nelson, Vice President 305-205-4605 cell saliha@urgentinc.org

Case Manger(s)

Linda Jones, Case Manager Intergenerational Project 305-495-3287; linda@urgentinc.org

Alternate Crisis Manager

Shedia Nelson, Programs Manager 305-586-6694 cell shedia@urgentinc.org

Emergency Contacts

Emergency Non-Emergency Metro-Dade PoliceMiami PoliceMiami-Dade Non-Emergency Metro Fire RescueMiami Dade County InformationThe Children’s Trust

911

ACC HALL International Philadelphia Insurance Companies Richard Hall or Cathy Sterner csterner@answerrisk.com

305-577-4270

Insurance Provider

Primary Funders

305-595-6263 305-579-6111 305-476-5423 305-759-2468 311 211

Alliance for Aging Last Modified 3/11

4


760 NW 107 Ave., Suite 201,214 Miami, FL 33172 305-670-6500; Contact Maria Scotto, Contract Officer Miami Dade County Dept. of Human Services 2525 NW 62nd Street, 4th Floor Miami, Fl 33147 305-514-6000 Main 305-514-6085; Contact Yvette McLeod, Contracts Officer The Children’s Trust 3150 SW 3rd Ave., 8th Floor Miami, FL 33129 305-571-5700; Contact Aundra Adams, Program Coordinator 305-571-5700; Contact Donald Loutsch, Program Coordinator The City of Miami 444 SW 2nd Ave. 2nd Floor Miami, FL 33130 305-416-2090; Contact Makelly Scott, Contracts Officer Women’s Fund of Miami Dade County 2650 SW 27th Ave. Miami, FL 33133 305-284-0118; Contact Fran Katz, Associate Director Program Locations

Lenora B. Smith Elementary 4700 NW 12th Ave. Miami, FL 33127 305-635-0873 Miami Edison Middle School 6101 NW 2nd Ave. Miami, FL 33127 305-754-4683 Gibson Charter School 1682 NW 4th Ave. Miami, FL 33136 305-573-8532 Booker T. Washington Senior High School 1200 NW 6th Ave. Miami, FL 33136 305-324-8900 Goulds Elementary School 23555 SW 112th Ave. Miami, FL 33032 305-257-4400 Williams Park 1717 NW 5th Ave. Miami, FL 33136 305-579-6978 University of Miami 111 Memorial Dr. Memorial Bldg. Rooms 106-109 Summer Camp Manager: 305-586-6694

Last Modified 3/11

5


MISSION ESSENTIAL FUNCTIONS PRIORITY

ESSENTIAL FUNCTIONS

RESPONSIBLE PARTY

1

Establish safe working location

Vice President

2

Contact staff and verify safety status and work availability

Programs Manager

3

Restore computer systems

Vice President

4

Contact contract managers/funding organizations and notify of level of service the organization can provide and verify status of payments and when funding will resume

Vice President

5

Contact clients and check if need resources and referral to community services and inform when services will resume

Case Manager

LOGISTICS Office Condition

Demographics

Client Assistance

1. 2. 3.

Current office location has not been subject to flooding Current office has survived prior occurrences of wind/storm damage Falling trees next to Current office building would not affect structure

1. 2. 3.

Youth between the ages of 6-17 Caregivers between the ages of 18- 79 Clients in need of evacuation assistance: 8

1.

Case Manager assigned to clients needing evacuation assistance will be responsible for notification prior to and after disaster to ensure client safety and provide resource and referral if necessary

2.

Case Manager will identify and contact high-risks clients, on a prioritized basis based on age and family size prior to and immediately following a disaster

3.

Case Manger will help at-risk clients register with the Special Needs Registries in the local County Emergency Offices, as necessary

EDUCATION AND TRAINING Clients

1.

Each client will be given the Hurricane Preparedness Brochure from the County at the start of each Hurricane Season Last Modified 3/11

6


Staff

2.

Each client will be given a list of Emergency Contact Numbers

3.

At each opportunity arrangements will be made to educate our consumers with Emergency Preparedness Workshops

1.

COOP training shall take place at least 4-6 weeks prior to the beginning of Hurricane Season each year. Tentatively set for May 5, 2011 from 10:00-12:00noon

1.

The Vice President will be responsible for initiating call down notification procedures in the event the COOP needs to be implemented

2.

Staff will look to the Organizational Chart for clarification on who they are supposed to call, i.e. that is the person directly under their supervision

3.

In the event an employee does not receive a call, he/she must contact the agency voice mail by the start of the next business day to inform of his/her status

4.

Salaried staff must remain on-call; Hourly staff will report as operations allow. However, hourly staff will only be paid on the basis of actual time worked.

5.

In the event offices are unable to be utilized, staff will have the option to work at home if safe conditions allow or report to the alternate work location at St. Francis Xavier School.

6.

If program sites do not allow for services to be rendered in the event of pre and post disaster, no services will be rendered for safety reasons.

LEADERSHIP Notification Procedures

Alternate Office Operations

DISASTER PROCEEDURES Storage of Agency Documents

1.

Storage of all books, and other equipment as far as possible from windows or areas subject to damage or entry of water. Store these items above the floor to protect them from water damage due to minor flooding

2.

Move audiovisual, computer, and business machine equipment to secure location. If equipment cannot be moved, cover with plastic to protect form water damage.

3.

All Files are backed-up offsite.

4.

Essential files will be taken by staff and Managers as appropriate and safe

VOLUNTEER ASSISTANCE 1.

URGENT, Inc. staff will look to the Elder Helpline administered by the Alliance for Aging for referrals, conducting outreach, and delivering services to elderly persons, other than existing clients Last Modified 3/11

7


2.

The Vice President will look to the current staff of the Elder Helpline for request to help cover after-hour coverage of the Elder Helpline and other network services. Based on need, he/she will assign Urgent staff to help with coverage needs

3.

In the event URGENT, Inc. staff shall need to help at area shelters outside of the disaster area to help elderly evacuees with special needs, the Vice President will notify Urgent Management and proceed to schedule staff at appropriate locations.

Last Modified 3/11

8


Mandatory Reporting Suspicion of Abuse, Neglect, Exploitation What is abuse or mistreatment? Abuse or mistreatment:    

is a violation of an individuals’ human or civil rights by another person or persons; may consist of a single act or repeated acts; can occur in any relationship or setting; may result in harm to, or serious exploitation of, the person subjected to it, and may constitute a criminal offence.

This can take the form of:       

physical abuse; for example: hitting, slapping, punching, kicking, misuse of medication, restraint, or inappropriate sanctions; sexual abuse; for example: rape and sexual assault or sexual acts to which the person has not consented or was coerced into; psychological abuse; for example: emotional abuse, threats, humiliation, intimidation, verbal abuse; financial or material abuse; for example: theft, fraud, exploitation, the misuse or misappropriation of property; neglect; for example: ignoring medical or physical care needs, the withholding of adequate food, heat, clothing and medication; discriminatory abuse; for example: racist, sexist, or that are based on a person’s disability; institutional abuse; mistreatment or abuse by a regime or by any individual where care is provided.

Duty to Report Whatever position you hold within the organization you have a duty to report any allegation or suspicion of abuse of a vulnerable adult.

Initial Response Abuse discovered or suspected: 

Follow the organization’s procedures.

1


If the person is in immediate danger:   

Contact emergency services, including the police; and Inform your direct supervisor or any other manager within the organization immediately; and Keep a record of the incident.

If the person is not in immediate danger:     

inform your manager immediately discuss what you have seen or heard explain why you think abuse has taken place give as much information as possible refer to a more senior manager if your concerns involve the actions of your manager.

Record all your actions BE PREPARED TO PROVIDE: 1. 2. 3. 4.

Victim name, address or location, approximate age, race and sex; Physical, mental or behavioral indications that the person is infirm or disabled; Signs or indications of harm or injury, including a physical description if possible; Relationship of the alleged possible responsible person to the victim. If the relationship is unknown, a report will still be taken if other reporting criteria are met.

TWO WAYS TO MAKE A REPORT:   

TELEPHONE:1 - 800 - 96ABUSE (1-800-962-2873) TDD (Telephone Device for the Deaf): 1-800-453-5145 FAX: 1 (800) 914-0004 A written report with your name and contact telephone or FAX using this fax form (in PDF Format, use Adobe Acrobat to view and print) to: 1 - 800 - 914 - 0004

NOTIFICATION OF REPORT: 

Telephone reporters will always be told prior to concluding your conversation,

For faxed information, notification will be provided only when additional information is needed to accept a report, or when the report does not fall within the jurisdiction of The Department of Children & Families. Your fax number must be clearly indicated on your report. Although you may request confirmation, you can assume that your report was accepted if you provided your fax number and receive no response from the Hotline.

whether the information provided has been accepted as a report.

2


EMPLOYEE PERSONNEL FILE CHECKLIST Name:______________________________

DOH:__________________

JOB DESCRIPTION EMPLOYMENT HISTORY FORM RESUME COMPUPAY APPLICATION A S S E T M A P Q U E S T I O N A I R E - ON-LINE

HIRING FORMS & DOCS LEVEL 2 BACKGROUND S CREENING [ A F F I D A V I T O F M O R A L C H A R A C T ER W-4 I-9 DIRECT DEPOSIT & VOIDED CHECK

DOCUMENTS STATE ISSUED ID OR LICENSE SOCIAL SECURITY CARD AUTO INSURANCE DEGREE DIPLOMA CREDENTIALS/TRAINING CERTIFICATES

FORMS EMPLOYEE HANDBOOK RE CIEPT CONFIDENTIALITY SOCIAL MEDIA POLICY NO SMOKING POLICY MANDATORY REPORTING

MISCELLANEOUS KEY CHECK OUT EMPLOYEE EVALUATION

] MDCPS

[

] FDLE


URGENT INC. EMPLOYMENT HISTORY FORM URGENT, Inc. (the "Company") is an equal opportunity/affirmative action employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, nation origin, marital status, ancestry, citizenship, veteran status, sexual orientation or preference, or physical or mental disability.

PERSONAL Last Name

First

Initial

Social Security #

Other Name(s) Used

DOB:

Address

Home Telephone # ( )

Business or Message # ( )

Fax:

Email:

Position Applied For

Referred By

Salary Desired

Are you at least 18 years old?  Yes No

If under 18, do you have a work permit?

EDUCATION Circle Highest Grade Completed:

School

High School College, Trade or Business Graduate Studies Address

9 1

10 2

Major Studies

11 3

12 4

Degree, Diploma, License or Certificate

High School College/University Vocational, Business, Other List Any Professional Designations Other Special Knowledge, Skills or Qualifications

Form 7-5

1


Do you type?  Yes

 No

If yes, WPM:

Computer Skills (Hardware/Software)

EMPLOYMENT HISTORY List all employments for the past 10 years, starting with the most recent position. All information must be completed. However you may attach a resume, but not in place of completing the required information. (Information on resume does not have to be repeated) Employed From / /

Employer Name

Supervisor Name

Starting Salary

Employed Until / /

Employer Address

Supervisor Phone #

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Employed From / /

Employer Name

Supervisor Name

Starting Salary

Employed Until / /

Employer Address

Supervisor Phone #

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Form 7-5

2


Employed From / /

Employer Name

Supervisor Name

Starting Salary

Employed Until / /

Employer Address

Supervisor Phone #

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Employed From / /

Employer Name

Supervisor Name

Starting Salary

Employed Until / /

Employer Address

Supervisor Phone #

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

GENERAL Yes

No

May we contact your current employer for references?

If hired, will you be able to work evenings and weekends?

Will you be able to perform the essential job functions for the position you are applying for with or without reasonable supervision?

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or seals by court? (A yes response does not automatically disqualify your application.)



Will you submit for a background screening?



CERTIFICATION & AUTHORIZATION The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery. I authorize the Company to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will

Form 7-5

3


hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize the Company to obtain a criminal and driver background check. I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing. If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9. I hereby acknowledge that I have read and agree to the above statements.

Signature

Date

Copyright Š1999 by Richard D. Harroch. All Rights Reserved.

Form 7-5

4


Company Name URGENT, INC.

Account #

* Rehire Date

* New Hire Date

EMPLOYEE INFORMATION * Social Security # / 1099 EIN

Change Date

* Pay Type X W2

Home Dept.

* Last Name

Terminate Date

1099

3rd. Party

W/C Class

Clock Number

* First Name

* Date of Birth

* FEDERAL WITHHOLDING Single

* Address: Married Married but W/H @ Single Rate Exempt * City, State: Number of Exemptions * Zip Code:

Home Phone #:

(

)

Additional Withholding

* PAY FREQUENCY Weekly

Semi-monthly

Bi-weekly

Monthly

PAY TYPES AND RATES Salary

Regular Rate $

Hourly Tipped Direct

Special Rate (Code X) $

$

Salary per pay period

Misc. Rate (Code M) $

$

Hours per pay period

Indirect

DEDUCTIONS ITEM

AMT

REIMBURSEMENTS ITEM

FREQ

STATE UNEMPLOYMENT

Name of State FL

STATE WITHHOLDING

Name of State FL

Single

Married

Exempt

Number of Exemptions Additional Withholding

LOCAL TAX Resident

EARNED INCOME CREDIT COMMENTS

FREQ

ITEM

AMT

Manual

Yes

No

Describe Yes

No

1 Cert

2 Cert

Void

HOURS

Check Number

Regular

Gross - Tips

O/T

Tips

Code

FICA

Sick

FWT

Vacation

SWT

Holiday

SALARY

TYPE

Ded / Reim

Other Pay

Ded / Reim

Other Pay

Ded / Reim

Other Pay Ded / Reim

NET PAY

FREQ

CURRENT PAY

PAYROLL ADJUSTMENT TYPE

Rate of Pay

OTHER PAYS

SDI

% of Gross for W/H

STATE DISABILITY

AMT

1099 Payee

Ded / Reim

Tips

AMOUNT


Employee Direct Deposit Payee Authorization Form SC(6) PAYROLL MANAGER: Please complete this section and send a copy to your CompuPay payroll specialist or new accounts coordinator. (Please print) Account #

Date

Company Name URGENT, INC.

To enroll in Full Service Direct Deposit, simply fill out this form and give it to your payroll manager. Attach a voided check for each checking account - not a deposit slip. If depositing into a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn’t always the same as the number on a savings deposit slip. This will help ensure that you are paid correctly.

Important! Please read and sign before completing and submitting.

I hereby authorize Compupay to deposit any amounts owed me as instructed by my employer by initiating credit entries to my accounts at the financial institutions (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Compupay to my accounts. In the event that Compupay deposits funds erroneously into my account, I authorize Compupay to debit my account for an amount not to exceed the original amount of the erroneous credit account. I further authorize Compupay to debit my account in the event my employer does not provide funds to cover credits initiated by Compupay. This authorization is to remain in full force and effect until Compupay and Bank have received written notice from me of its termination in such time and in such manner as to afford Compupay and Bank reasonable opportunity to act on it.

Employee Name:

Social Security #:

Employee Signature:

Date:

Account Information

Make sure to indicate what kind of account, along with the amount to be deposited if less than your total net paycheck. Account Type Bank Name A C Checking Savings C T Account # Amount to deposit Routing/Transfer # $

1 A C C T

2 A C C T

3 A C C T

4 A C C T

5

or

Other Balance of Net

Account Type

Bank Name Checking Routing/Transfer #

Account #

Savings

Other

Amount to deposit $

or

Balance of Net

Account Type

Bank Name Checking Routing/Transfer #

Account #

Amount to deposit $

Savings or

Other Balance of Net

Account Type

Bank Name Checking Routing/Transfer #

Account #

Amount to deposit $

Savings or

Other Balance of Net

Account Type

Bank Name Checking Routing/Transfer #

Account #

Amount to deposit $

Savings or

Other Balance of Net

Below is a sample check MICR line, detailing where the information necessary to complete the form can be found.

A 012345678 A Routing/Transit # (A 9-digit number always between these two marks)

123456789C Checking Account #

0101 Check # (this number matches the number in the upper right corner of the check-not needed for sign-up)

ATTENTION PAYROLL MANAGER: Employers must keep each original employee enrollment form on file as long as the employee is using FSDD, and for two years thereafter. Version 0306

SC(6) Page 1


AFFIDAVIT OF GOOD MORAL CHARACTER State of Florida

Miami-Dade County of ______________________

Before me this day personally appeared _________________________________________ who, being duly (Applicant’s/Employee’s Name)

sworn, deposes and says: As an applicant for employment with, an employee of, a volunteer for, or an applicant to volunteer with URGENT, INC. ________________________________________________, I affirm and attest under penalty of perjury that I meet the moral character requirements for employment, as required by the Florida Statutes and rules, in that: I have not been arrested with disposition pending or found guilty of, regardless of adjudication, or entered a plea of nolo contender or guilty to or have been adjudicated delinquent and the record has not been sealed or expunged for, any offense prohibited under any of the following provisions of the Florida Statutes or under any similar statute of another jurisdiction for any of the offenses listed below: Relating to: Section 393.135 Section 394.4593 Section 415.111 Section 741.28 Section 782.04 Section 782.07 Section 782.071 Section 782.09 Chapter 784 Section 784.011 Section 784.03 Section 787.01 Section 787.02 Section 787.025 Section 787.04(2) Section 787.04(3) Section 790.115(1) Section 790.115(2) (b) Section 794.011 Former Section 794.041 Section 794.05 Chapter 796 Section 798.02 Chapter 800 Section 806.01 Section 810.02 Section 810.14 Section 810.145 Chapter 812 Section 817.563 Section 825.102 Section 825.1025 Section 825.103 Section 826.04 Section 827.03 Section 827.04 Former Section 827.05 Section 827.071 Section 843.01

sexual misconduct with certain developmentally disabled clients and reporting of such sexual misconduct sexual misconduct with certain mental health patients and reporting of such sexual misconduct adult abuse, neglect, or exploitation of aged persons or disabled adults or failure to report of such abuse criminal offenses that constitute domestic violence, whether committed in Florida or another jurisdiction murder manslaughter, aggravated manslaughter of an elderly person or disabled adult, or aggravated manslaughter of a child vehicular homicide killing an unborn quick child by injury to the mother assault, battery, and culpable negligence, if the offense was a felony assault, if the victim of offense was a minor battery, if the victim of offense was a minor kidnapping false imprisonment luring or enticing a child taking, enticing, or removing a child beyond the state limits with criminal intent pending custody proceeding carrying a child beyond the state lines with criminal intent to avoid producing a child at a custody hearing or delivering the child to the designated person exhibiting firearms or weapons within 1,000 feet of a school possessing an electric weapon or device, destructive device, or other weapon on school property sexual battery prohibited acts of persons in familial or custodial authority unlawful sexual activity with certain minors prostitution lewd and lascivious behavior lewdness and indecent exposure arson burglary voyeurism, if the offense is a felony video voyeurism, if the offense is a felony theft and/or robbery and related crimes, if a felony offense fraudulent sale of controlled substances, if the offense was a felony abuse, aggravated abuse, or neglect of an elderly person or disabled adult lewd or lascivious offenses committed upon or in the presence of an elderly person or disabled adult exploitation of disabled adults or elderly persons, if the offense was a felony incest child abuse, aggravated child abuse, or neglect of a child contributing to the delinquency or dependency of a child negligent treatment of children sexual performance by a child resisting arrest with violence

CONTINUED ON NEXT PAGE CF 1649, Aug 2010 (Obsoletes previous editions which may not be used)

Page 1 of 3


Section 843.025 Section 843.12 Section 843.13 Chapter 847 Section 874.05(1) Chapter 893 Section 916.1075 Section 944.35(3) Section 944.40 Section 944.46 Section 944.47 Section 985.701 Section 985.711

depriving a law enforcement, correctional, or correctional probation officer means of protection or communication aiding in an escape aiding in the escape of juvenile inmates in correctional institution obscene literature encouraging or recruiting another to join a criminal gang drug abuse prevention and control only if the offense was a felony or if any other person involved in the offense was a minor sexual misconduct with certain forensic clients and reporting of such sexual conduct inflicting cruel or inhuman treatment on an inmate resulting in great bodily harm escape harboring, concealing, or aiding an escaped prisoner introduction of contraband into a correctional facility sexual misconduct in juvenile justice programs contraband introduced into detention facilities

THE FOLLOWING APPLIES ONLY TO THOSE APPLICANTS FOR MENTAL HEALTH POSITIONS In addition to the Chapter 435, F.S., listed offenses, the following offenses are also applicable for “Mental Health Personnel” screened pursuant to section 394.4572, F.S., defined as program directors, professional clinicians, staff members, or volunteers working in a public or private mental health program or facility who have direct contact with individuals held for examination or admitted for mental health treatment. The additional offenses apply only to “Mental Health Personnel” as determined pursuant to Section 408.809, F.S. as listed below: Relating to: Chapter 408 Section 408.8065(3)

Section 409.920 Section 409.9201 Section 817.034 Section 817.234 Section 817.505 Section 817.568 Section 817.60 Section 817.61 Section 831.01 Section 831.02 Section 831.07 Section 831.09 Section 831.30 Section 831.31

felony offenses contained in Chapter 408 offers service or skilled service without valid license when licensure is required, or knowingly files a false or misleading license or license renewal application, or submits false or misleading information related to application Medicaid provider fraud Medicaid fraud fraudulent acts through mail, wire, radio, electromagnetic, photoelectronic, or photooptical systems false and fraudulent insurance claims patient brokering criminal use of personal identification information obtaining a credit card through fraudulent means fraudulent use of credit cards, if the offense was a felony forgery uttering forged instruments forging bank bills, checks, drafts or promissory notes uttering forged bank bills, checks, drafts, or promissory notes fraud in obtaining medicinal drugs the sale, manufacture, delivery, or possession with the intent to sell, manufacture, deliver any counterfeit controlled substance, if the offense was a felony.

I also affirm that I have not been designated as a sexual predator pursuant to s. 775.21; a career offender pursuant to s. 775.261; or a sexual offender pursuant to s. 943.0435, unless the requirement to register as a sexual offender has been removed pursuant to s. 943.04354. I understand that I must acknowledge the existence of any applicable criminal record relating to the above lists of offenses including those under any similar statute of another jurisdiction, regardless of whether or not those records have been sealed or expunged. Further, I understand that, while employed or volunteering at URGENT, INC. ________________________________________________ in any position that requires background screening as a condition of employment, I must immediately notify my supervisor/employer of any arrest and any changes in my criminal record involving any of the above listed provisions of Florida Statutes or similar statutes of another jurisdiction whether a misdemeanor or felony. This notice must be made within one business day of such arrest or charge. Failure to do so could be grounds for termination.

CONTINUED ON NEXT PAGE CF 1649, Aug 2010 (Obsoletes previous editions which may not be used)

Page 2 of 3


I attest that I have read the above carefully and state that my attestation here is true and correct that my record does not contain any of the above listed offenses. I understand, under penalty of perjury, all employees in such positions of trust or responsibility shall attest to meeting the requirements for qualifying for employment and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses. I also understand that it is my responsibility to obtain clarification on anything contained in this affidavit which I do not understand prior to signing. I am aware that any omissions, falsifications, misstatements or misrepresentations may disqualify me from employment consideration and, if I am hired, may be grounds for termination or denial of an exemption at a later date. SIGNATURE OF AFFIANT:_______________________________________________________

Sign Above OR Below, DO NOT Sign Both Lines To the best of my knowledge and belief, my record contains one or more of the applicable disqualifying acts or offenses listed above. I have placed a check mark by the offense(s) contained in my record. (If you have previously been granted an exemption for this disqualifying offense, please attach a copy of the letter granting such exemption.) (Please circle the number which corresponds to the offense(s) contained in your record.) SIGNATURE OF AFFIANT:_______________________________________________________

Sworn to and subscribed before me this _____ day of ___________, 20___.

___________________________________________________ SIGNATURE OF NOTARY PUBLIC, STATE OF FLORIDA

___________________________________________________ (Print, Type, or Stamp Commissioned Name of Notary Public) (Check one) Affiant personally known to notary OR Affiant produced identification Type of identification produced:______________________________

CF 1649, Aug 2010 (Obsoletes previous editions which may not be used)

Page 3 of 3


Form W-4 (2011) Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes. Exemption from withholding. If you are exempt, complete only lines 1, 2, 3, 4, and 7 and sign the form to validate it. Your exemption for 2011 expires February 16, 2012. See Pub. 505, Tax Withholding and Estimated Tax. Note. If another person can claim you as a dependent on his or her tax return, you cannot claim exemption from withholding if your income exceeds $950 and includes more than $300 of unearned income (for example, interest and dividends). Basic instructions. If you are not exempt, complete the Personal Allowances Worksheet below. The worksheets on page 2 further adjust your withholding allowances based on itemized deductions, certain credits, adjustments to income, or two-earners/multiple jobs situations.

Complete all worksheets that apply. However, you may claim fewer (or zero) allowances. For regular wages, withholding must be based on allowances you claimed and may not be a flat amount or percentage of wages. Head of household. Generally, you may claim head of household filing status on your tax return only if you are unmarried and pay more than 50% of the costs of keeping up a home for yourself and your dependent(s) or other qualifying individuals. See Pub. 501, Exemptions, Standard Deduction, and Filing Information, for information. Tax credits. You can take projected tax credits into account in figuring your allowable number of withholding allowances. Credits for child or dependent care expenses and the child tax credit may be claimed using the Personal Allowances Worksheet below. See Pub. 919, How Do I Adjust My Tax Withholding, for information on converting your other credits into withholding allowances. Nonwage income. If you have a large amount of nonwage income, such as interest or dividends, consider making estimated tax payments using

Form 1040-ES, Estimated Tax for Individuals. Otherwise, you may owe additional tax. If you have pension or annuity income, see Pub. 919 to find out if you should adjust your withholding on Form W-4 or W-4P. Two earners or multiple jobs. If you have a working spouse or more than one job, figure the total number of allowances you are entitled to claim on all jobs using worksheets from only one Form W-4. Your withholding usually will be most accurate when all allowances are claimed on the Form W-4 for the highest paying job and zero allowances are claimed on the others. See Pub. 919 for details. Nonresident alien. If you are a nonresident alien, see Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens, before completing this form. Check your withholding. After your Form W-4 takes effect, use Pub. 919 to see how the amount you are having withheld compares to your projected total tax for 2011. See Pub. 919, especially if your earnings exceed $130,000 (Single) or $180,000 (Married).

Personal Allowances Worksheet (Keep for your records.) A

Enter “1” for yourself if no one else can claim you as a dependent . . . . . . . . . . . . . . . . . . A • You are single and have only one job; or Enter “1” if: B • You are married, have only one job, and your spouse does not work; or . . . • Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less. Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse or more than one job. (Entering “-0-” may help you avoid having too little tax withheld.) . . . . . . . . . . . . . . C Enter number of dependents (other than your spouse or yourself) you will claim on your tax return . . . . . . . . D Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above) . . E Enter “1” if you have at least $1,900 of child or dependent care expenses for which you plan to claim a credit . . . F (Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information. • If your total income will be less than $61,000 ($90,000 if married), enter “2” for each eligible child; then less “1” if you have three or more eligible children. • If your total income will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter “1” for each eligible child plus “1” additional if you have six or more eligible children . . . . . . . . . . . . . . . . . . G Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) ▶ H • If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions For accuracy, and Adjustments Worksheet on page 2. complete all • If you have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed worksheets $40,000 ($10,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld. that apply. • If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.

{

B C D E F G

H

}

{

Cut here and give Form W-4 to your employer. Keep the top part for your records. Form

W-4

Department of the Treasury Internal Revenue Service

1

Employee's Withholding Allowance Certificate

OMB No. 1545-0074

▶ Whether you are entitled to claim a certain number of allowances or exemption from withholding is

2011

subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS. Type or print your first name and middle initial. Last name 2 Your social security number

Home address (number and street or rural route)

3

Single

Married

Married, but withhold at higher Single rate.

Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box. City or town, state, and ZIP code

4 If your last name differs from that shown on your social security card, check here. You must call 1-800-772-1213 for a replacement card. ▶

5 6 7

Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5 Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . . 6 $ I claim exemption from withholding for 2011, and I certify that I meet both of the following conditions for exemption. • Last year I had a right to a refund of all federal income tax withheld because I had no tax liability and • This year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions, write “Exempt” here . . . . . . . . . . . . . . . ▶ 7

Under penalties of perjury, I declare that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.

Employee’s signature (This form is not valid unless you sign it.) 8

Date ▶

Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

9 Office code (optional)

Cat. No. 10220Q

10

Employer identification number (EIN) Form W-4 (2011)


Page 2

Form W-4 (2011)

Deductions and Adjustments Worksheet Note. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income. 1

2 3 4 5 6 7 8 9 10

Enter an estimate of your 2011 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state and local taxes, medical expenses in excess of 7.5% of your income, and miscellaneous deductions . . . . . . . . . . . . . . . . . . . . . . . . . $11,600 if married filing jointly or qualifying widow(er) Enter: $8,500 if head of household . . . . . . . . . . . $5,800 if single or married filing separately Subtract line 2 from line 1. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . Enter an estimate of your 2011 adjustments to income and any additional standard deduction (see Pub. 919) Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to Withholding Allowances for 2011 Form W-4 Worksheet in Pub. 919.) . . . . . . . . . . .

{

}

Enter an estimate of your 2011 nonwage income (such as dividends or interest) . . . . . . . . Subtract line 6 from line 5. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . Divide the amount on line 7 by $3,700 and enter the result here. Drop any fraction . . . . . . . Enter the number from the Personal Allowances Worksheet, line H, page 1 . . . . . . . . . Add lines 8 and 9 and enter the total here. If you plan to use the Two-Earners/Multiple Jobs Worksheet, also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1

1

$

2

$

3 4

$ $

5 6 7 8 9

$ $ $

10

Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.) Note. Use this worksheet only if the instructions under line H on page 1 direct you here. Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 1 2 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if you are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter more than “3” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

1

2

If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter “-0-”) and on Form W-4, line 5, page 1. Do not use the rest of this worksheet . . . . . . . . .

3 Note. If line 1 is less than line 2, enter “-0-” on Form W-4, line 5, page 1. Complete lines 4 through 9 below to figure the additional withholding amount necessary to avoid a year-end tax bill. 4 5 6 7 8 9

Enter the number from line 2 of this worksheet . . . . . . . . . . 4 Enter the number from line 1 of this worksheet . . . . . . . . . . 5 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed . . Divide line 8 by the number of pay periods remaining in 2011. For example, divide by 26 if you are paid every two weeks and you complete this form in December 2010. Enter the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld from each paycheck . . . . . . . .

Table 1 Married Filing Jointly If wages from LOWEST paying job are—

Enter on line 2 above

6 7 8

$ $

9

$

Table 2 All Others

If wages from LOWEST paying job are—

Married Filing Jointly Enter on line 2 above

$0 - $5,000 0 $0 - $8,000 0 1 8,001 - 15,000 1 5,001 - 12,000 2 15,001 - 25,000 2 12,001 - 22,000 3 25,001 - 30,000 3 22,001 - 25,000 4 30,001 - 40,000 4 25,001 - 30,000 5 40,001 - 50,000 5 30,001 - 40,000 6 50,001 - 65,000 6 40,001 - 48,000 7 65,001 - 80,000 7 48,001 - 55,000 8 80,001 - 95,000 8 55,001 - 65,000 9 95,001 -120,000 9 65,001 - 72,000 10 120,001 and over 10 72,001 - 85,000 11 85,001 - 97,000 12 97,001 -110,000 13 110,001 -120,000 14 120,001 -135,000 15 135,001 and over Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. Internal Revenue Code sections 3402(f)(2) and 6109 and their regulations require you to provide this information; your employer uses it to determine your federal income tax withholding. Failure to provide a properly completed form will result in your being treated as a single person who claims no withholding allowances; providing fraudulent information may subject you to penalties. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation, to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their tax laws; and to the Department of Health and Human Services for use in the National Directory of New Hires. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

If wages from HIGHEST paying job are— $0 65,001 125,001 185,001 335,001

- $65,000 - 125,000 - 185,000 - 335,000 and over

Enter on line 7 above $560 930 1,040 1,220 1,300

All Others If wages from HIGHEST paying job are— $0 35,001 90,001 165,001 370,001

- $35,000 - 90,000 - 165,000 - 370,000 and over

Enter on line 7 above $560 930 1,040 1,220 1,300

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by Code section 6103. The average time and expenses required to complete and file this form will vary depending on individual circumstances. For estimated averages, see the instructions for your income tax return. If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return.


Employee Direct Deposit Payee Authorization Form PAYROLL MANAGER: Please complete this section and send a copy to Compupay or fax information to the Direct Deposit Department at (305) 591-4393 (Please print) Account #

Company Name Urgent, Inc.

Date

To enroll in Full Service Direct Deposit, simply fill out this form and give it to your payroll manager. Attach a voided check for each checking account - not a deposit slip. If depositing into a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn’t always the same as the number on a savings deposit slip. This will help ensure that you are paid correctl y.

Important! Please read and sign before completing and submitting.

I hereby authorize Compupay to deposit any amounts owed me as instructed by my employer by initiating credit entries to my accounts at the financial institutions (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Compupay to my accounts. In the event that Compupay deposits funds erroneously into my account, I authorize Compupay to debit my account for an amount not to exceed the original amount of the erroneous credit account. I further authorize Compupay to debit my account in the event my employer does not provide funds to cover credits initiated by Compupay. This authorization is to remain in full force and effect until Compupay and Bank have received written notice from me of its termination in such time and in such manner as to afford Compupay and Bank reasonable opportunity to act on it.

Employee Name:

Social Security #:

Employee Signature:

Date:

Account Information

Make sure to indicate what kind of account, along with the amount to be deposited if less than your total net paycheck. Account Type Bank Name A C Checking Savings C T Account # Amount to deposit Routing/Transfer # $

1 A C C T

2 A C C T

3 A C C T

4 A C C T

5

or

Other Balance of Net

Account Type

Bank Name Checking Account #

Routing/Transfer #

Savings

Other

Amount to deposit $

or

Balance of Net

Account Type

Bank Name Checking Account #

Routing/Transfer #

Amount to deposit $

Savings or

Other Balance of Net

Account Type

Bank Name Checking Account #

Routing/Transfer #

Amount to deposit $

Savings or

Other Balance of Net

Account Type

Bank Name Checking Account #

Routing/Transfer #

Amount to deposit $

Savings or

Other Balance of Net

Below is a sample check MICR line, detailing where the information necessary to complete the form can be found.

Memo

: 012345678 : Routing/Transit # (A 9-digit number always between these two marks)

123456789 Checking Account #

0101 Check # (this number matches the number in the upper right corner of the check-not needed for sign-up)

ATTENTION PAYROLL MANAGER: Employers must keep each original employee enrollment form on file as long as the employee is using FSDD, and for two years thereafter.


EMPLOYEE MANUAL RECIEPT I have read and fully understand Urgent's Employee Manual. At the time of signing, I have received and reviewed the Employee Handbook and agree to abide by the rules, policies and proceedures. All conditions are clear to me and I understand that by signing this form, I acknowledge my responsibility and to abide by all policies & procedures.

I _______________________________________________ have read and received Urgent, .Inc.’s Employee Manual.

____________________________________________ Employee Signature

Please return this form to your Supervisor

_______________ Date


URGENT, INC. CONFIDENTIALITY POLICY All client information obtained while working as a staff member, intern, consultant or volunteer of Urgent, Inc. will be held in the strictest confidence from any outside person or agency. When preparing reports, responding to surveys or requests from the media, or providing educational presentations, only non-identifying information will be disseminated unless client expresses consent. All records containing confidential information will be maintained securely in locked files accessible only to representatives of Urgent, inc. The only exceptions to confidentiality include:  Client signs a release that the program may release information  Client makes a report of child or elder abuse  Client threatens to hurt self or others  Court orders disclosure via subpoena  Grantors request client information Every client will be informed of the conditions of this confidentiality policy during the first Program contact with that client. In addition, HIPAA (Health Information Portability Accountability Act) regulations protect medical records and other “individually identifiable health information” (communicated electronically, on paper, or orally) that are created or received by covered health care entities that transmit information electronically. “Individually identifiable health information...” includes  any information, including demographic information collected from an individual; and  any information that identifies an individual, or could be reasonably believed to identify an individual HIPAA protects “individually identifiable health information” which…  relates to the past, present, or future physical or mental health condition of an individual, the provision of health care or the payment for such care  is maintained or transmitted, and is (or has been) in electronic form is used or disclosed by covered entities I, the undersigned, do hereby agree to abide by the Confidentiality Policy. I fully understand that any violation of this requirement may result in immediate termination. I further understand that this confidentiality requirement will continue after my employment, internship, contract, or role as a volunteer in this office is completed.

Name: _______________________________ Signed:_______________________________

Date:________


URGENT, INC. Policy on Social Networking Our Nonprofit recognizes that many of our employees use social media such as Facebook, Twitter, LinkedIn, and YouTube, to name a few. However, employees' use of social media could become a problem if it:  Interferes with the employee's work  Is used to harass or discriminate against co-workers or our clients  Creates a hostile work environment  Divulges confidential information about our agency or our clients; or  Harms the goodwill and reputation of our nonprofit. As a result we encourage employees to use social media within the following guidelines. If you are uncertain about the appropriateness of a social media posting, check with your manager or supervisor. Social Media Guidelines:  Do not post any comment or picture involving an employee, volunteer or client of our nonprofit without their express consent.  If you post any comment about our nonprofit, you must clearly and conspicuously state that you are posting in your individual capacity and that the views posted are yours alone and do not represent the views of our organization.  Unless given written consent, you may not use our nonprofit's logo or any organizational material in your posts.  All postings on social media must comply with our policies on confidentiality and disclosure of proprietary information. If you are unsure about the confidential nature of information you are considering posting, consult Saliha Nelson, Vice President who is in charge of these matters.  Do not link to the organization's website or post any agency material on a social media site without written permission from Saliha Nelson, Vice President.  Don't forget that you are responsible for what you write or present on social media. You can be sued by other employees or any individual that views your social media posts as defamatory, harassing, libelous, or creating a hostile work environment.  All organizational policies that regulate off-duty conduct apply to social media activity including, but not limited to, policies related to illegal harassment, code of conduct, nondiscrimination, and protecting confidential and/or proprietary information.  Employees may not use organizational equipment for non-work-related activities without permission. Additionally, our policy on Use of Computers and Electronic Media apply to social media use at work, including our policy that personal use of our computers, including personal social media activities, should not interfere with your duties at work. We monitor our facilities to ensure compliance with this restriction.  Violation of this policy may lead to discipline up to and including the immediate termination of employment.

__________________________________________ Employee/Volunteer __________________________________________ Signature

_____________________ Date


1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 (O) 866-811-7778 fax office@urgentinc.org www.urgentinc.org “Empowering and Revitalizing Urban Communities” A 501 ( c ) 3 Organization

POLICY TOBACCO FREE ENVIRONMENT NOTICE TO STAFF AND PROGRAM FACILITY MANAGERS It is Urgent, Inc.’s obligation to protect the health, welfare and safety of children and youth in our care. In light of scientific evidence that the use of tobacco is hazardous to one’s health, and to be consistent with the ProChildren Act of 1994, all staff, consultants, volunteers and clients are prohibited from the possession, use, distribution or sale of tobacco in any form within Urgent’s facilities or within any facility Urgent operates its youth programs, including Urgent sponsored activities on owned, rented, leased or in-kind facilities. For the purpose of this policy “tobacco” is defined to include any lighted or unlighted cigarette, cigar, pipe, bidi, clove cigarette, and any other smoking product, spit tobacco, also known as smokeless, dip, chew, snuff, in any form. Violation of this policy will lead to appropriate disciplinary action up to and including termination of staff, consultants, volunteers and clients. Moreover, it is Urgent’s policy to require all staff, consultants, volunteers and clients to comply with the ProChildren Act of 1994 which states that smoking within any portion of any indoor facility used for the provision of services for children as defined by the Pro-Children Act of 1994. This language will be included in all service agreements and personnel policies.

I, _________________________________________ have read and understand Urgent, Inc.’s Tobacco Free Environment Policy and agree to comply with the policy. I understand that failure to comply with this Policy may lead to my dismissal.

________________________________________________ Employee Signature

______________ Date

1


URGENT, INC.

CORPORAL PUNISHMENT POLICY

POLICY In summary, it is the policy of the agency to prohibit corporal punishment by all employees in the routine performance of their duties towards any client; and to comply with appropriate laws governing child abuse and neglect. Urgent, Inc. must respond to suspected or known child abuse or sexual abuse whether it occurs inside or outside of the program. Each person within the agency must report child abuse and neglect in accordance with the provisions of applicable state or local law. Florida law requires reporting by individuals, although an agency may have a policy of “name of agency” reporting. This is designed for use when a series of incidents / reports / staff observations result in suspicion of neglect or abuse. It is infrequently required as citizens have a primary responsibility to report child abuse; name of agency reporting is applicable to sever neglect cases. PROCEDURES A.

Corporal punishment may include, but is not limited to: spankings, segregation or humiliation of any type; and exposure of anyclient to physiological or psychological abuse, including shaking or threats.

B.

Corporal punishment is defined as the use of physical force as a discipline measure. This includes, but is not limited to, spanking, slapping, pulling of hair, etc. Isolation refers to separating the child from normal association with classroom activities as a punishment measure. Isolation includes, but is not limited to, confining the child in a small area, retaining the child in the classroom when other children go to play, or restricting the child from snack with his/her classmates. Physical punishment and total isolation are not consistent with Urgent, Inc. Performance Standards. These Standards define goals of increased social competence, establishment of patterns and expectations of success for the student, and the enhancement of dignity and self-worth within the child.

C.

The utilization of corporal punishment and total isolation of the child is not consistent with the Urgent, Inc. Standards and cannot be tolerated in any Urgent. Inc. Program. Performance Standards prohibit the use of meals as punishment, thus isolation at meal times is forbidden.

D.

In the event an employee is found to be guilty of child abuse, he/she will be tentatively dismissed immediately and may face criminal charges. Staff who report abuse at a program are not subject to retaliation of any kind and are afforded “whistle-blower” protection.


Corporal Punishment, Page 2 E.

Staff will comply with Florida Laws pertaining to Child Abuse and Neglect, and will report all cases of suspected Child Abuse to the appropriate agency designated in Floriday State Statutes. In addition, suspected child abuse should also be reported to the appropriate coordinator or on-duty Program Manager, who will facilitate initializing an official report in the name of the agency. Preparation of name of agency reporting does not relieve individuals of the responsibility to report. Individual staff may wish to verify that the report was forwarded promptly and appropriately. Although additional information may be required, no other direct call related to that incident may be required by law if name of agency reporting was completed

F.

Individuals in the agency will preserve the confidentiality of all records pertaining to child abuse or neglect in accordance with applicable state law.

G.

No one within the agency will undertake, on their own, to treat cases of child abuse and neglect.

H.

Each person in the agency will cooperate fully with child protective service agencies.

I.

Urgent, will make every effort to retain in the program children allegedly abused or neglected.

J.

The Program Manager is designated with responsibility for: 1.

2. 3.

5. 6.

Establishing and maintaining cooperative relationships with the agencies providing child protective services in the community, and with any other agency to which child abuse and neglect must be reported under state law, including regular formal and informal communication with staff at levels of the agencies; Informing parents and staff of what state laws require in cases of child abuse and neglect; Knowing what community medical and social services are available for families in an abuse or neglect problem; Discussing the report with the family if it appears desirable (preferable) or necessary to do so; Informing other staff regarding the process of identifying and reporting child abuse and neglect.

I, ________________________________________ have read and understand the above policy and proceedures. __________________________________________ Signature

_____________ Date


Time Sheet

1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax ww.urgentinc.org

Program:

Employee name: Supervisor name:

Sunday

Monday

Tuesday

( ) After School

( ) Intergenerational

Pay period Starting:

( ) Prevention

( ) Other____________

Pay Period Ending:

Wednesday

Thursday

Friday

Saturday

DATE

Time In Time Out Meal Break Time In

Total Hours Worked

Time Out Total

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Time In Time Out Meal Break Time In

Total Hours Worked

Time Out Total

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Time In Time Out Meal Break Time In

Total Hours Worked

Time Out Total

GRAND TOTAL

Employee Signature

Date

Supervisor Signature

Date

Management Only: Total Hours Worked

Time Allocation:

Compensatory Time Earned This Period:

Promotion and Prevention

City of Miami

Holiday Hours

OOS- YES Camp

SYE

Personal Hours

Alliance for Aging

OOS- AS

Vacation Hours

MD County

__________


PROMOTING SOCIAL CHANGE SOCIAL CHANGE ORIENTATION 1.

It is not enough for our program to_________________________________________, we should be aspiring to_________________________________________________________________________. a.

What is the root cause for the work being done by our organization? ______________________________________. (Ex. Poverty, racism/discrimination, etc.)

b. What is the system or context of the work being done by our organization? _______________________________________ (Ex. Education, Juvenile Justice, Child Welfare, etc.) 2.

Working towards Social Change is a focus on: _________________________, _________________________, _________________________, _________________________, _________________________, _________________________, _________________________, _________________________, _________________________.

3.

The Well Being Indicators our work currently focuses on are: PERSONAL

4.

Urgent’s Vision:

5.

Urgent’s Mission:

6.

Urgent’s Guiding Principle:

RELATIONAL

Urgent, Inc. rd 1600 NW 3 Ave. Bldg. D Miami, FL 33136 www.urgentinc.org

ORGANIZATIONAL

COMMUNITY


7.

Personal and Organizational Alignment: PERSONAL WORK VALUES

ORGANIZATIONAL CORE VALUES

1.

1.

2.

2.

3.

3.

4.

4.

5.

5.

6.

6.

7.

7.

8.

My Work’s Purpose:

9.

Work Values Statement:

10. Urgent’s Field(s) of Service: PROGRAM

Youth Development

YES Camp Summer Youth Employment Rites of Passage Intergenerational Project Youth Empowerment After School Urgent, Inc. rd 1600 NW 3 Ave. Bldg. D Miami, FL 33136 www.urgentinc.org

Family & Child Welfare

FIELD OF SERVICE

Workforce Training & Employment

Education

Root Cause


11. Organization’s Human Service Function: PROGRAM

HUMAN SERVICE FUNCTION Ameliorative/ Social Care

Social Control

Rehabilitation

System

Community

Structural

& Adaptation

Institutional

Empowerment

Transformation

Reform

Y E S Camp Summer Youth Employment Rites of Passage Intergeneratio nal Project Youth Empowerment After School Asset Based?

LOW Constituent Engagement in the Work of the Organization HIGH

Level of Intervention Timing of Intervention 12. How can this program help Urgent achieve its mission: a._____________________________________________________________________________________ b._____________________________________________________________________________________ c._____________________________________________________________________________________ 13. Give an example of how this program helps Urgent work towards its Vision: Social- ________________________________________________________________________________ ______________________________________________________________________________________ Economic- _____________________________________________________________________________ ______________________________________________________________________________________ Educational- ___________________________________________________________________________ ______________________________________________________________________________________

Urgent, Inc. rd 1600 NW 3 Ave. Bldg. D Miami, FL 33136 www.urgentinc.org


CORE VALUES IN ACTION WORKSHEET

Program_________________________________________________________________ VALUES

QUALITIES OF…

COMPASSION INNOVATION LEARNING PATIENCE RECIPROCITY RESPONSIBILITY TEAMWORK

Urgent, Inc. rd 1600 NW 3 Ave. Bldg. D Miami, FL 33136 www.urgentinc.org

What Does it Look Like?

How Will We Know It?


URGENT, INC.-EMPOWERING YOUNG MINDS TO HELP TRANSFORM THEIR COMMUNITIES

CRA Summer Youth Employment Program

InternshipHandbook


URGENT, INC.

An Agency, Mentor, Parent and Intern Guide to the Internship Process

© Urgent, Inc. 1600 NW3rd Ave. Bldg. D Miami, FL 33136 Phone 576-3084 • Fax 576-2089 office@urgentinc.org www.urgentinc.org

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Dear Staff, Interns, Parents and Host Agencies, Thank you for taking part in this powerful learning process in partnership with Urgent, Inc.’s Rites of Passage Youth Empowerment Academy. Through the Rites of Passage Youth Empowerment Academy we promote positive adolescent development as a means of helping youth tranision successfully to adulthood. The Academy takes a comprehensive positive youth development approach. Activities are geared to increase the knowledge, skills, opportunities and behaviors necessary for youth to make positive life choices, increase their self-estem, increase knowledge of risk behaviors and increase their knowledge of career opportunities and employment readiness skills. We look forward to working with you this summer. This manual has been created as a reference guide for administration, staff, interns, career mentors, host agencies and other key stakeholders. It contains vital information, policies and procedures about our career development initiative and internship program. Please use this manual as a reference guide for any questions you may have. If you have further questions, please call Saliha Nelson, Project Director at (305) 576-3084 O, (305) 205-4605 C or email at interns@urgentinc.org. The Rites of Passage Program is generously funded by The Children’s Trust. The Children’s Trust is a dedicated source of funding created by voter referendum in 2002 to improve the lives of children and families in Miami-Dade County by making strategic investments in their future – because all children are our children.

The CRA Summer Youth Employment Program is made possible by The Miami Community Redevelopment Agency, South East Park West CRA- Chaired by City of Miami Commissioner Richard P. Dunn.

Additional internship stipends have been made possible by the Dade Bar Association, and NCJW Teens.

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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TABLE OF CONTENTS ADMINISTRATIVE OVERVIEW .................................................................................... 5 ABOUT URGENT, INC. ................................................................................................... 6 PROGRAM ADMINISTRATION............................................................................................ 6 Planning and Implementation of Internship Program................................................. 6 Promotion of Internship Program ............................................................................... 7 INTERNSHIPS BENEFITS .................................................................................................... 7 Youth........................................................................................................................... 7 Employers ................................................................................................................... 8 Community ................................................................................................................. 8 Internship Coordinator Roles and Responsibilities................................................... 10 Recognition/Celebration Activities........................................................................... 11 Internship Records .................................................................................................... 12 Document Management ............................................................................................ 12 INTERNSHIP OVERVIEW............................................................................................. 14 INTERNSHIP GOAL.......................................................................................................... 15 WHAT IS AN INTERNSHIP? .............................................................................................. 15 INTERN ROLES AND RESPONSIBILITIES .......................................................................... 15 EVALUATION OF SUCCESS.............................................................................................. 16 OUTCOMES .................................................................................................................... 16 PROGRAM PARTICIPANTS ............................................................................................... 16 PRE-REQUISITE ACTIVITIES ........................................................................................... 16 HOW LONG IS THE INTERN EXPERIENCE?....................................................................... 17 WILL I GET PAID? .......................................................................................................... 17 COMMUNITY SERVICE .................................................................................................... 17 DURING THE INTERNSHIP ............................................................................................... 17 COMPLETION OF THE INTERN EXPERIENCE .................................................................... 17 INTERN SUMMER SCHEDULE .......................................................................................... 18 TRANSPORTATION .......................................................................................................... 18 STAFFING ....................................................................................................................... 18 STRATEGIES FOR A SUCCESSFUL INTERN EXPERIENCE ................................................... 18 WHAT CAN YOU EXPECT AS AN INTERN ....................................................................... 19 JOB SUCCESS SKILLS...................................................................................................... 20 Employer Expectations ............................................................................................. 20 Communication......................................................................................................... 21 Personal..................................................................................................................... 21 HOST AGENCY OVERVIEW ........................................................................................ 22 WHAT IS A HOST AGENCY?............................................................................................ 23 HOST AGENCY ROLES AND RESPONSIBILITIES ............................................................... 23 Interns Site Activities................................................................................................ 23 Evaluation of Success ............................................................................................... 23 Site Supervisors/Career Mentors .............................................................................. 24 PARENTAL INVOLVEMENT........................................................................................ 26 URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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General Conduct Expectations.......................................................................................... 28 APPENDIX....................................................................................................................... 29 GLOSSARY ..................................................................................................................... 30 RESOURCES .................................................................................................................... 31 RESUMES ................................................................................................................ 32 THE INTERVIEW.................................................................................................... 33 FORMS ........................................................................................................................... 34 Management Forms................................................................................................... 34 Intern Forms................................................................................................................ 34 Host Agency Forms ................................................................................................... 34

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ADMINISTRATIVE OVERVIEW

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ABOUT URGENT, INC. URGENT, Inc. stands for Urban Renewal Greater Enhancement National Team. The organization was founded in 1994 to empower and revitalize urban communities. URGENT, Inc. aims to provide opportunities for urban residents to develop the knowledge, skills, and opportunities needed to create and shape urban renewal. One strategy implemented to fulfill our mission was the creation of the Rites of Passage Youth Empowerment Academy in 1999. The Academy is an intensive, focused and sustained effort which empowers youth with the knowledge, skills and abilities to transition successfully from childhood to adulthood. At the same time, the Academy offers support and training to caregivers so that the youth in their care may become productive, positive and contributing members of society. URGENT, Inc. provides youth with a series of skill development workshops including training modules on the following topics: personal development, personal health and hygiene, creating positive relationships, business and economic literacy, civic engagement, conflict resolution, the power of creativity, career development, academic achievement, environmental appreciation, real life 101-independent living skills and technology literacy. Workshops are offered after school and during the summer. Workshops are enhanced through case management, skill building retreats, outings and community service projects. For caregivers, including grandparents raising grandchildren, we offer an parenting skills classes, support groups, family bonding workshops and family outings. Current programming includes our Rites of Passage Prevention Program, serving girls in grades 6-12 (since 2001); Intergenerational Project serving grandparents raising grandchildren, relative caregivers and parents (since 2001); Summer Camp for girls ages 6-12 (since 2002); and Youth Empowerment After School Program which provides youth in grades 2-5 academic, social and enrichment opportunities after school (since 2006). Service areas include the Miami-Dade Empowerment Zone communities of Overtown and Liberty City, the targeted urban area of Little Haiti and the neighborhood revitalization areas of Goulds.

PROGRAM ADMINISTRATION Planning and Implementation of Internship Program The Project Director and Internship Coordinators to work together to plan and implement the Internship Program. Listed below are things to consider in the process: •

Respond to the needs of all stakeholders URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Assist the Internship Coordinator to ensure the following are in place and approved: … Criteria for selection of interns and internship sites … Clearly stated program objectives … Competencies to be met by interns … Required length and scheduling of internship agreements … Documents for interns/parents/guardians, internship site supervisors/mentors, and others involved in the program specifications concerning coordination of the program, placing and coordinating interns, and working with other community groups

Provide adequate time and proper staffing to support the program to include placement and visitation of youth interns and other coordination activities Review required records and documentation (training agreement, training plans, documentation of conferences, etc.) maintained by Internship Coordinator as necessary Provide input on program strengths and weaknesses to Internship Coordinator Collaborate with Internship Coordinator to develop written policies for use in decision-making situations and provide guidance in achieving program goals Assist Internship Coordinator in the selection of prospective youth Provide Internship Coordinator with professional development opportunities Ensure a follow-up survey of internship graduates is conducted as necessary Communicate with companies who are involved Contact businesses to select appropriate internship sites Assist in determining appropriate placements Orient new site supervisors/mentors Prepare training agreements Develop training plans Comply with local, state, and federal labor laws relating to safety and employment of (as applicable)

• • • • • • • • • • • • •

Promotion of Internship Program Internship programs offer real and tangible value to business, industry, and labor in the community. Promotion of internship programs in the community is essential to ensure their quality and success. It is vital that Internship Coordinator promote internship programs to both internal and external audiences.

INTERNSHIPS BENEFITS Youth Youth benefit from working and learning in a high-skill environment. They observe all aspects of the company’s operations and discover how the knowledge they gain in high URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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school and through participation in the Program is applied in the workplace.

Employers Employers benefit from the strong, long-term relationships with community groups, schools and potential qualified job candidates for their companies. Other employer benefits:

Obtain assistance with project needs

Increase awareness of your organization in the community to attract additional qualified employees and internship candidates Enables business/industry to grow future workforce. Training or orientation costs may be reduced if the business/industry hires youth after the internship period ends Allows site supervisors/mentors to share their expertise and serve as positive role models for young adults Brings recognition to the host agency for partnering with community groups

• • • •

Community Community advantages include: • • • •

Provides the opportunity to develop good community and industry relationships Encourages young adults to stay in their local community May reduce the dropout rate by providing relevant career exploration Allows better community understanding of an organization's structure and responsibilities

Program Promotion to School Administrators and Grant makers: • Invite to a meeting with parent/guardian(s) for an orientation meeting • Arrange an internship site visit • Invite to an internship recognition/celebration activity • Ask to become a member of an advisory committee • Invite to see interns’ capstone presentations • Update on intern achievement • Request to promote the internship program through civic organization involvement • Provide reports as requested

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Program Promotion to Perspective Host Agencies: • Build relationships • Invite to a coffee break • Invite to a lunch in fall and spring to update on program • Arrange an internship site visit • Ask them to participate in a class activity • Participate as a member of the advisory committee • Invite to see interns’ capstone presentations • Invite to an internship recognition/celebration activity • Prepare video for staff to use in outreach and recruitment process • Involve in intern selection process • Provide reports as requested • Share intern roster and list of internship sites Program Promotion to Youth: • Recruit through direct mailings, brochures, posters, bulletin boards, presentation, websites, multi-media and community partnerships and schools, etc. • Encourage youth-to-youth recruiting • Display pictures • Visit classes • Prepare announcements for daily bulletins Program Promotion to Community: • Create direct mailings, brochures, display windows, press releases (including pictures),etc. • Prepare newspaper releases • Make personal contacts • Recruit advisory committee membership/participation • Provide token of appreciation (plaque, certificate, etc.) • Organize an internship recognition/celebration activity • Present programs to civic organizations • Recruit guest speakers • Become a member of community organizations • Form an alumni group of former interns to help promote the program • Invite to participate in a class activity • Invite to review curriculum • Organize youth community service project • Display brochures in public libraries

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Program Promotion to Parents/Guardians: • Communicate through direct mailings, phone calls, brochures, multi-media presentations, individual conferences, etc. • Invite to open house and parent/guardian orientation • Invite to visit a seminar/class • Place articles/pictures in a parent newsletter • Schedule a personal conference • Invite to assist with program activities Internship Coordinator Roles and Responsibilities An Internship Coordinator coordinates internship experiences for youth. Monitoring daily operations, troubleshooting potential problems, and acting as the liaison for program partners are among the Internship Coordinator's key responsibilities. Many of the additional responsibilities are outlined below. • Interview prospective interns for entry into the program • Work with staff, community partners and host agencies to facilitate the proper placement of youth in the internship program • Meet with interns prior to the start of the internship to help them prepare • Confer with site supervisors/mentors to secure internship placements • Ensure that interns are placed in an internship site directly related to their career objective • Provide parent/guardian orientations • Review and complete training agreement, training plan, dress code, and daily schedule with each intern, site supervisor/mentor, and parent/guardian • Ensure that all legal requirements have been met • Document and file visitations and conferences with site supervisors/mentors, interns, and parents • Maintain accurate and current program records • Use appropriate evaluation instruments to measure intern achievement of performance expectations during the internship experience • Submit a list of interns’ names, career objectives, internship sites, and site supervisors/mentors to the agency, school principal(if applicable) and other stakeholders as requested • Select advisory committee and coordinate meetings • Gather data for follow-up • Visit internship sites to observe interns and to confer with site supervisors/mentors concerning intern performance and progress • Hold conferences with interns, site supervisors/mentors, and parents/guardians as needed • Resolve any problems that arise between the interns and the site supervisors/mentors • Adjust intern placements as needed URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Ensure that site supervisors/mentors provide consistent, effective guidance and supervision in accordance with interns’ training plans

Recognition/Celebration Activities The Project Director and the Internship Coordinator should work together to plan recognition activities. People like to be recognized and appreciated for the work they do. A variety of methods may be used to recognize the contribution of internship stakeholders. Many internship programs sponsor an appreciation event such as a reception, banquet, picnic, carry-in dinner, breakfast and/or luncheon. The event is used to: • Allow interns to share the impact that this experience has personally had on them • Acquaint people with the scope of the internship program • Involve the school administration in internship program relationships • Recognize business, industry, labor individuals, and groups who have made outstanding contributions to the internship program • Recognize intern leadership and achievement • Develop pride and group spirit for those involved with internship program A successful banquet is the result of thorough planning and the assignment of specific responsibilities. Planning for the banquet should include the interns and follow these guidelines: • Determine sources of funding • Secure a banquet location • Assist interns in developing an invitation, program, and script • Select and train the Master of Ceremonies and an alternate • Develop a timetable to ensure details are covered • Develop a guest list. Suggestions for possible invitees: 1. 2. 3. 4. 5.

School Administrators and Board members Grantmakers Advisory committee members Interns and their parents/guardians Site supervisors/mentors

• Provide practice time for program • Provide training for interns on appropriate dress and table manners • Develop seating arrangements • Prepare program activities, which may include the following: 1. 2. 3. 4.

Speakers Musical group Youth' skits, plays, talent shows, and entertainment Brief talks by several interns or several site supervisors/mentors URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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5. Visuals of internship sites (e.g., PowerPoint, video) 6. Inspirational video 7. Presentation of tokens of appreciation Internship Records A master binder for the internship program must be developed. Records for each intern and host agency are to be included. Records must be kept a minimum of five (5) years. For specific information about internship records, please refer to the section entitled Document Management. Document Management Keeping accurate records is the responsibility of the Internship Coordinator. A great deal of data is required and generated in the initiation and operation of the internship program. Information contained in intern files is subject to review by administrators, funding contract officers, parents/guardians, and youth. The following records must be kept for each intern and host agency. (See Appendix) Intern Records … … … … … … … … … … … … … … … … …

Internship Application (Note- that some internship sites may have additional required applications. The Internship Coordinator should aide the site supervisor/mentor in the facilitation of these documents Internship Interview Evaluation Form Internship Agreement Intern Resume Internship Training Plan Weekly Internship Report Time Sheet Internship Cumulative Hours Summary Orientation to Business Site Visit Record Intern Evaluation of the Internship Program Site Supervisor's/Mentor's Evaluation of the Internship Program (Interim and Final) Weekly Seminar Journal Topics Internship Career Portfolio Checklist Community Service Project Form Internship Termination Notice Internship Probation Notice

Host Agency Records …

Career Mentoring Application URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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… … …

Host Agency Memorandum of Understanding Interim Intern Evaluation Final Intern Evaluation

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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INTERNSHIP OVERVIEW

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INTERNSHIP GOAL The goal of the internship is for you to improve your capacity for economic selfsufficiency.

WHAT IS AN INTERNSHIP? An internship is NOT a part-time job. The internship is an experiential learning opportunity to put into practice what you have been learning in the program and in school. Most importantly, it is an opportunity for you, the intern, to increase your knowledge in a career choice that requires additional degrees, certification, or on-thejob training following high school. Business leaders in a real-world setting will supervise you.

INTERN ROLES AND RESPONSIBILITIES As a participant who has been accepted in the internship program. You have demonstrated that you have acquired the competencies for the internship program and that you are now ready to apply and further develop your skills during the internship period. In addition, you are required to: • Adhere to dress and behavior guidelines • Participate in all approved activities structured by the Internship Coordinator and the internship site supervisor/mentor, focusing on the training plan • Complete, sign, and submit all documentation as directed by the Internship Coordinator • Communicate with the Internship Coordinator throughout the internship experience, especially if concerns or problems need to be addressed • Evaluate and share information about the internship experience • Comply with the policies and procedures of the internship site • Meet established criteria of the internship program • Comply with training agreement • Comply with policies and procedures of the work site • Complete and submit weekly reports and cumulative hour summaries • Cooperate with the Internship Coordinator in securing appropriate internship placement • Notify Internship Coordinator and internship site supervisor/mentor if unable to report to internship site or seminars/classes • Have transportation to and from the internship site • Participate in internship recognition/celebration activities • Cooperate with the site supervisor/mentor and Internship Coordinator; engage in the program as a learning experience; observe business etiquette; and abide by safety rules • Furnish the Internship Coordinator with requested information URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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• Demonstrate honesty, punctuality, respect, courtesy, cooperative attitude, proper health and grooming habits, and a willingness to learn both in the seminars/classes and at the internship site. • Remain at the assigned internship site for the duration of the internship period except by mutual agreement of all parties • Maintain confidentiality guidelines

EVALUATION OF SUCCESS In order to effectively gauge your competency development over the course of the internship, the evaluation methods utilized entail a multi-method approach. Evaluation tools utilized include: pre and post assessment, collection of participant records and knowledge based pre and post tests. The evaluation measures used are: • • • • • • •

Work Investment Act Job Readiness Pre/Post Test- completed by intern Career Portfolio- completed by intern Internship Journal- completed by intern Meaningful Future Plan- completed by intern Final Presentation- completed by intern Supervisor Interim and Final Evaluation- completed by Internship Coordinator Site Monitoring Evaluation- Completed by Internship Coordinator

OUTCOMES Initial outcomes to gauge your success are: •

Increased practical job knowledge, experience and skills.

Intermediate outcomes are: • •

Increase self-efficacy Increased application or placement to post secondary education and/or occupational training.

PROGRAM PARTICIPANTS Targeted youth for participation are youth in career academies and/or participatin in Urgent programs. Other eligibility criteria may be determined by funding source.

PRE-REQUISITE ACTIVITIES Part of the success of any internship program requires careful screening of youth before acceptance. The selection is a privilege and honor since the intern is representing him/herself, his/her family, and URGENT, Inc. in an adult career environment. URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Screening guidelines are determined by the Programs Manager and funding guidelines for the internship program.

HOW LONG IS THE INTERN EXPERIENCE? Most internships will last between four to six weeks. You are expected to complete a minimum of 20 hours a week. You must adhere to the work schedule given to you by your host agency. Your time commitment to the internship is required. Actual length of the internship experience will be determined by funding source.

WILL I GET PAID? You will have the opportunity to earn a stipend during the internship. The stipend amount paid will be directly related to your time and attendance at your host agency. The stipend will be paid in 3-4 payments and be distributed on designated days. High interns will earn $7.31/hour and collge students will earn $9/hour up to 150 hours.

COMMUNITY SERVICE Community service hours will be offered each Friday during the Continuing Education Seminars. Community service hours are not optional and are an integral part of the learning experience.

DURING THE INTERNSHIP During your internship you will be required to: • •

Complete weekly time sheets and activity reports Attend weekly seminars to review your experiences, concerns and work on your internship journal, portfolio and final project presentation

COMPLETION OF THE INTERN EXPERIENCE

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At the end of the internship you will be expected to present your final project. The Internship Coordinator will give you the criteria for completing this project. This project is a required activity to receive your stipend. Use the Internship Career Portfolio Checklist as a guide.

INTERN SUMMER SCHEDULE Interns must participate in a variety of activities each week. In general, the Intern’s summer schedule will be as follows: Activity Complete Internship Application Internship Orientation & Training Mock Interviews Host Agency Interviews Internships Begin Continuing Education & Training Internships End Final Recognition Ceremony

Time Frame Due by June 10, 2011 8:00am-1:00pm; 6/17, 6/20, 6/21, 6/22 6/21 6/22, 6/23, 6/24 Week of 6/27-6/30 8:30-1:00; 7/1,7/8, 7/15, 7/22, 7/29 Week of 8/1-8/4 9:00am-11:00am; 8/5

TRANSPORTATION Buss passes or tokens may be available for interns needing transportation to and from their internship location and Internship Seminar Meetings.

STAFFING Interns will be monitored weekly on site by program staff. The Internship Coordinator serves as the liaison between the host agency and URGENT, Inc. The Project Director will be available if the Internship Coordinator is unavailable or needs assistance.

STRATEGIES FOR A SUCCESSFUL INTERN EXPERIENCE Show your employer you are a good intern: • •

By being on time! Make sure you have reliable transportation Use your time efficiently URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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1. Limit socializing with other co-workers or socializing online or by text 2. Do not abuse your lunch hour and break time 3. Do Not Gossip! • •

Follow the dress code of the company or program. Always be neat and clean Learn as much as you can about the company 1. Look at the company’s website

• •

Ask questions. When you are unsure of something be sure to ask the supervisor assigned to you Alert your Internship Coordinator of any potential problem

Go Above and Beyond: 1. You will receive favorable reviews if you are willing to exceed your employer’s expectations

• • •

Display Energy and Enthusiasm Smile! Show enthusiasm, the most successful interns are those that display an upbeat attitude and a genuine interest in performing their role

Network 1. This is your opportunity to meet people who can assist you in your career choice 2. This is your opportunity to learn what skills, education are necessary for this field 3. This is your opportunity to learn more about this industry

Portfolio 1. Be sure to list your intern experience in your portfolio 2. List summaries of projects completed 3. List positive feedback from your employer

Thank You 1. Upon completion of your intern experience, be sure to write a thank you to the company and supervisor for giving you this opportunity. This is required as part of your earned stipend during the internship.

WHAT CAN YOU EXPECT AS AN INTERN 1. Real work! URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Some amount of clerical work comes with any internship, but you will find good learning experiences. 2. The Site Supervisor/Career Mentor will give directions. Your employer will discuss the company’s expectation in the beginning in order to avoid miscommunication. 3. Expect feedback The Site Supervisor/Career Mentor will help you, the intern, by communicating with you. 4. Company events You may be included in the daily life of the company. 5. What if I don’t understand the task assigned to me? The company will work with you to. Don’t be afraid to ask questions. 6. Who will assist me? The company will assign a staff member to mentor and guide you. 7. Will I get paid? Yes. This activity is designed to assist you in determining your career path by giving you “real world” experience. You will have the opportunity to earn a stipend based on your attendance on site and on Fridays. 8. What is a Stipend? We define a stipend as a fixed sum of money paid as an allowance or scholarship to a youth based on the number of successful internship hours performed. 11. Will I be evaluated? Yes, look at the evaluation in the appendix. Your employer will complete this and give it to our Internship Coordinator.

JOB SUCCESS SKILLS Employer Expectations • Positive attitude, do not carry negative feelings into your new workplace • Time – always be on time • Good attendance – if you are going to be unavoidably late or out sick, ask your supervisor the proper method of informing them • Follow all office rules, policies and procedures

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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• Listen and learn Communication • Communicate with your mentor on a regular basis • Be a team player. Be willing to help. Avoid the “know-it-all” attitude • Ask for help when you need it Personal • Have an emergency plan for transportation. Have all personal appointments out of the way so that you need not ask for time off • Be willing to learn new skills • Be positive and upbeat with co-workers • Be clean and well groomed. Avoid wearing strong perfumes or colognes • Keep your personal life and problems at home • Don’t use the employer’s equipment and time to do personal things • Be patient with yourself • Volunteer for projects • Accept criticism as constructive. Don’t become defensive • Always be friendly • Treat everyone with courtesy and respect • Keep your emotions under control • Show appreciation • No Gossip!

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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HOST AGENCY OVERVIEW

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WHAT IS A HOST AGENCY? A Host Agency is any business entity, government agency, university or non-profit organization that can provide an experiential learning and mentoring experience for an intern. Internship sites are carefully selected so that interns are placed in locations and situations that provide quality learning experiences compatible with the intern's meaningful future plan. Parents/guardians may not serve as an internship site or supervisor/mentor to their children.

HOST AGENCY ROLES AND RESPONSIBILITIES Interns Site Activities The intern’s site activities should include special projects, a sampling of tasks from different jobs, or tasks from a single occupation. The Internship Coordinator will work with the Internship Site Supervisor/Career Mentor to ensure meaningful learning opportunities will be available during the internship. Evaluation of Success Training Plan An internship training plan must be developed and followed for each intern. The Internship Coordinator and internship site supervisor/mentor should jointly prepare this plan. The plan should include the tasks, assignments, and/or observations specific to the internship site. Time Sheets Each Intern is required to complete a weekly time sheet and summary of activities. A collection of time sheets will be provided to each host agency at the start of the internship for distribution. Time sheets also document a summary of intern performance in which the Site Supervisor/Career Mentor must complete. The intern and Site Supervisor must sign time sheet. The intern is to turn in the time sheet each Friday. Site Visits Visits to the internship site are extremely important. However, the exact number of visits to the workplace by the Internship Coordinator will depend upon the length and scheduling of the experience as well as any problems or concerns that may develop at particular internship sites. The number of site visits must be sufficient to obtain appropriate placements for all interns, to conduct conferences with the internship site supervisors/mentors, to develop internship training plans, to resolve any problems, and to evaluate intern performance and progress. Regular communication is essential and should be done by fax, phone, e-mail, and face-to-face. URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Evaluation The Site Supervisor/Career Mentor will be asked to complete the following evaluations over the course of the internship: • • • •

Weekly Time Sheet and Performance Summary Site Visit monitoring with the Internship Coordinator Interim and Final Intern Evaluation Internship Evaluation Survey

Recognition Host agencies may choose to recognize their interns’ achievements and development of skills and competencies gained as part of their mentoring activities. Payments to Youth Interns will have the opportunity to earn a stipend during their internship. The stipend will be paid by URGENT, Inc. unless the host agency wishes to sponsor the intern’s stipend. The stipend amount paid will be directly related to the interns’ number of hours worked at the host agency.

Site Supervisors/Career Mentors Roles and Responsibilities An internship site supervisor/mentor who is prepared for his or her role will demonstrate the following: • Ability to serve as a role model for the career field or discipline with a good understanding of the industry and current trends • Dedication to learning about and teaching about the major aspects of the field, including benefits and drawbacks • A strong work ethic • Ability to communicate with all involved parties • An understanding of the internship program and what is expected of all involved parties • Timeliness in completing school documentation for the intern and/or Internship Coordinator • A willingness to help develop the intern training plan and to implement or revise the plan as circumstances arise URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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• • •

A willingness to assist the Internship Coordinator in evaluating the intern throughout the internship experience A willingness to verify reports, time sheets, and other internship documents A willingness to comply with all items specified in the training agreement

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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PARENTAL INVOLVEMENT

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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Parents/Guardians are encouraged to support their youth during participation in the Rites of Passage Program and during the internship. Parents will be invited to attend an Intern Orientation to find out the details of the program. Parent permission to participate in the internship program is required. Overall Parents/Guardians should: • • • • • •

• • • • • • • • •

Communicate questions or concerns to the Internship Coordinator, not the Host Agency or the Site Supervisor/Mentor Understand that career exploration/preparation is the goal of the program Approve and sign appropriate forms for youth participation in the program Become knowledgeable concerning the purposes and procedures of the training agreement and training plan Provide proof of health and liability insurance coverage, understanding that because the intern is not an employee of the company, no worker’s compensation would apply Intern and parents or guardians assume all responsibility, accountability, and liability for any and all acts arising out of the intern’s participation in the internship program, including but not limited to the operation of a motor vehicle to and from the internship site Assist the intern in complying with the rules of the program Give intern permission to drive from school to internship site, take public transportation and/or be responsible for providing transportation for the intern if needed Provide time for conferencing with the Internship Coordinator Provide guidance in career selection Support the policies and expectations of the program Work cooperatively with Internship Coordinator and intern in solving school, work, and home problems Assume general legal responsibility for the actions of the intern while at the internship site Provide encouragement and assistance to ensure your youth meets program objectives which maximizes benefit from the internship experience Maintain and reinforce confidentiality regarding any information/encounters your youth gains while at their internship site.

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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General Conduct Expectations In general Site Supervisors, Participants, Staff and Parents shall: • • • •

Show respect to everyone Refrain from using abusive or foul language or sexually explicit language Refrain from causing bodily harm to self, other participants or staff Show respect to equipment, supplies, and facilities

Additionally, Urgent, Inc. believes that staff, volunteers, consultants and any other person working with program youth should be able to work in an environment free of threatening speech or actions. Threatening behavior consisting of any words or deeds that intimidate a staff member or cause anxiety concerning his/her physical and/or psychological well being is strictly forbidden. Any participant, parent, staff member, or agent of the above who is found to have threatened a member of the staff will be reported to the authorities. Interns will also be terminated from the program.

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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APPENDIX

URGENT, Inc. 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph 305-576-2089 fax office@urgentinc.org www.urgentinc.org

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GLOSSARY Administrator: Agency Management Advisory/Committee: Representatives from business/industry, organizations, secondary and post-secondary institutions, parents, and youth who meet periodically to assist in developing and maintaining program standards Career Portfolio: An organized, documented collection of an individual’s qualifications, skills, experience, and achievements Confidentiality: Not sharing, discussing, or revealing personal and private information to which one is privy Intern: a youth learner who has applied to and been accepted into the internship program Internship Application: Form completed by youth to seek entry into the internship program Internship Coordinator: Staff who is paid to implement internship program for youth Intern Evaluation: Form completed by site supervisor/mentor to rate the performance of the intern Internship Cumulative Hours Summary: Document used to tally hours completed during the internship Career Mentor: An experienced, competent person at the internship site who supports, coaches, nurtures, and guides interns; may also be the internship site supervisor Host Agency: Location where an intern is placed, also known as Internship Site. Internship Site Supervisor: Designated liaison between the Internship Coordinator and mentor Internship Agreement: Document that states the conditions and parameters that participants agree to when taking part in an internship program Internship Training Plan: An outline of the competencies to be developed during the internship Meaningful Future Plan: An individualized career plan that fits the youth’s unique specific needs and is designed to facilitate the transition from high school to future learning or employment Program Evaluation Survey: Comments and suggestions from site supervisor/mentor and intern regarding the quality of the internship experience and program Proof of Insurance: Documentation furnished by the parent/guardian verifying that the intern has insurance coverage Request for Absence Form: Used by the intern to request an absence in advance Self Sufficiency: The capacity to manage one's own affairs, make one's own judgments, and provide for oneself: independence , self-determination; financially and socially Screening Process: The guidelines/prerequisites that must be met by a youth prior to acceptance into the internship program Seminar/Class Instruction: In-house training related to the internship experience Termination: Removal from the internship program Weekly Internship Report and Time Sheet: Documentation of activities, hours, duties, tasks, and/or observations verified by the internship site supervisor/mentor


RESOURCES


RESUMES Submitting your resume for review is the initial step in obtaining a new job. Since an employer's review of a resume almost always precedes an interview, it is critical that the information you wish to convey is properly constructed. •

The purpose of a resume is not to get the job, but to get the interview

You should consider the job interview to be like a locked room and your resume as a key to that room. Before you can enter this room, it must be unlocked. Many keys will be tried; only a few will unlock the door

Your Skill Development Instructor or Internship Coordinator provides guidance and counseling on matters of resumes and cover letter construction

Your library is also full of wonderful examples of resume writing resources.

Points to Consider • Keep your resume brief (1-2 pages) • Use only 8 1/2” x 11” paper • Use white or off-white quality paper • Emphasize your skills and accomplishments • Don’t use abbreviations • Arrange the resume so it’s pleasing to the eye • Avoid fancy fonts, exotic colored paper, photographs and graphics, unless you are applying for a graphic art position • Clearly define your objective • Provide a summary of qualifications at the top using key words or phrases • Use clear concise bullet statements to describe your pertinent experience • List all related educational achievements or completed courses, starting with the most recent • List extra-curricular and after school activities as they relate to your career or leadership goals. • Offer to provide professional and personal references at the bottom


THE INTERVIEW Preparation Preparation is the key to success. Preparation will help win the interview and will improve chances of success. Points to Consider • • • • • • •

Gather all information and documents you may need for the interview Bring extra copies of your resume, typed list of references and letters of recommendation Bring school report cards and/or transcripts Bring copies of any awards or certifications You may want to bring work samples Bring pen and pad for taking notes Research the job and the employer. The more you know about the industry the better prepared you will be Think about some standard interview questions and how you might respond

• And…. •

Personality - People hire people, not paper. The personality you display in your interview will greatly influence how people react to you. In an increasingly team-based work world, most employers are looking for people who will fit in and are flexible and adaptable.

Attitude - For recent graduates and people with little experience, attitude may be the most important job qualification. Many employers have suggested they are willing to take a chance on someone who doesn't have skills but has a great attitude

Time – Get a good night’s sleep before the interview and plan your travel to arrive in plenty of time. Present yourself no more than 15 minutes early

Appearance - Your appearance is one of the main avenues for expressing your personality and attitude. It is best to dress in a professional manner

Additional Tips • • • • • •

Maintain good eye contact Don’t be a clock watcher Don’t discuss illegal or discriminatory subjects such as race, religion, etc. Be aware of nonverbal body language Dress a step above what you would wear on the job Ask for a business card in order to send a thank you note

After the Interview •

Write a thank you note to each person who took part in the interview. Thank the employer for their time, restate your interest in the job, and remind them of your intent to follow-up. Mail the letter the day of the interview.


FORMS Management Forms Internship Interview Evaluation Form Site Visit/Communication Summary Internship Termination Notice Internship Probation Notice Handbook Acknowledgement and Receipt

Intern Forms Internship Application Intern Agreement Orientation to Business Community Service Project Plan Weekly Internship Report Weekly Seminar Journal Topics Weekly Time Sheet and Performance Review Internship Cumulative Hours Summary Career Portfolio Checklist Interns Evaluation of the Internship Program

Host Agency Forms Career Mentoring Application Host Agency Fact Sheet Host Agency Memorandum of Understanding Internship Training Plan Site Supervisor’s/Mentor’s Evaluation of the Internship Program Interim Intern Evaluation Final Intern Evaluation


Summer Youth Internship Agreement The purpose of this agreement is to ensure that the internship experience is productive and beneficial to all parties. This agreement outlines the obligations of the intern and URGENT, Inc. This internship agreement is between ________________________________ a participant of URGENT, Inc.’s Summer Youth Internshi Internship p Program and Urgent, Inc. a non-profit organization.. This internship will beg begin in between June 23 and June 30, 2011 and end no later than August 4, 2011.

I understand that I will have the opportunity to earn an educational stipend up to an amount not am not an empl greater than $1096.50 as a high school student or $1350.00 as a college student. The stipend earned will be based soley on the number of internship hours completed at my host agency and volunteer but mandatory participation at weekly continuing education and training workshops.

The stipend will be paid approximately every two weeks and will only be based upon the complete and accurate submission or required attendance verification to the Internship Coordinator. I understand that attendance at all program activities are mandatory and include:

1) Internship Orientation & Training - 14SDays1 Saturday 3) Internship Continuing Education and Skill Building - 5 Fridays 4) Internship - 150 Hours 5) Internship Recognition and Presentation Ceremony - 1 Day I acknowledge that I have been given a unique opportunity to gain valuable professional experience. I have reviewed the attached internship handbook and training plan and feel confident that I will be able to fulfill the duties described in a timely a and nd professional manner. I also understand that this internship is to be considered an experiential learning opportunity and that my


performance will be evaluated and considered if I apply for this program again in the future. I am aware that the evaluation will be based on the following criteria: • My ability to perform in a professional manner, as indicated by my ability to arrive on time, my ability to meet deadlines, my ability to take initiative in learning, and my ability to interact with my supervisors and colleagues • My learning during the internship, as indicated by my ability to fulfill the training plan and my development of the skills identified in the training plan • The evaluation of my supervisor • My final presentation to completed by the end of the internship describing my learning experience I also agree to: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Perform the necessary tasks and follow instructions as given by the Internship Coordinator and/or Host Agency Site Supervisor/Career Mentor Abide by the regulations and policies of the business and the program Attend the weekly Internship Seminars Notify the Internship Coordinator and my Site Supervisor on days absent or late prior to starting time (when possible) Submit complete and accurate weekly reports of my activities as required Report to the Internship Coordinator as soon as possible when problems arise affecting my internship placement Study the internship handbook and accept the conditions set forth therein Not hold the business or URGENT, Inc. liable for accidents or injuries sustained during the internship Dress appropriately for the internship Support all activities related to the internship program, including the final recognition ceremony Keep all matters confidential

The Parent or Guardian agrees to: 1. 2. 3. 4. 5. 6.

7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

Direct the intern in carrying out his/her responsibilities Contact the Internship Coordinator, NOT the business, when problems or questions arise concerning the intern’s internship Understand that career exploration/preparation is the goal of the program. Approve and sign appropriate forms for student participation in the program (application, proof of insurance, permission to drive, etc.) Become knowledgeable concerning the purposes and procedures of the training agreement and training plan Provide proof of health and liability insurance coverage, understanding that because the intern is not an employee of the company, no worker’s compensation would apply. The intern and parents or guardians assume all responsibility, accountability, and liability for any and all acts arising out of the intern’s participation in the internship program Grant permission to the host agency to call for medical assistance in the event of an emergency. Assist the intern in complying with the rules of the program Give intern permission to drive from school to internship site, be responsible for providing transportation for the intern and/or give permission for intern to use public transportation Provide time for conferencing with the internship coordinator Provide guidance in career selection Support the policies of the program Work cooperatively with internship coordinator and intern in solving school, work, and home problems Assume general legal responsibility for the actions of the intern while at the internship site. Provide encouragement and assistance to ensure your youth meets program objectives, which maximizes benefit from the internship experience Maintain and reinforce confidentiality regarding any information/encounters your youth gains while at their internship site Abide by the Behavior Agreement (See Addendum)


General Release: I understand that URGENT, Inc. reserves the right to make cancellations, changes, or substitutions in the cases of emergency or changed conditions or in the general interest of the program. It is further expressly agreed that the host agency and use of any of its facilities shall be undertaken by me at my own sole risk and that URGENT, Inc. shall not be liable for any and all claims, demands, injuries, damages, actions, or causes of actions, whatsoever to me or property arising with of or connected with the program and with any and all services, and facilities associated with the intern experience; and do hereby expressly forever release and discharge URGENT, Inc. from any and all claims demands, injuries, damages, actions, or censuses or action, arising from or related to any and all acts of active or passive negligence on the part of URGENT, Inc. and or its officers, employees, volunteers or agents.

Student Name: ___________________________________

Date of Birth:___________

Student Signature: ________________________________

Date: ____________

Parent/Guardian Name: ___________________________ Parent/Guardian Signature: ________________________

Date:_____________

Age:_______


ADDENDUM #1 Internship Policies and Code of Ethics Agreement Your initials and signature at the bottom of this form indicate you understand the following details as they are outlined below and agree to the requirements listed. 1. I understand that Urgent, Inc. Internship Policies and Code of Ethics apply towards my behavior during any internship assignment. Initial ______ 2. I understand that permissible work absences include illness or other serious circumstances. I will be responsible to notify my site supervisor and my Internship Coordinator in case of absence. Initial _______ 3. I understand that any changes in my internship status (cutback in hours, or dismissal) must be reported immediately to my Internship Coordinator. Initial ______ 4. I am responsible to behave in a professional manner and to hold in professional confidence any information gained regarding the host agency organization. Initial ______ 5. If I feel victimized by a work-related incident (e.g. job misrepresentation, unethical activities, sexual harassment, discrimination, etc.), I will contact my Site Supervisor and Internship Coordinator immediately. Initial ______ 6. I understand that due to the nature of an Internship arrangement, I may not withdraw from a placement except in severe and justifiable circumstances as determined by the Site Supervisor and Internship Coordinator. A dismissal or if I quit will nullify the internship arrangement and cancel my opportunity to receive a stipend or portion thereof. Initial ______ 7. I am aware of all applicable personal medical needs and have consulted with a medical doctor with regard to them I assume all risk and responsibility for my medical or medication needs and the cost thereof. Initial ______ 8. I have provided, and will continue to provide, Urgent, Inc. with all medical data and any other personal information necessary for a safe and healthy internship experience. There are no physical or mental health-related reasons or problems that preclude or restrict my participation in the Internship Program. I assume full responsibility for any undisclosed physical, mental or emotional problems that might impair my ability to complete the internship experience. Initial _______ 9. I understand that Urgent, Inc.’s Internship Coordinator may take actions he/she considers to be warranted under the circumstances to protect my health and safety and/or to guard the integrity of the Internship Program, including termination of the internship experience. Initial ______


11. I will not change my internship work schedule, including community service hours, without obtaining permission from my site supervisor, and Internship Coordinator. Initial ______ 12. I will maintain satisfactory job performance and follow all policies of my host agency. If I fail to do so, I may be terminated from the internship. Initial ______ 13. I understand my internship may be contingent on a physical exam, immunization confirmation, drug screening and/or background investigation. I understand that in some instances if a background check turns up even minor violations, it may prevent me from qualifying for an internship. Initial ______ 17. I understand that I am not an employee and as an intern this experience is part of an educational program, and I am not entitled to unemployment benefits or workmen’s compensation. Initial ______ 18. I will comply with the Internship Program Guidelines and Policies. Initial ______ 19. I will conform to the professional standards of the internship site and will employ high standards of ethical behavior at all times during the internship. Initial ______ 20. I agree to release to the internship site any necessary information that would enable the internship site to provide reasonable accommodations for my participation in an internship experience if I have a documented disability or limitation. Initial ______

_________________________________________________ Intern Name _________________________________________________

Intern Signature Parent/Caregiver Name__________________________________ Parent/Caregiver Signature_______________________________

_____________

Date


ADDENDUM #2 Participant Behavior Policies and Procedures URGENT, Inc. aims to create a positive, educational, safe and effective learning and work environment for all staff, clients and partners. To that end, the following behavior policies apply to all staff, clients, parents and partners. Engaging in any of the behaviors below will result in immediate termination from the program/agency on a case by case basis: 1) Threatening, intimidating or coercing staff, peers or others for any reason, for any purpose 2) Dishonesty, willful falsification or misrepresentation of any information provided to staff, peers or others for any reason, for any purpose 3) Immoral conduct or indecency in communications with staff, peers and others. This includes the use of profanity, sexually explicitly language, and name calling towards staff, peers and others, for any reason and for any purpose. 4) Unwillingness to support or further the mission of the organization. This list in not meant to be all inclusive. If events occur falling outside of this list consequences will be reviewed on a case by case basis. Please indicate if you agree to comply with this policy and procedure below: Â…

Yes, I agree to this policy and will follow the stated behavior guidelines.

Participant Name: Participant Signature:

Date:

Parent Name: Parent Signature:

Date:


INTERNSHIP CAREER PORTFOLIO and FINAL PRESENTATION CHECK LIST Directions: Think about your career portfolio as a collection of artifacts that thoroughly document the work you have done to become job ready and the knowledge and skills you have acquired as an intern. Your portfolio should demonstrate the following: • Connections between your intern experiences and your knowledge • Reflect your personal, academic and career goals • Provide evidence of your performance • Document your acquisition of specific skills or knowledge • Record your personal growth • Provide future employers with evidence of your work experience Your portfolio will serve as the foundation for your final presentation. Career Portfolio Check List … … …

Materials are collected and organized in a three ring binder. Plastic sheet protectors are used for items that should not be whole punched. Dividers are used where appropriate The outside front cover and on the spine should display your name, year of internship, career focus area and internship site Documents that should be included: … Internship Application … Intern Agreement … Resume (Before and After Internship) … Business Orientation Form … Training Plan … Information about your host agency (ex. brochures, flyers, manuals, etc.) … Journal Questions and Answers … Weekly Internship Report … Time Sheets … Community service project plan and results … Samples of internship work (ex. Reports, flyers, photos, email messages, certificates, thank you notes, letter of commendation from supervisor, etc.) … Sample cover letter that would model how you would present yourself for another internship or job … Research on career field including skills, education, salary range, experience needed to continue in field


W-9

Request for Taxpayer Identification Number and Certification

Form (Rev. January 2011) Department of the Treasury Internal Revenue Service

Give Form to the requester. Do not send to the IRS.

Print or type See Specific Instructions on page 2.

Name (as shown on your income tax return) Business name/disregarded entity name, if different from above Check appropriate box for federal tax classification (required):

Individual/sole proprietor

C Corporation

S Corporation

Partnership

Trust/estate Exempt payee

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶ Other (see instructions) ▶ Address (number, street, and apt. or suite no.)

Requester’s name and address (optional)

City, state, and ZIP code List account number(s) here (optional)

Part I

Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Social security number

Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.

Employer identification number

Part II

Certification

Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4.

Sign Here

Signature of U.S. person ▶

Date ▶

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

Cat. No. 10231X

Form W-9 (Rev. 1-2011)


Protect your child with Student Accident or Health (Injury or Sickness) Insurance This certificate contains a Deductible provision. Kids will be kids.

Online Enrollment Secured Accident & Health Plans

School is not a spectator sport. From hopping and skipping to blocking and tackling, our commitment to protecting kids starts as early as kindergarten.

• Coverage can be purchased any time throughout the year.

That’s why we’re here!

• Checks, money orders, or credit cards accepted. • DO NOT SEND CASH www.k12StudentInsurance.com

Underwritten by: UnitedHealthcare Insurance Company

Excess Insurance - Mandatory Coverage TOLL-FREE NUMBER FOR INQUIRES: For inquires and to obtain information about your coverage, or for assistance in resolving a complaint, please call 1-866-409-5734.

ABC-06-BR(HC/PC) (Rev 08)

FL10WBSREMD


STUDENT ACCIDENT OR HEALTH INSURANCE Choose Your Coverage Plan Voluntary Plan 24-HOUR ACCIDENT (STUDENT & EMPLOYEES) • Around-the-clock/anywhere in the world; until one year after the date the school year begins • Before, during and after school • Weekends, vacation and all summer including summer school • School sponsored and extracurricular sports excluding high school football Grades K-12

$66.00

AT-SCHOOL ACCIDENT (STUDENT & EMPLOYEES) • During regular school term on school premises while school is in session • Direct and uninterrupted travel to and from home and scheduled classes • School sponsored and supervised sports excluding high school football • Travel to and from school sponsored and supervised sports while in a school furnished vehicle Grades K-6

$14.00

Grades 7-12

$16.00

EXTRACURRICULAR ATHLETICS / ACTIVITIES REQUIRING MANDATORY INSURANCE (Must be purchased through Senior High School’s Athletic Department) All Students participating in certain extracurricular activities / athletics are required by the School Board Policy to purchase the student accident insurance. Badminton

Bowling

Golf

Swimming

Volleyball

Basketball

Cheerleading

Soccer

Tennis

Water Polo

Baseball

Cross Country

Softball

Track and Field

Wrestling

Mandatory Coverage for Extracurricular Activities / Athletics (School Term Only) Grades 7-12

$45.00

Required coverage for all students who tryout, participate, or practice interscholastic sports or extracurricular competitive activities. • • • •

During regular school term, on school premises while school is in session Direct and uninterrupted travel to and from home and scheduled classes School sponsored and supervised sports excluding high school football Travel to and from school sponsored and supervised sports while in a school furnished vehicle

STUDENT HEALTH PLAN (STUDENTS AGES 5 - 18 ONLY) • $147 per quarter, or $588 annual (Per Policy Year - can not be purchased after September 30th). • Covers sickness & accidents which happen anytime, 24-hours a day, while your student is insured under this plan (excluding interscholastic sports) • Benefits are payable according to the benefit schedule up to $50,000, after the $50 deductible has been met per policy year.


REVIEW YOUR BENEFITS: ACCIDENT ONLY COVERAGE MAXIMUM BENEFITS - PAID AS SPECIFIED BELOW The Policy provides benefits for loss due to a covered Injury up to the Maximum Benefit specified below for each Injury. Provided that treatment by a qualified, licensed Physician begins within 60 days from the date of the Injury, benefits will be paid for Covered Medical Expenses incurred within 104 weeks from the date of the Injury up to the maximum benefit per services as shown below. Any supply or service not specifically listed is not covered. Usual and Customary Charges (U&C) are based on the 75th percentile. (For Mandatory Coverage) Policy Benefits are not payable for any expenses incurred which are paid or payable by other valid and collectible insurance. MAXIMUM BENEFIT DEDUCTIBLE

$25,000 (For each Injury) $0

INPATIENT Room & Board Hospital Miscellaneous Registered Nurse Physician’s Visit (Benefits are limited to one visit per day and do not apply when related to surgery) Pre-Admission Testing (Payable within 3 working days prior to admission)

$1,000 maximum per day U&C U&C $45 first day / $40 each subsequent day Paid under Hospital Miscellaneous

OUTPATIENT Day Surgery Miscellaneous

U&C

(Usual & Customary Charges are based on Florida Workers’ Compensation Fee Schedule) Physician’s Visits $45 first day / $40 each subsequent day (Benefits are limited to one visit per day and do not apply when related to surgery or physiotherapy) Physiotherapy (Benefits are limited to one visit per day)

$30 per day / 10 days maximum

Medical Emergency U&C (Use of room and supplies; treatment must be rendered within 72 hours from the time of the Injury) X-Rays U&C / $75 maximum CAT Scan $375 maximum MRI $750 maximum Laboratory No Benefits Prescription Drugs Injections Orthopedic Braces & Appliances

No Benefits No Benefits $250 maximum

INPATIENT AND/OR OUTPATIENT Surgery U&C (Specified Surgery based on data provided in the Florida Workers’ Compensation Fee Schedule) (No more than one procedure through the same incision will be paid) Anesthetist U&C Assistant Surgeon U&C Ambulance $250 maximum Consultant Paid under Physician’s Visits Dental (Benefits are paid on Injury to Sound, Natural Teeth only) $500 per tooth / $1,000 maximum (Includes Orthodontia as a result of a Covered Injury) Dental X-Rays $15 for one tooth / $40 for full mouth Replacement of Eye Glasses, Contact Lenses or Hearing Aids U&C that are broken as a result of a Covered Injury Home Health Care 40 non-surgical visits (Per Policy Year) (Services must be rendered within 7 days after hospital stay or outpatient surgery. Physician must recommend treatment must be certified by the Utilization Review Program.) Food Poisoning

Paid as any other Injury

(The exclusion will be waived and benefits will be paid for food poisoning caused by school supplied food.) Hearing Aids (Benefits are paid as a result of a Covered Injury) Motor Vehicle Injury (Other than 2 or 3 wheeled)

Paid under Orthopedic Braces & Appliances $2,000 maximum

Benefits are provided as mandated by the state of Florida for the Benefits for Outpatient Services and Benefits for Procedures Involving Bones or Joints of the Jaw and Facial Region. Details of these benefits may be found in the Master Policy on file at the School District.

NOTE: This is a brief summary of the benefits and not a contract. A Master Policy has been provided to your school district that contains all of the provisions, limitations, and exclusions and qualifications of the insurance benefits. The Master Policy is the contract and will govern and control the payment of benefits.


REVIEW YOUR BENEFITS: STUDENT HEALTH PLAN COVERAGE STUDENT INJURY AND SICKNESS BENEFITS MAXIMUM BENEFITS PAID AS SPECIFIED BELOW The Policy provides benefits for loss due to a covered Injury or Sickness up to the $50,000 Maximum Benefit as specified below for each Injury or Sickness after the $50 deductible. Benefits will be paid up to the maximum benefit for each service as scheduled below. Any supply or service not specifically listed is not covered. Usual & Customary Charges (U&C) are based on the 75th percentile.

MAXIMUM BENEFIT DEDUCTIBLE INPATIENT

$50,000 (For each Injury or Sickness) $50 (Per Policy Year)

Room & Board / Hospital Miscellaneous

$950 aggregate maximum per day

Registered Nurse

100% of U&C

Physician’s Visit (Benefits are limited to one visit per day and do not apply when related to surgery) $50 first day / $30 each subsequent day Pre-Admission Testing (Payable within 3 working days prior to admission)

Paid under Room & Board / Hospital Miscellaneous

OUTPATIENT Day Surgery Miscellaneous (Usual & Customary Charges are based on Florida Workers’ Compensation Fee Schedule)

$950 maximum

Physician’s Visits (Benefits are limited to one visit per day and do not apply when related to surgery $60 first day / $40 each subsequent day / 5 days or physiotherapy) (Office visits for physical exams are covered up to $50 Per Policy Year) maximum Physiotherapy (Benefits are limited to one visit per day)

Paid under Physician’s Visits

Medical Emergency (Use of room and supplies; treatment must be rendered within 72 hours from $200 maximum the time of the Injury or first onset of Sickness) X-Rays

$350 maximum

CAT Scan / MRI

$350 maximum

Laboratory

$200 maximum

Prescription Drugs

No Benefits

Injections

No Benefits

Orthopedic Braces & Appliances

$100 maximum

INPATIENT AND/OR OUTPATIENT Surgery (Specified Surgery based on data provided in the Florida Workers’ Compensation Fee Schedule) (No more than one procedure through the same incision will be paid)

$100 surgery coefficient / $2,500 maximum

Anesthetist

25% of Surgery Allowance

Ambulance

$250 maximum

Consultant

No Benefits

Dental (Benefits are paid on Injury to Sound, Natural Teeth only)

$200 per tooth

Maternity

Paid as any other Sickness

Complications of Pregnancy

Paid as any other Sickness

Benefits are provided as mandated by the state of Florida under the Student Health Plan for the Benefits for Outpatient Services, Benefits for Procedures Involving Bones or Joints of the Jaw and Facial Region, Benefits for Postdelivery Care for a Mother and Her Newborn Infant, Benefits for Diabetes, Benefits for Mastectomies, Prosthetic Devices and Reconstructive Surgery, Benefits for Post-Surgical Mastectomy Care, Benefits for Osteoporosis, Benefits for Cleft Lip and Cleft Palate, and Benefits for Hospital Dental Procedures. Details of these benefits may be found in the Master Policy on file at the School District. NOTE: This is a brief summary of the benefits and not a contract. A Master Policy has been provided to your school district that contains all of the provisions, limitations, and exclusions and qualifications of the insurance benefits. The Master Policy is the contract and will govern and control the payment of benefits.


Policy Exclusions and Limitations: for Accident Only Coverages Benefits will not be paid for: a) loss or expense caused by, contributed to, or resulting from: or b) treatment, services or supplies for, at, or related to: 1. Air travel except while as a fare-paying passenger on a regularly scheduled commercial air carrier; travel in or upon, sitting in or upon, alighting to or from, or working on or around any motorcycle or recreational vehicle including but not limited to: two or three-wheeled motor vehicle; four-wheeled all terrain vehicle (ATV); jet ski; ski cycle; snowmobile or off-road motorized vehicle not requiring licensing as a motor vehicle. 2. Artificial aids such as eyeglasses, contact lenses, hearing aids, or examinations or prescriptions therefore unless specifically provided for in the Schedule of Benefits. 3. Cosmetic surgery of any kind, except reconstructive surgery as a direct result of a covered Injury. 4. Dental treatment, except for accidental Injury to Sound, Natural Teeth. 5. Food poisoning or bacterial infections (except an infection occurring through an open visible wound); cysts or skin lesions such as blisters or boils; tumors; over-exerting; fainting; hernia, regardless of how caused; illness or disease in any form. 6. Immunizations; preventive medicines or vaccines, except where required for treatment of a covered Injury. 7. The addiction to or use of alcohol, intoxicants, hallucinogenics, illegal drugs or medicines that are not taken in the dosage or for the purpose as prescribed by the Covered Person’s Physician. 8. Injury for which benefits are paid by the prior insurer to the extent of its accrued liability and extension of benefits or benefits period as required by F.S.627.667. 9. Injury for which benefits are paid or payable by worker’s compensation or employer’s liability or occupational disease law. 10. Injury where the Covered Person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator’s license (except in a Driver’s Education Program). 11. Nuclear reactions or radiation contamination; war, declared or undeclared (a pro-rata premium will be refunded upon request for such period not covered); participation in a riot or civil disorder; or while a member of the Armed Services. 12. Play or practice of interscholastic high school football; except where a specific additional premium is paid. 13. Pre-existing Conditions or aggravation of a Pre-existing Condition. 14. Routine physical examinations and routine testing; preventive testing or treatment; screening exams or testing in the absence of Injury. 15. Skiing, scuba diving, surfing, roller skating, riding in a rodeo. 16. Skydiving, parachuting, hang gliding, glider flying, flight in an ultra light aircraft, parasailing, sail planing, bungee jumping, bob-sledding, or ballooning. 17. Suicide or attempt thereat, while sane or insane (including drug overdose); intentionally self-inflicted Injuries; fighting. 18. Supplies, except as specifically provided in the policy. 19. While committing or attempting to commit an assault or felony, or to which a contributory cause was the Covered Persons being engaged in an illegal occupation..

Accidental Death and Dismemberment: Accident Only Coverages One amount, the greatest, may be payable at the Covered Person’s option within 180 days from the date of accident in lieu of other benefits under the Policy. Accidental Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 1,500

Accidental Loss of: Both Hands, Both Feet, or Sight of Both Eyes . . . . . . . . . . . . .$ One Hand and One Foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ One Hand or One Foot and Sight of One Eye . . . . . . . . . . . . .$ One Hand or One Foot or Sight of One Eye . . . . . . . . . . . . . . .$

7,500 7,500 7,500 1,000

Definitions Injury means bodily injury which is: 1) directly and independently caused by specific accidental contact with another body or object; 2) unrelated to any pathological, functional, or structural disorder; 3) a source of loss; and 4) sustained while the Covered Person is covered under this policy. All injuries sustained in one accident, including all related conditions and recurrent symptoms of these injuries will be considered one injury. Injury does not include loss which results wholly or in part, directly or indirectly, from disease or other bodily infirmity. Pre-existing Condition means any condition which manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment or for which medical advice, diagnosis, care or treatment was recommended or received within the 12 months immediately prior to the Covered Person’s Effective Date under this policy. Routine follow-up care to determine whether a breast cancer has recurred in a person who has been previously determined to be free of breast cancer does not constitute medical advice, diagnosis, care or treatment for purposes of determining pre-existing conditions unless evidence of breast cancer is found during or as a result of the follow-up care. Sickness means illness or disease of a Covered Person which first manifests itself after the Effective Date of insurance and while the insurance is in force. All related conditions and recurrent symptoms of the same or a similar condition will be considered one sickness.


Policy Exclusions and Limitations: for Health Plan Coverages Benefits will not be paid for: a) loss or expense caused by, contributed to, or resulting from: or b) treatment, services or supplies for, at, or related to: 1. Acne, acupuncture, allergy, including allergy testing. 2. Air travel except while as a fare-paying passenger on a regularly scheduled commercial air carrier; travel in or upon, sitting in or upon, alighting to or from, or working on or around any motorcycle or recreational vehicle including but not limited to: two or three-wheeled motor vehicle; four-wheeled all terrain vehicle (ATV); jet ski; ski cycle; snowmobile or off-road motorized vehicle not requiring licensing as a motor vehicle. 3. Artificial aids such as eyeglasses, contact lenses, hearing aids, or examinations or prescriptions therefore; treatment for visual or hearing defects and problems, except when due to a disease process. 4. Assistant Surgeon Fees. 5. Autistic disease of childhood, hyperkinetic syndromes, milieu therapy, learning disabilities, behavioral problems, parent-child problems, attention deficit disorders, conceptual handicap, developmental delay or disorder or mental retardation. 6. Congenital conditions, except as specifically provided in the policy under Benefits for Procedures Involving Bones or Joints of the Jaw and Facial Region or except as specifically provided under Benefits for Cleft Lip and Cleft Palate. 7. Cosmetic surgery of any kind, except reconstructive surgery as a direct result of a covered Injury. 8. Dental treatment, except for accidental Injury to Sound, Natural Teeth. 9. Elective Surgery or Elective Treatment (except cosmetic surgery made necessary as the result of a covered Injury or to correct a disorder of a normal bodily function); Elective abortion. 10. Immunizations; preventive medicines or vaccines, except where required for treatment of a covered Injury. 11. The addiction to or use of alcohol, intoxicants, hallucinogenics, illegal drugs or medicines that are not taken in the dosage or for the purpose as prescribed by the Covered Person’s Physician. 12. Injury or Sickness for which benefits are paid or payable by worker’s compensation or employer’s liability or occupational disease law. 13. Injury or Sickness for which benefits are paid by the prior insurer to the extent of its accrued liability and extension of benefits or benefit period as required by F.S. 627.667. 14. Injury where the Covered Person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator’s license (except in a Driver’s Education Program). 15. Mental and Nervous Disorders. 16. Nuclear reactions or radiation contamination; war, declared or undeclared (a pro-rata premium will be refunded upon request for such period not covered); participation in a riot or civil disorder; or while a member of the Armed Services. 17. Organ transplants, including organ donation. 18. Orthodontics (braces) for any reason or damage to or loss of orthodontics. 19. Play or practice of interscholastic sports. 20. Prescription Drugs and medicines not actually administered to the patient in a Hospital or office of a licensed Physician. 21. Pre-existing Conditions will apply for the first 12 months, except for individuals who have been continuously insured under the school’s student health insurance policy for at least 12 consecutive months. Credit will be given for the time the Covered Person was covered under a previous similar plan if the previous coverage was continuous to a date not more than 63 days prior to the Covered Person’s Effective Date under this policy. 22. Routine newborn infant care, well-baby nursery and related Physician charges. 23. Routine physical examinations and routine testing; preventive testing or treatment; screening exams or testing in the absence of Injury or Sickness; except as specifically provided in the policy. 24. Skiing, scuba diving, surfing, roller skating, riding in a rodeo. 25. Skydiving, parachuting, hang gliding, glider flying, flight in an ultra light aircraft, parasailing, sail planing, bungee jumping, bob-sledding, or ballooning. 26. Suicide or attempt thereat, while sane or insane (including drug overdose); intentionally self-inflicted Injuries; fighting. 27. Supplies, except as specifically provided in the policy. 28. While committing or attempting to commit an assault or felony, or to which a contributory cause was the Covered Persons being engaged in an illegal occupation.

Privacy Policy We know that your privacy is important to you and we strive to protect the confidentiality of your nonpublic personal information. We do not disclose any nonpublic personal information about our customers or former customers to anyone, except as permitted or required by law. We believe we maintain appropriate physical, electronic and procedural safeguards to ensure the security of your nonpublic personal information. You may obtain a detailed copy of our privacy practices by calling us toll-free at (866) 313-4512 or by visiting us at www.K12StudentInsurance.com.


Facts About the Policy 1. STUDENT TRANSFER: The policy continues in force anywhere in the world if the Covered Person should relocate prior to the expiration of coverage. 2. CANCELLATION: Coverage under the policy will not be cancelled, and accordingly, premiums may not be refunded after acceptance by the Company. However, a pro-rata refund of premium shall be made in the event a Covered Person enters the Military Service. 3. The Master Policy on file with the school district is a non-renewable one year term policy. 4. This is a limited benefit policy. 5. INITIAL ENROLLMENT: Coverage is effective the date the correct application and premium are received by the Company. 6. LATE ENROLLMENT: There is no premium reduction for any individual who enrolls late in the year. 7. STUDENT INJURY AND SICKNESS POLICY (Health Plan): Coverage terminates on the earliest of: 1) the date the Master Policy terminates as held by the School District; or, 2) the last day of the period for which the appropriate premium has been paid. 8. Your cancelled check, credit card billing, or money order stub is your only receipt and notification of coverage.

Choose How to Enroll

ON-LINE @ : www.K12StudentInsurance.com for fast, easy and secure enrollment or: • Complete and detach the enrollment form. • Make check or money order payable to UnitedHealthcare StudentResources. Do not send cash. The Company is not responsible for cash payments. • Write your child’s name on your check or money order. • Mail directly to Health Special Risk, P.O. Box 650093, Dallas, TX 75265-9580. • Your cancelled check, credit card billing, or a money order stub will be your official receipt and confirmation of payment. • Keep this brochure for future reference. Individual policies will not be sent to you. • For Student Health Plan, no premium notices will be sent. Initial enrollment deadline is September 30th for Annual Premium Payment (Per Policy Year).

Excess Provision (Mandatory Plan Only) No Benefits are payable for any expense incurred for Injury which had been paid or is payable by other valid and collectible insurance or under an automobile insurance policy. Covered Medical Expenses excludes amounts not covered by the primary carrier due to penalties imposed on the Covered Person for failing to comply with policy provisions or requirements. Important: This Excess provision has no practical application if you do not have other medical insurance or if your other insurance does not cover the loss.

Extension of Benefits after Termination The coverage provided under the Policy ceases on the Termination Date. However, if a Covered Person is Totally Disabled on the Termination Date from a covered Injury or Sickness, Covered Medical Expenses for such Injury or Sickness will continue to be paid as long as the condition continues but not to exceed 90 days after the Termination Date. The total payments made in respect of the Covered Person for such condition both before and after the Termination Date will never exceed the Maximum Benefit. Totally Disabled means the Covered Person’s inability to engage in most normal activities of a person of like age and sex in good health.

How to File a Claim NOTE: Medical treatment must be received from a qualified, licensed Physician within 60 days from the date of accident. 1. Obtain a claim form quickly from our website, or from your school office, or call UnitedHealthcare StudentResources (866-4095734). Answer all questions in detail and include signatures to avoid claim from being returned for incomplete information. 2. Attach all bills to the completed form and mail to the insurance company within 90 days of the accident or first treatment of sickness. 3. Any bills not filed with the claim form should be sent to the company identified with the student’s name, school district, and date of accident. Bills that cannot be attached to the initial form must be submitted within 90 days of the date of service. Bills submitted after one year will not be considered for payment except in the absence of legal capacity. 4. (For Mandatory Coverage) If you have other insurance, file simultaneous claims with your other insurance carrier and UnitedHealthcare StudentResources, to avoid delay in benefit payments.

Administered by: Health Special Risk P.O. Box 117558 • Carrollton, TX 75011-7558 866-409-5734

Underwritten by: UnitedHealthcare Insurance Company


ENROLL ONLINE FOR QUICKER SERVICE Enrollment Form (School Year 2010-2011) Underwritten by UnitedHealthcare Insurance Company Student’s Last Name

(Please Print)

Student’s First Name

DOB

MI

Phone

Social Security #

Grade

Street #

Address

City

State

Name of School District

Name of School

(Required to Process)

X

Zip

Date

Email Address

Signature of Parent or Guardian

Student Insurance Check  Your Selection

Accident Only Coverage Plans 24-HOUR (K-12)

$66.00 ❑

AT-SCHOOL (Grades K-6) AT-SCHOOL (Grades 7-12)

$14.00 ❑ $16.00 ❑

Student Health Plan $147.00 ❑ Per Quarter $588.00 ❑ Annual* (Per Policy Year) (Note: No premium notices will be sent. It is the insured’s responsibility for timely premium payments) *Annual Coverage may not be purchased after September 30th COMPANY USE ONLY Check No.__________________ Amount Received ____________________

Enclose check for total payment payable to: UnitedHealthcare StudentResources TOTAL ENCLOSED $ ____________________________

Company does not issue refunds nor accept responsibility for cash payments. (Rejection of check or credit card by bank for any reason, will invalidate insurance.) FL10WBSREMD

NRLK1206

Full Name on Card: First Name

Complete this section only if you wish to pay with MASTERCARD/VISA MI

Last Name

Billing Address (if different then above) Address

Apt #

Street # City

State

Zip Expiration Date:

Card Number

Mo

Year

(MM/YYYY) good thru

Cardholder signature: X ___________________________________________________

Retain for Your Records

v2

Student Insurance Card Student’s Name If premium has been paid, the student whose name appears above has been insured under a Policy issued to: School District: Miami-Dade County - Policy #2010-201912-1 Accident Only Coverage: ❏ 24-HOUR ❏ AT-SCHOOL (Grades K-6) ❏ AT-SCHOOL (Grades 7-12) Health Plan Coverage: ❏ INJURY AND SICKNESS Paid by Check #________ Amount Paid:__________ Date Paid:_________

Underwritten by: UnitedHealthcare Insurance Company Claims Questions: Health Special Risk, Inc. P.O. Box 117558 • Carrollton, TX 75011-7558 • 866-409-5734


A Guide for Host Agencies

PROGRAM MANAGED BY 1600 NW 3RD AVE. Bldg. D Miami, FL 33136 305-576-3084 ph 866-811-7778 fax interns@urgentinc.org www.urgentinc.org

PROGRAM MADE POSSIBLE BY

TEENS


WELCOME! Thank you for choosing to partner with Urgent, Inc. and provide a meaningful learning experience for a young person this summer. As a career mentor and host agency you are helping our community by preparing our youth to make a successful transition from school to work.


WHAT WILL BE COVERED • About Urgent, Inc. • Program Overview • Important Dates • Host Agency Responsibilities • How to Prepare for your Intern • Best Practices • Intern Responsibilities • Next Steps • C0ntact Us


ABOUT URGENT, INC. • About Us: Urgent, Inc. is a 501 (c) 3 community based organization

established in 1994.

• Vision: All people have the social, economic and educational resources to thrive • Mission: To empower young minds to help transform their communities • Guiding Principle: To promote shared leadership through empowerment, education and civic engagement to create collective well-being • Operational Values: Compassion, Innovation, Learning, Patience, Reciprocity, Responsibility and Teamwork


PROGRAM OVERVIEW WHAT: The CRA Summer Youth Employment Program is sponsored by the South East Overtown Park West Community Redevelopment Agency. Rites of Passage Internships are funded by The Children’s Trust, NCJW Teens and the Dade Bar Association- New Horizon’s Committee WHO: 180 youth and young adults ages 15-24 will participate as summer interns at host agencies throughout Miami-Dade County WHEN: Internships will begin between June 23 -30, 2011. Internships will end between July 25- August 4, 2011. WHERE: Interns are able to work up to 150 hours at their host agency HOW: You will interview interns to work at your agency. Once selected, Interns earn an educational stipend paid by Urgent, Inc.


IMPORTANT DATES JUNE • June 13, 2011- June 15, 2011 1) Sign-up to participate in Mock Interviews with perspective interns (optional) 2) Confirm your intern interview time slot ( Mandatory); You will receive email to confirm your time and date Dates available 6/22, 6/23, 6/24 • June 23- June 30, 2011 1) Host Agency Webinar for agencies who have selected an intern 6/23 at 9:30-10:00am (will receive an email invite) 2) Internship agreements prepared and finalized 3) Internship placements begin *Interns only work Mon-Thursday each week


IMPORTANT DATES CONT. JULY • July 4, 2011 HOLIDAY 1) Office and Program Closed • July 13, 2011 1) Youth Empowerment on Tour- A spotlight multi-media event to feature host agencies and interns doing great things in the community. •

July 15, 2011 1) Host Agency Networking Event, 6:00-8:00pm. Location TBA 2) Interim Evaluations due online


IMPORTANT DATES CONT. • July 21, 2011 1) Government and Civic Engagement Day @ Miami City Hall *Your intern may be asked to participate in this event • July 26, 2011 1) Miami Community Redevelopment Agency (SEOPW CRA)Meeting, Tentative 6:00pm, Location TBA- Provide update of program *Attendance at this meeting would be a great show of support for the program • July 29, 2011 1) Final Program Evaluations due on-line 2) Final week of internships July 28- August 4, 2011


IMPORTANT DATES CONT. AUGUST • August 4, 2011 1) All internships end • August 5, 2011 1) Intern & Host Agency Recognition Event Time: 9:00-11:00 am Location- Booker T. Washington SHS 1200 NW 6 Ave. , Auditorium


HOST AGENCY RESPONSIBILITIES OVERVEIW: As a host agency and career mentor, your primary responsibility is to provide a meaningful work and learning experience for your intern GOAL: To increase the intern’s ability to perform and achieve in the workplace WEEKLY ACTIVITIES: • Complete , Sign and Fax to 866-811-7778 or Scan & Email to irene@urgentinc.org Internship Time Sheet • Complete Performance Evaluation on-line • Weekly review of intern task, responsibilities & performance OTHER ACTIVITIES: • Intern Interim Evaluation on-line • Final Intern & Program Evaluation on-line


BEST PRACTICES • #1 – Provide interns with real and meaningful work related to their career interest, even if they must make copies explain how its important to work being done at the agency • #2 – Set clear performance goals and high expectations for your intern from the start. It is always harder to increase expectations than to lower them • #3 – Know your intern’s strengths, so you can match them to their responsibilities and needs of your agency • #4 – Meet with your intern to provide feedback weekly for at least 15 -30 minutes. Informing them of where they are doing well and what can be improved • #5 – Supervision, be available for questions for clarification and to provide support and encouragement • #6 – Inform your staff that an intern will be coming on board and develop a support team for the intern • #7 – Develop projects, directions and supervision protocols before your intern begins


INTERN RESPONSIBILITIES • OVERALL • Understand what is being asked relating to work assignments and due dates and reporting updates • Come prepared to work, i.e. on time, great attitude and appropriately dressed • PAPERWORK 1) Weekly Time Sheet 2) Weekly On-line Reflection and Work Report 3) Final Evaluation • ASSIGNMENTS 1) Research Host Agency and Career Mentor 2) Interview Agency CEO/President 3) Prepare final career development portfolio and presentation


NEXT STEPS 1) Become a part of Urgent’s Community Asset Map Click Here to Complete Questionnaire 2) Download Summer Internship Handbook Click Here to Access Document 3) Mark all important dates in your calendar 4) Prepare to interview perspective internship candidates 5) Prepare internship work projects and supervision protocols so you are ready when your intern arrives


CONTACT US Saliha Nelson, Project Director – saliha@urgentinc.org or 305-205-4605 cell Dr. Yelena Revere, Internship Program Coordinator – yelena@urgentinc.org Ms. Liz de las Cuevas, Host Agency Coordinator – liz@urgentinc.org Phone: 305-324-8900 ext. 2251 General Information and Inquiries – interns@urgentinc.org

Main Office: 1600 NW 3rd Ave. Bldg. D Miami, FL 33136 305-576-3084 ph, 866-811-7778 fax E-Mail: office@urgentinc.org URL: www.urgentinc.org


THANK YOU!


SEOPW CRA Objective: Employment and Training

CRA SUMMER YOUTH EMPLOYMENT PROGRAM 2011 PROPOSAL

Project Description: The Summer Youth Employment Program is a 10-week summer program that will provide 160 Overtown youth and young adults between the ages of 15-24 one hundred and fifty hours (150) of paid part-time work experience, weekly experiential learning activities and the opportunity to earn community service hours. The goals are for Interns to develop teamwork, leadership and career skills they need to navigate adolescence, succeed in college or technical school and prosper as young adults. A highlight of the program is that it will engage young people in a valuable educational and employment experience using the community's resources to expose youth to potential educational and career paths and prepare youth for employment. The objectives of the program are to improve work readiness skills , decision-making and problem solving skills. In order to achieve the program’s goal and objectives the Summer Youth Employment Program is designed to a) Emphasize real-world labor expectations, b) Increase awareness of career options, and 3) provide opportunities for career instruction, work readiness training, academic improvement, and social growth and community service. The components of the program include:     

Orientation to the program 20 hours of mandatory and volunteer work readiness training and preparation for placement 150 hours of a paid mentored internship 25 hours of continuing education, training & community service 1 Final Recognition and Presentation Ceremony

Program Sites: Coordination and management of program activities will take place at Urgent’s offices located the Culmer Service Center at 1600 NW 3rd Ave. Miami, FL 33136. Direct youth services and training will take place at Booker T. Washington Senior High School located at 1200 NW 6th Ave Miami, FL 33136. Target Population: 160 youth and young adults’ ages 15- 24 will targeted for participation. Priority placement will be given to those who reside within the SEOPW CRA boundaries and who are enrolled in high school, college or technical school. Youth must also meet minimum eligibility requirements consisting of: 2.5 GPA, mentor recommendation, state issued identification with photo, social security card, and address verification, complete application and resume. Second priority will be youth and young adults residing in Overtown, but outside of the SEOPW boundaries as established by the Miami Dade North/Central Empowerment Zone Boundaries. Finally, last priority will be given to youth residing in City of Miami’s District 5. It must be noted, that second and third priority youth must work for businesses established within the SEOPW boundaries. Steps to Program Eligibility and Summer Job Placement: 1) Complete intern application and submit with required documents: Registrar printout of most recent report card copy of state issued photo identification, copy of social security card, resume and adult recommendation form.

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Alternate verification documents will be accepted and include: school ID, parent utility bill, school registrar print out and birth certificate. Note: All youth without a State issued ID must obtain one prior to first payment if accepted into the program. 2) All acceptable addresses be certified by Urgent Inc. and approved by the CRA. Eligible the youth will be notified to attend the mandatory volunteer program orientation and training. 3) Upon successful completion of program training and application, youth will be scheduled to interview for summer employment. If selected by the employer the youth will be scheduled to begin work. 4) All youth must commit to Friday training and community service to remain in the program and receive their educational stipend. Outreach & Recruitment: High School youth will primarily be recruited through Booker T. Washington (BTW) SHS’s Smaller Learning Community Academies. The Lead Teacher within each of BTW’s seven Academies will recommend eligible students. College or Vocationally enrolled students will be recommended by Miami Dade College Service Learning Department and MDCPS Lindsay Hopkins will also make referrals to this program. Referrals from other community-based organizations and schools where Overtown youth attend will be accepted based on slot availability and agency recommendations. Additionally, a print ad will be placed in the Miami Times and Miami Today, a link to the program application will be made available from the Miami CRA and Urgent Inc. website , area businesses will be asked to post or distribute program flyers, the Overtown NET office will distribute flyers upon request and Urgent will notify stakeholders via its email distribution listserv and Overtown Community Oversight Board Listserv.

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PRIMARY ACTIVITIES Work Readiness Training Topics 20 hours (including lunch)- Tentative GOALS: By the end the Employment Competency Workshop, participants will be able to: -Identify and articulate personal values and competencies that will guide their work in the Summer Employment Program. -Identify and understand the power of words, personal beliefs and habits that can either block or promote positive youth outcomes. OBJECTIVES: Orient the participants to participate in learning through empowerment instead of fear and receiving coaching from the staff in their summer employment program. The youth will have a sense of determination, reliability and responsibility for the part they play in their development and empowerment. Day 1— 5 hours  About Urgent, Inc., CRA & Program Overview, Henry Crespo Training, Emily Gunter  Work Mission, Vision and Performance Values  You Are a Leader: The 10 Points of Leadership  Work Ethics & Standards  How Am I Intelligent: Linking Mind & Brain Power at Work Day 2—5 hours  Pre-Work Readiness Assessment, All Staff  Employment Paperwork & Understanding Payroll 101, Liz de las Cuevas  Rights & Responsibilities in the Workplace, Dr. Yelena Revere  Professional Etiquette –From Online to Co-Worker Interaction, Holly Howard & Mike Burms Day 3—5 hours  Dressing for Succes, Liz de las Cuevas  Resume & Cover Letter Development, Liz de las Cuevas  Interview Basics, Liz de las Cuevas  Where Would I like to Work? Selecting a Host Agency to Interview, Job Coaches Day 4—5 hours  Finalize Resumes & Cover Letters, Job Coaches  Mock Interviews, Community Partners & Job Coaches  Civic Responsibility and Service, Saliha Nelson  Post Work Readiness Assessment, All Staff Frequency- 4x/week; Intensity- 5 hrs; Duration-1 week; Cycles- 1

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Stipend Career-Based Internship— Participants will have the opportunity to use their new and improved skills in the real world through 150 hours of PT paid work experience aimed to strengthen pro-social norms and behaviors, problem solving skills, self-regulation, language and communication competencies. Participants will work four days a week totaling 20 hours at their internship host agency. High School students will be paid a stipend based upon the minimum wage of $7.25 an hour. College or Technical/Vocational School students will be paid a stipend based upon $9.00 an hour. Participants will also have the opportunity to earn incentives over the course of the internship experience. Additionally, transportation assistance in the form of bus passes will be provided to youth as needed to get back and forth to work and to attend weekly job counseling sessions. Frequency- 4x/week; Intensity- 5 hrs; Duration-7 weeks; Cohort- 1 Frequency- 5x/week; Intensity- 6 hrs; Duration- 5 weeks; Cohort- 2 (BTW Academy of Finance)

Continuing Education, Training & Community Service (CETCS)— Participants will come together one day a week to reflect on their work experience, learn new skills and work on their culminating project presentation. In addition, students requiring additional socio-emotional support will receive small group or one-on-one job counseling and case management. Participants will also have the opportunity to earn community service hours. Lunch will be provided. CETCS- Reflection & Learning Topics 25 Hours (including lunch)- Tentative Week 1- 5 hours  First Impressions  Host Agency & Career Research  Topic Related Reading & Discussion  Guest Speaker, Emily Gunter Week 2- 5 hours  Becoming a Team Player  How am I Contributing at the Workplace  Topic Related Reading & Discussion  On-line Portfolio Development  Guest Speaker Week 3- 5 hours  Organizational Culture & Climate  Interviewing the CEO/President- A Case Study: How did they get to the top? Discussion of Findings  On-line Portfolio Development  Topic Related Reading & Discussion  Guest Speaker Week 4- 5 hours  What is an organization? Components, Departments & Positions  Educational Requirements & Salary Potential for Possible Careers Interests- Discussion of Findings  Successes and Set-Backs: What have you learned? What do you still need to learn?  Topic Related Reading & Discussion  Guest Speaker Week 5- 5 hours  What have I taken away from this experience?

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 Portfolio Presentations  Intern & Host Agency Recognition Preparation Frequency- 1x/week; Intensity- 5 hrs; Duration-5 weeks

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Project Timeline:

SUNDAY

June 2011 MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

1 *Grant Project Begins -SYE Application Period Opens -Project Hiring Begins -Host Agency Recruitment Begins

2 *Collection and Certification of all Applications *Outreach and Marketing of Program

3 *Collection and Certification of all Applications *Outreach and Marketing of Program

4

5 Week 1

6 *Collection and Certification of all Applications *Outreach and Marketing of Program -Begin Pay Period #1

7 *Collection and Certification of all Applications *Outreach and Marketing of Program

8 *Collection and Certification of all Applications *Outreach and Marketing of Program

9 *Collection and Certification of all Applications *Outreach and Marketing of Program

10 -SYE Application Period Closes -Host Agency Application Period Closes -Project Hiring Closes

11

12 Week 2

13 -Day 1 Staff Training 8:30-4:30

14 -Day 2 Staff Training 8:30-4:30

15 -Day 3 Staff Training 8:30-4:30

16 Preparation for Youth Training Continues 7:00-3:00, Coordinators

17 Day 1 Youth Training 7:30- Sign In 8:30- Welcome 9:00-1:00 Training 1:00- Lunch

18

24 -Placement Interviews Cont. -Time Sheets Due

25

-Host Agency Orientation Available On-line 19 Week 3

20 Day 2 Youth Training 7:30- Sign In 8:30- Training 12:30 Lunch

21 Day 3 Youth Training 7:30- Sign In 8:30- Training 12:30 Lunch

22 - Day 3 Youth Training 7:30-12:30 - Host Agency Interviews Begin 1:303:30

23 -First Day of Internships for BTW Academy of Finance -Placement Interviews Cont. -Host Agency Webinar

26 Week 4

27 WK1 Internships Begin Site Visits Begin

28

29

30

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July 2011 SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

1 - Education Seminar #1 -Time Sheets Due 8:00am-1:00pm

2

3 Week 5

4 - Internships WK2 HOLIDAY OFFICE CLOSED

5

6

7

8 - Education Seminar #2 -Time Sheets Due 8:00am-1:00pm

9

10 Week 6

11 - Internships WK3

12

13 -Youth Empowerment on Tour 8:30-5:00pm

14

15 -Education Seminar #3 -Time Sheets Due; -Interim Evaluation; -1st Pay date #2 8:00am-1:00pm *Host Agency Networking

16

17 Week 7

18 - Internships WK4

19

20

21 *Govt & Public Service Day at City Hall

22 - Education Seminar #4 -Time Sheets Due 8:00am-1:00pm

23

24 Week 8

25 - Internships WK5

26 -SEOPW CRA Meeting -Project Update

27

28 -Last day of internships BTW Academy of Finance

29 -Education Seminar #5 -Intern Projects Due -Time Sheets Due -Final Evaluations Due 8:00am-1:00pm -2nd Pay date

30

31

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August 2011 SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

31 Week 9

1

2

3

4 -All Internships End

5 -Intern & Host Agency Recognition Event 9:30am-12noon -Time Sheets Due

6

7 Week 10

8 -Close Out Activities and Final Report Preparation

9

10

11

12 -3rd Pay date

13

14

15 -Last Day all Project Employees

16

17

18

19

20

21

22

23

24

25

26 -Final Pay date

27

28

29

30

31

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Evaluation: Program participants will be evaluated through pre and post testing utilizing the Work Investment Act (WIA) Readiness Skills assessment. To meet the programs objective, 85% of participants will increase their practical job knowledge, experience and skills. The pre-test will be administered during program enrollment. The post-test will be administered during the last 2 weeks of employment. In addition, an external evaluator will be engaged to examine the value of the Summer Youth Employment Program as evidenced by the knowledge and behavior skill development of the youth in the program. The reasons for this evaluation are threefold: (a) to assist in future program planning and provide information to stakeholders, (b) to judge the overall value, worth, and merit of the program for participants, (c) to determine if program goals or objectives are being met and to what extent for the stakeholders. Program Management: The program will be managed by the Project Director and site activities will be coordinated by 2 Internship Coordinators. The Project Director will work with the Project Finance & Payroll Manager to oversee the implementation and reporting requirements of the grant project. The Project Finance & Payroll Manager will also prepare payroll and reimbursement packages to the CRA for review and approval. The Internship Coordinators will directly oversee the Case Manager/Job Counselor and Job Coaches. The supervision protocol will include weekly team meetings, monthly project team meetings and intra-agency weekly status updates. Meeting content will include: program goals, implementation status, reflection and problem-solving, discussion of individual and aggregate participant progress, and new learning related to performance improvement. Key Project Staff: FT Vice President/Project Director, Saliha Nelson The Project Director will manage the grant program to ensure that implementation and prescribed activities are carried out in accordance with the grant contract; Review and analyze evaluation data for accuracy; Utilize evaluation analysis to improve program performance and Prepare grant program reports. 25% of time will be dedicated to this project. FT Project Finance & Payroll Manager, Irene Tiffany Edwards The Finance Manager will manage and maintain the financial accounts for the grant program in the accounting system including recognition of grant receivables & expenditures; and Prepare accurate invoices, payroll submissions, budget and grant fiscal reports. Grant fiscal reports will be given to the Project Director for review and approval. 50% of time will be dedicated to this project. FT Training and Education Manager, Emily Diane Gunter The Training and Education Manager will be responsible for preparing and implementing staff and youth training materials, conducting orientation and training sessions and monitoring weekly continuing education sessions. 20% of time will be dedicated to this project. FT Internship Coordinators, Yelena Stewart-Revere, Ed.D & Liz de las Cuevas, BS, MIBA The Internship Coordinators will be responsible for student outreach, recruitment, screening, placement and monitoring for student progress. They will document program services, manage weekly staff meetings, oversee job coaches and prepare data for program reporting. 100% of time will be dedicated to this grant program.

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PT Case Manager/Job Counselor, Holly Howard, M.S. The Case Manager will provide additional support and encourage to especially high-risk youth participating in this project. She will provide resource and referral to other community services as necessary. Weekly, she will hold small group and/or one-on-one counseling to promote youth healthy functioning and successful completion of program activities. 100% of time will be dedicated to the grant program. Project Partners: Role in Program

Resources Committed

Miami Dade County Public Schools, National Academy Foundation, Booker T. Washington Senior High

In-kind use of facilities and access to students

MECA, a non-profit corporation of Miami Dade County Public Schools: Management of B.T. Washington SHS Academy of Finance Students

Established relationships with businesses within the community to help place students in appropriate internships

Budget Summary: Urgent’s budget request of $322,317 is requested to implement the CRA’s Summer Youth Employment Program over a 10-week period beginning in June 1, 2011- August 15, 2011 serving 160 youth between the ages of 14-24. Program personnel required to implement a high quality performance-based program include 1 FT Project Director @ 25%, 2 FT Internship Coordinators @ 100%, 1Training and Education Manager @ 20%, 5 PT Job Coaches @ 100%, Finance & Payroll Manager @ 50% and fringes. In addition, 150 youth between the ages of 15-18 will earn a stipend based upon minimum wage at $7.31/hour and 10 young adults will earn a stipend based upon $9/hour for up to 150 hours over the summer months. Funds will also be critical to fund staff background checks, travel between sites, printing of participant and staff training, program t-shirts, youth incentives, program materials, office supplies, marketing, program evaluation, a host agency meet & greet, final recognition event and provide for student bus passes. An administrative Fee is maintained at 9% of the program budget. Organizational Capacity: Mission The mission of Urgent, Inc. is to empower and revitalize distressed urban communities. Background Urgent is a 501 (c) 3 Community Based and Development Corporation founded in 1994 by a small group of concerned urban residents who wanted to see positive change in their Miami community. Urgent started out as a grassroots initiative to inform change through media education and provide an avenue for open dialogue between community stakeholders on public access television and radio in order to promote solutions to problems facing urban communities. In 1999, Urgent, Inc. began direct services through its Rites of Passage Youth Empowerment Academy. In 2003, Urgent added a community development component creating home ownership opportunities for low and moderate income families. Today, Urgent celebrates 15 years dedicated to empowering and revitalizing urban communities through arts & culture, civic engagement and youth, family and economic development. Urgent remains committed to promoting solutions to the issues faced by today's urban communities. Programs and Services Urgent’s current programming is targeted in Miami-Dade’s high-risk communities of Overtown, Liberty City, Little Haiti and Goulds. Our present programs include:

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    

2001-Present: Rites of Passage Prevention Program promoting positive female development for girls ages 10-18 through skill building, career development, arts & culture and health risk education 2001-Present: Intergenerational Project supporting grandparents raising grandchildren, relative caregivers and the children in their care through support groups, parenting skills education, sitter service and case management 2002-Present: Youth Empowerment Summer Camp providing girls in grades k-7 with literacy, social skills, entrepreneurship, fitness and arts & culture during opportunities during the summer months 2003-Present: Affordable Housing Initiative providing affordable home ownership opportunities low income MiamiDade residents 2006-Present: Youth Empowerment After School Program providing boys and girls in grades 2-5 academic, social skills, fitness, math, science and arts & culture opportunities after school

Proposer’s Experience and Past Performance: 1.

Urgent, Inc. was founded in 1994 and celebrates 15 years dedicated to empowering and revitalizing urban communities through the arts, culture, youth development, family building, community service and economic development activities. Urgent, Inc. currently employs a total of 11 staff to provide programs and services to the primary markets of Overtown, Liberty City, Little Haiti and Goulds.

2.

To date, Urgent, Inc. has over ten years experience administering both Miami-Dade County and City of Miami Community Development Block Grant Public Service programs as follows:  City of Miami, CDBG 2001, 2008, 2009, 2010, 2011  Miami Dade County, CDBG 2004, 2005, 2006

3.

Urgent, Inc. has successfully completed and is in progress of managing the following comparable contracts for which we are seeking funding within the past five years. a.

The Children’s Trust Program: Rites of Passage Prevention Program Contract Amount: $145, 416/year Terms: FY 05-06, 06-07, 07-08, 08-09 Contact: Aundray Adams, Contract Officer #305-571-5700 Direct recipient of grant. Project Results: 25-30 youth placed in career based summer internships each year. 95%-100% of youth improved knowledge of job skills each year through the provision job training and educational workshops.

b.

Women’s Fund of Miami-Dade Rites of Passage Youth Empowerment Academy FY 2006 $10,000, FY 2007 $10,000, FY 2008 $8500, FY 2009 $7500 Contact: Fran Katz, Associate Director # 305- 441-0506 Direct Recipient of grant. Project Results: 25-30 youth placed career based summer internships each year. 95%-100% of youth improved knowledge of job skills each year through the provision job training and educational workshops. c. Miami-Dade Empowerment Zone

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Rites of Passage Youth Empowerment Academy/ Summer Camp/Employment Program FY 01-02 $25,000, FY 03 $25,000, FY 2004 $25,000, FY 2010 $116,000 Contact Person: Lydia Osborne/Lori Weldon, Contracts Officers, #786 469-2262 Direct recipient of grant. Project Results: Achieved all outcomes. d. Miami-Dade County, OCED- CDBG & Public Services Intergenerational Project FY 2004 $40,000/ FY 2005 $23,000/ FY 2006 $10,000, FY 2007 $8500, FY 2008 $8500/ FY 2009 $5950, FY 2010 $2450 Contact: Yvette McCleod, Contracts Officer, # 305.514.6085 Direct recipient of grant. Project Results: Achieved all outcomes e. Miami-Dade County, Office of Grants Coordination Rites of Passage Pregnancy Prevention Project FY 01-02/02-03/03-04 $25,000/year, FY 04-05 $41,000, FY 05-06 $37,583 FY 06-07 $51,250, FY 07-08, 08-09 $34850/year FY 09-10 $24,596 Contact: Yvette McCleod, Contracts Officer, # 305.514.6085 Direct recipient of grant. Project Results: Achieved all outcomes

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SYE Admin Training Docs  

Urgent Inc. Summer Youth Employment Training Docs 2011

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