1. STAFFING: MANAGING YOUR MOST VALUABLE ASSET

2. Your staff are the key to your success! Impact on the “bottom line” Impact on resident satisfaction HUMAN RESOURCES 2

3. Size of community Universal workers Departmental assignments GENERAL CONSIDERATIONS 3

4. Department Heads/Managers Administrator/Executive Director Nurse Activity director Business manager HR manager Marketing and sales manager Dining/food service manager Housekeeping manager Maintenance COMMON ROLES, DUTIES, AND QUALIFICATIONS Line Staff Caregivers Cooks Servers Housekeepers Maintenance Activity assistant Receptionist 4

5. Turnover INDUSTRY TRENDS 5 Source: NCAL 2012 Assisted Living Staff Vacancy, Retention, and Turnover Survey

6. Vacancy INDUSTRY TRENDS 6 Source: NCAL 2012 Assisted Living Staff Vacancy, Retention, and Turnover Survey

7. Federal and State Agencies 7

8. State and federal agencies Department of Labor IRS Employment Development Department (EDD) US Citizenship and Immigration Services Cal/OSHA OTHER AGENCIES INVOLVED 8

9. COBRA FLSA FMLA OSHA Wage Order 5 KEY EMPLOYMENT LAWS 9

10. Fair Labor Standards Act Standards for the basic minimum wage and overtime pay Restricts the hours that children under age 16 can work and forbids the employment of children under age 18 in certain jobs deemed too dangerous. Learn more: www.dol.gov/compliance/laws/comp-flsa.htm www.dol.gov/compliance/laws/comp-flsa.htm FLSA 10

11. Published by the California Department of Industrial Relations Regulates the wages, hours, and working conditions in certain industries or occupations www.dir.ca.gov/iwc/wage orderindustries.htm WAGE ORDER 5 11

12. Consolidated Omnibus Budget Reconciliation Act (COBRA) Gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods Under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. Generally applies to group health plans sponsored by employers with 20 or more employees in the prior year. Learn more: www.dol.gov/dol/topic/health-plans/cobra.htmwww.dol.gov/dol/topic/health-plans/cobra.htm COBRA 12

13. Family and Medical Leave Act Up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons: Birth and care of the eligible employee's child, or placement for adoption or foster care of a child with the employee Care of an immediate family member (spouse, child, parent) who has a serious health condition Care of the employee's own serious health condition. At least 50 employees Learn more: www.dol.gov/compliance/laws/comp-fmla.htmwww.dol.gov/compliance/laws/comp-fmla.htm FMLA 13

14. Occupational Safety and Health (OSHA) Act “Assure safe and healthful working conditions for working men and women" Created the Occupational Safety and Health Administration (OSHA) at the federal level States can run their own programs as long as those programs were at least as effective as the federal program Learn more: www.dol.gov/compliance/laws/comp-osha.htm www.dol.gov/compliance/laws/comp-osha.htm OSHA 14

15. The Employment Lifecycle 15

16. HUMAN RESOURCES Identify Needs Recruit Screen and Interview HireManageTerminate 16

17. Recruiting and Hiring Staff 17

18. Advertising Classifieds Online Word of mouth Refer a friend programs Local schools/colleges WHERE TO FIND QUALITY STAFF? 18

19. ________________________________________ HOW DO YOU BECOME A PREFERRED EMPLOYER? 19

20. SCREENING Pre-ScreenInterview Offer of employment 20

21. Review resume/application CCL Form 995F Review the position Review pay range Help avoid “wasting time” with a full interview PRE-SCREENING 21

22. LIC995 F 22

23. Fill out an application first Include a statement on the application that you are an “Equal Opportunity Employer” Include a statement on the application that it does not constitute a promise or guarantee of employment THE INTERVIEW 23

24. Ask open ended questions Evaluate responses critically. Did the applicant answer the questions fully? Do not make any promises or guarantees with regard to the job or future employment. For example, avoid comments such as “You are by far the strongest candidate I’ve interviewed.” Take notes on a piece of paper separate from the job application or resume. THE INTERVIEW Adapted from www.monster.com 24

25. Questions to avoid Fair Employment and Housing (CA DFEH) THE INTERVIEW 25

26. Have more than one person interview each candidate. Check references! Avoid the costs of a bad hire! THE HIRING DECISION 26

27. Hiring Process 27

28. Contingencies: Criminal clearance Health screening Drug testing Offer letter Avoid promising specific shifts, days, schedules, etc. OFFER OF EMPLOYMENT 28

29. Effective January 1, 2012, California law requires offer letters for non-exempt employees Must include: The rates of pay and basis for those rates (e.g., whether the employee is paid by the hour, shift, day, week, salary, etc.) including any rates for overtime, as applicable Allowances, if any, claimed as part of the minimum wage, including meal or lodging allowances The regular payday designated by the employer The name of the employer The physical address of the employer’s main office or principal place of business and a mailing address, if different The telephone number of the employer The name, address, and telephone number of the employer’s workers’ compensation insurance carrier OFFER LETTERS 29

30. Assists in explaining the job to applicants. Serves as a basis for writing of postings and developing a list of criteria for a successful candidate to meet. After the person has been hired, it gives the new employee a direction and basis from which to start. Serves as a tool in the measurement of performance. Provides information related to physical and emotional requirements of the job and to assist the health care provider in completion of Health Screening (LIC 503). JOB DESCRIPTIONS 30

31. Persons who must be cleared Exempt from criminal clearance requirements Timeframes for clearances Criminal clearance transfers Criminal record statements Penalties for violation CRIMINAL CLEARANCE REQUIREMENTS 31

32. Licensee Administrator, supervisors Any adults other than a client, residing in the facility Caregivers (some exceptions for home health, etc.) Any staff or volunteer who has contact with residents CEO and Officers of the board WHO MUST BE CLEARED? 32

33. Spouse or friend of a resident who visits Volunteers (must meet criteria) Third party contractor (must meet criteria) Licensed or certified medical professionals, not employed by the RCFE Home health and hospice staff Clergy WHO IS EXEMPT? 33

34. Must be completed “prior to working, residing or volunteering in a licensed facility” TIMEFRAMES FOR CLEARANCE 34

35. CRIMINAL RECORD STATEMENT (LIC508) 35

36. CRIMINAL CLEARANCE PROCESS Fingerprints Submitted DOJ Conducts Background Check No Criminal History Clearance forwarded to individual and CBCB Criminal History CBCB reviews transcript from DOJ Exemption or denial 36

37. Replaced ink fingerprint cards in 2005 Done at CCL offices or other non-contracted sites Fees vary “Dummy” number: 3455 88888 LIVESCAN 37

38. CRIMINAL CLEARANCE FEES DOJ Fee$42 FBI Fee$17 DOJ CACI Feen/a Livescan Fee (varies)$16 TOTAL$75 38

39. All convictions other than minor traffic violations, including misdemeanors, felonies and convictions that occurred a long time ago require an exemption Serious crimes such as robbery, sexual battery, child abuse, elder or dependant adult abuse, rape, arson or kidnapping are not eligible for an exemption CRIMINAL RECORD EXEMPTION 39

40. Health Screening 40

41. All personnel A health screening by a physician Including a chest x-ray or an intradermal test (TB) Not more than 6 months prior to or 7 days after employment or licensure HEALTH SCREENING 41

42. Managing Staff 42

43. Paychex ADP Labor attorneys California Chamber of Commerce www.calchamber.com DON’T DO IT ALONE! 43

44. Employee Records 44

45. Personnel record Health screening/TB test Criminal record statement Criminal clearance Administrator certificate, if applicable First aid card, if applicable Verification of education/experience Copy of driver’s license Training documentation SOC 341A EMPLOYEE RECORDS 45

46. CCL STAFF RECORDS CHECKLIST 46

47. LIC501 47

48. FORM I-9 48

49. FORM W-4 49

50. Staff Training 50

51. Water safety certificate (80065) Appropriate on the job training (80065) Standard precautions Egress control devices (80065) Health-related services (80075) First aid (80075) Total care (80077.2) Restricted health conditions (80092.1) ARF 51

52. Caregiver orientation (AB1570, SB911) 10 hours now, 40 hours in 2016 Dementia care added in 2016 (12 hours) Postural supports, restricted conditions, and hospice care added in 2016 (4 hours) LGBT Caregiver ongoing (4 hours now, 20 hours in 2016) CPR (AB2044) RCFE 52

53. Medications – 16+ residents (AB1570, SB911) 16 hours now 24 hours in 2016 Medications – 0-15 residents (AB1570, SB911) 6 hours now 10 hours in 2016 Medications – 0-15 residents (AB1570, SB911) 4 hours now 8 hours in 2016 RCFE 53

54. Employee safety Injury and Illness Prevention Handwashing Back safety Workplace violence Bloodborne pathogens Personal protective equipment Disaster, emergency, and fire safety DON’T FORGET OSHA 54

55. Retaining Staff 55

56. Group Project! Working in small groups prepare a 5 minute presentation on the three most effective strategies you have utilized to become a preferred employer in your local job market PREFERRED EMPLOYERS 56

57. TURNOVER, RETENTION, AND VACANCY 57

58. Performance Management 58

59. 90 days Annually Important feedback tool Opportunity for pay increases Set measurable goals PERFORMANCE REVIEWS 59

60. Terminating Staff 60

61. Documentation is critical Performance reviews Opportunities for improvement Performance Improvement Plans (PIP) California is “At-Will” but still must maintain a paper trail Must provide final paycheck at termination TERMINATING STAFF 61

62. Wage and Hour Requirements 62

63. 8 hour shifts, 12 hour shifts or 24 hours shifts Staffing must be adequate to meet the needs of the resident population Utilization of shifts over 8 hours in a day will require payment of overtime wages. A staff person cannot be paid on an exempt basis in order to avoid overtime. Always refer to Wage Order 5 to guide your staffing decisions. STAFFING PATTERNS 63

64. CALIFORNIA OVERTIME REQUIREMENTS RateApplies To Regular rate of pay Up to eight hours in any workday Up to 40 hours in a workweek 1.5 x regular rate of pay All hours worked in excess of eight hours up to and including 12 hours in any workday, and The first eight hours worked on the seventh consecutive day of work in a workweek 2 x regular rate of pay All hours worked in excess of 12 hours in any workday, and All hours worked in excess of eight on the seventh consecutive day of work in a workweek. 64

65. LIVE-IN FORMULA AS OF JULY 1, 2014 65 8 hours X $9.00$72.00 1 hour meal break relieved of all duties, unpaid$0.00 8 hours of sleep, unpaid as long as staff is uninterrupted$0.00 4 hours X $9.00 X 1.5 times rate (overtime)$54.00 3 hours X $9.00 X 2 times rate (overtime)$54.00 TOTAL DAILY RATE$180.00 per day TOTAL WEEKLY RATE (Daily Rate X 5 days)$900.00 per week Less Meals, $12.21 (3 meals daily) X 5 days- $61.05 Less lodging- $37.63 TOTAL FOR 5 DAYS COVERAGE$801.32 per week TOTAL MONTHLY COVERATE (4.2 X weekly total)$3,365.55 per month

66. Regulations only specify a ratio for night staff “Sufficient” staff Our business is 24/7/365 Scheduling for weekends and holidays can be challenging STAFFING PATTERNS AND RATIOS 66

67. 4-on/2-off staffing patterns Weekday/weekend staffing Live-in staff Holiday pay Shift differentials STAFFING/SCHEDULING IDEAS 67

68. Workers’ Compensation 68

69. California law requires employers to have workers' compensation insurance if they have even one employee An employer cannot ask employees to help pay the insurance premium You must post the “notice to employees” poster in a conspicuous place at the work site WORKERS’ COMPENSATION INSURANCE 69

70. Provide a workers’ compensation claim form to them within one working day Return a copy of the completed form to the employee within one working day of receipt Forward the claim form, along with your report of occupational injury or illness, to the claims administrator within one working day of receipt Within one working day of receiving the employee’s claim, authorize up to $10,000 in appropriate medical treatment Provide transitional work (light duty) whenever appropriate SICK OR HURT ON THE JOB 70

71. Cost of claims, claims administration, and risk control are 91% of workers’ compensation costs Source: Marsh USA CONTROLLING WORKERS’ COMP COSTS 71

72. Involve everyone in workplace safety Safety committees Injury and Illness Prevention Programs Ongoing training Hazard communication CONTROLLING WORKERS’ COMP COSTS 72

73. Employers are required to have an effective written Injury and Illness Prevention Program (IIPP) An effective IIPP improves the safety and health in your workplace INJURY AND ILLNESS PREVENTION PROGRAMS 73

74.  Statement of management commitment and identification of responsible party  Hazard identification: The employer is required to identify any hazards that exist in the workplace, including a personal protective hazards assessment  Hazard correction and prevention: The employer must correct all existing hazards, and perform periodic walk- through of the facility to identify and correct any future hazards  System for reporting accidents, and investigation and correction of all accident situations YOUR IIPP MUST INCLUDE 74

75.  Hazardous substance safety procedures  Fire prevention training (including fire extinguisher operation)  Emergency response and first aid procedures  General office safety plan  Medical waste disposal plan  Infection control and Bloodborne pathogens training  Personal Protective Equipment training ONGOING TRAINING FOR ALL EMPLOYEES 75

76.  System for training employees on the proper use, labeling and storage of hazardous substances  System for notifying all employees of new hazardous materials brought into the workplace  “Globally Harmonized System”  Labels  Safety Data Sheets HAZARD COMMUNICATION 76

77.  Identification of all biohazard wastes and appropriate disposal methods  Training for all employees on the differences between “biohazard waste” vs. “regulated medical waste” and the appropriate disposal methods of each  Systems for disposal of regulated medical waste, if your Community generates such  EPA registration number and waste manifests, if your Community generates hazardous medical waste  Approved sharps containers MEDICAL WASTE DISPOSAL PLAN 77

78.  Appropriate action to be taken in the event of an emergency, fire, earthquake, explosion, or other disaster  Identification of evacuation procedures, emergency response personnel and locations of nearest hospital, fire stations or other emergency centers  Identification of personnel (if any) trained in CPR or emergency first aid procedures  Location of assembly points and evacuation checklists  Operation shut down procedures and responsible parties EMERGENCY ACTION PLAN 78

79.  Location of all fire extinguishers in the facility  Appropriate training of all personnel in fire extinguisher handling and fire prevention  Location of nearest fire department and appropriate notification procedures, including responsible parties  Identification of specific fire hazards in your facility, if any  Site Plan sketch, identifying location of fire extinguisher and any specific hazards, as well as evacuation routes FIRE PREVENTION PLAN 79

80.  Tuberculosis exposure control plan  Bloodborne Pathogens training, including offer of Hepatitis B vaccinations for all personnel with occupational exposure, or signed declination forms  Ergonomics training, with identification of potential problem areas, and corrective steps taken to eliminate or reduce repetitive motion injuries SPECIALIZED TRAINING FOR HEALTHCARE FACILITIES 80

81. Harassment and Bullying in the Workplace 81

82. Working in a “hostile environment” negatively affect productivity and decrease morale, it also can be extremely costly. California Assembly Bill 1825 requires that all supervisors are trained on sexual harassment every two years. SEXUAL HARASSMENT TRAINING 82

83. The California Fair Employment and Housing Act: Verbal Harassment Physical Harassment Visual Harassment Sexual Favors CALIFORNIA LAW 83

84. Involves the use of epithets, derogatory comments or slurs including: Name-calling, belittling, or sexually explicit or degrading words used to describe someone Sexually explicit jokes Comments about an employee’s anatomy and/or attire Sexually oriented remarks or noises Questions about a person’s sexual practices Verbal abuse Graphic verbal commentaries about the body VERBAL HARASSMENT 84

85. Touching, patting, pinching, grabbing, brushing against, or poking another employee’s body An initiation or hazing event that involves a sexual component Requiring an employee to wear sexually suggestive clothing PHYSICAL HARASSMENT 85

86. Displaying sexual pictures, writings, or objects Obscene invitations or letters Unwanted notes or love letters Staring at an employee’s anatomy Leering Sexually oriented gestures Mooning VISUAL HARASSMENT 86

87. Quid pro quo A Latin phrase which means “this for that” and refers to sexual harassment undertaken by a high-ranking employee, such as a manager or supervisor. Typically this involves a person of power demanding sexual favors of the employee who would in turn receive employment benefits such as raises or promotions. TYPES OF SEXUAL HARASSMENT 87 Hostile work environment When an employee has to deal with unwanted sexual advances, or visual, verbal or physical conduct that is of a sexual nature. Subjectively and objectively unwelcome and was severe and pervasive as to alter the victim’s employment or create an intimidating or offensive work environment.

88. AB 2053 Beginning January 1, 2015 Requires employers with 50 or more employees to include prevention of abusive conduct as a component of currently requirement harassment training BULLYING (“ABUSIVE CONDUCT”) 88

89. Repeated infliction of verbal abuse, such as the use of derogatory remarks, insults, and epithets Verbal or physical conduct that a reasonable person would find threatening, intimidating, or humiliating The gratuitous sabotage or undermining of a person’s work performance WHAT IS ABUSIVE CONDUCT? 89

90. Verbal Social Physical Work interference TYPES OF BULLYING 90

91. If you are an employer, co-worker, manager or supervisor you may be held liable for acts of sexual harassment. If you are an employer, you can be held liable for the inappropriate conduct of your managers, supervisors, as well as your coworkers, vendors, customers, and visitors. YOUR RESPONSIBILITIES 91

92. Co-workers Non-employees Staff provided by temporary employment agencies Independent contractors Other professional relationships HARASSMENT LAWS ALSO APPLY TO… 92

93. 1.Display the required posters and notices. 2.Develop and implement a sexual harassment policy that contains an effective complaint process. Communicate zero tolerance for sexual harassment. Adopt a policy regarding employee relationships. 3.Train supervisors and other non-supervisory employees. 4.Investigate and resolve complaints in a timely manner. PREVENTING HARASSMENT 93

94. ANY QUESTIONS 94