General Safety Orientation
Employee Name
A. HAZARD COMMUNICATION PROCEDURES
Under OSHA Hazard Communications Regulations, every employee must:
1. Be informed of all hazardous substances he/she may be exposed to in the workplace. 2. Have access to a list of all hazardous substances in the workplace, the Material Safety Data Sheet (MSDS) prepared for each, and the written program to inform and train employees in safe handling. 3. Be trained in the identification, labeling and handling of hazardous substances to which you may be exposed in the workplace.
This occupational hazard communication responsibility rests with the employer in control of each workplace. If you have any questions relative to hazardous substances on your assignment or wish to be informed relative to their program, please ask your supervisor on the worksite.
B. GENERAL SAFE PRACTICES (please check all boxes stating that you have read and understand the policies and procedures) 1. I understand the Hazard Communication Procedures listed above. 2. I understand and comply with the General Safety Rules 3. I will comply with any additional worksite safety rules or safety programs in effect. 4. I will use any personal protective equipment required by my assignment 5. I will call my Spherion client service representative if I am asked to change assignments after arrival on the job. I may be entitled to a higher wage on this new job.
6. If I am Injured on the job, I will call my Spherion client service representative immediately.
7. I will report any unusual or hazardous job conditions to my Spherion client service representative immediately. I understand that I may do so anonymously.
8. I have watched Spherion's General Safety Orientation Video and I am aware of the rules and regulations above.
GENERAL SAFETY RULES
1. Know your job and follow instructions. If you do not know the safe way to do the job, ask your supervisor.
2. If the office equipment is not working properly, turn the equipment off and report malfunction to your supervisor immediately.
3. Worn Wiring, overloaded outlets and defective equipment should not be used.
4. Use office chairs for only intended use. Do not stand on chairs, table or desks to obtain or reach for any object. Ask for assistance.
5. Do not attempt to move any office equipment. Ask your supervisor to arrange for any moving required.
6. Keep desk drawers, file cabinets and doors in closed position when not in use to avoid hitting or striking.
7. When using duplicating machines, copy machines, addressing machines or paper cutters, use the machines in a safe work manner to avoid getting hands caught.
8. If you are required to carry any printed material, the weight should be limited to 20 pounds. The material should be carried to provide you with a clear path of the direction you are walking.
9. When lifting, use approved lifting techniques; i.e., bend your knees, grasp the load firmly, then raise the load keeping your back as straight as possible. After the object has been firmly grasped, the lifting is done by straightening the legs. Never lift while the body is twisted since this puts the entire load on the muscles of one side of the body. Ask for help when necessary to lift or move any object which, because of its weight or shape, is difficult for one person to handle safely.
10. When ascending or descending steps or stairs, use the handrail to give support and balance. Be careful when wearing high heels. Walk, do not run, in the halls, rooms, passageways or on steps/stairs. Always keep to the right and approach corridor intersections carefully. Open doors slowly using handle or push plate. Do not go into rooms that are not properly lighted. Do not use stairways that are not properly lighted.
11. Do not place or stack material or objects which will obstruct pathway to work area, aisles or walkways.
12. Watch for conditions and situations which are likely to cause falls, such as objects on the floors or stairways.
13. Report all unsafe conditions to your Spherion supervisor immediately. This includes broken furniture, broken glass and defective office equipment. You may report unsafe conditions anonymously if you prefer.
14. If you are required to enter the production area, be constantly alert to moving machinery and equipment. Stand clear of moving machinery and equipment. Notify your Spherion supervisor of any changes in your assigned duties.
15. Whenever you are involved in a workplace accident or observe a workplace accident, even if there appears to be no injuries, the accident must be reported to your Spherion office immediately. Get first aid promptly.
SPHERION'S CERTIFICATION OF GENERAL SAFETY ORIENTATION I have read and fully understand the above policies and procedure and agree to the same. I understand that failure to comply with these policies will lead to disciplinary action, could lead to my termination and may jeopardize my insurance benefits.This document will not be "signed" in the sense of a traditional paper document. To verify the contents of this form, the signatory must enter any combination of alpha/numeric characters that has been specifically adopted to serve the function of the signature, preceded and followed by the forward slash (/) symbol. Acceptable "signatures" could include: /john doe/; /jd/; and /123-4567/. For example: if your name is John Miller, you could type /John Miller/ below.
Signed Social Security Number
POLICIES AND PROCEDURES-APPLICATION SUPPLEMENT Applicant-Please Read and Check the following:
I understand that the continuing ability of Spherion to provide work for me and others desiring flexible assignments, depends upon the quality of service rendered to clients. Upon acceptance of employment with Spherion, I therefore agree to the following.
YES I will report to my assignment as scheduled until the duties are completed.
I will not leave the assignment without prior consent from both the client and Spherion, and understand that if I do so , it will be considered voluntary quit.
I will follow directions and perform job duties as explained to me upon acceptance of each new assignment and understand that refusal to do so may result in termination.
I will be professional and courteous at all times. I will wear appropriate work attire conductive to the working environment of each assignment.
I will notify Spherion immediately if I report to an assignment and there are any changes in the required uniform, equipment or if any of the job duties are different from what I was initially told.
I understand that Spherion is my employer and I will address all problems and concerns directly with Spherion, never the client. I understand that Spherion will communicate with the client for me.
I understand that Spherion is my employer and while on assignment I will call them if I am going to be late or absent from my assignment or to address any employment issues. If I don not show up for work and do not call to notify Spherion, I will be considered to have abandoned my job which may result in disciplinary action, up to and including termination.
I will notify Spherion of my availability as soon as my assignment ends and on a weekly basis make contact with the office. I also understand that failure to do so will be considered voluntary quit and I may be disqualified from receiving employment benefits in accordance with the unemployment law as mandated by my individual state.
I understand that the assignments that I will be sent on through Spherion vary in length and are subject to termination at any time without notice, and that my employment with Spherion is also subject to termination at any time without notice. I also understand that neither Spherion nor any of Spherion's clients will have any further obligation to me after termination of my employment with Spherion or termination of my assignment with the client.
I understand that I am required to submit a complete and accurate time slip, which has been signed by both myself and the client, at the end of each weekly pay period for the purpose of generating my paycheck (unless an automated time keeping system is utilized and a time slip is not required). Failure to submit my time slip on a timely basis may result in a late paycheck. I also understand that any falsification of company time slips will result in immediate termination.
I understand that time slips may be submitted to Spherion's office in person, by fax, or by mail. I also have the option of picking up my paycheck directly from Spherion's office, having the check mailed to me, or having direct deposit to my bank account.
I will follow all safety standards, policies and procedure set by Spherion's clients and wear all required Safety Equipment.
I will advise Spherion of any on the job accident or injury immediatly, as well as keep Spherion informed of any unsafe conditions at the worksite or if I am not being provided required safety training. I am aware that I may do so anonymously.
I will notify Spherion of any changes to my address, phone number, or anything else affecting my availability.
I understand that I am employed by Spherion and not a client to which I may be assigned and that I am not eligible to participate in any client profit sharing, pension, welfare benefit, bonus or other compensation or benefit plan of a client made available to its employees.
I will never discuss and hold strictly confidential business information that comes into my possession as a result of my employment with Spherion, pertaining to Spherion's business and of Spherions clients.
I will notify Spherion immediately if any client offers me direct employment, wether full-time while on assignmnent or within 90 days after that assignment has ended, before accepting any offer.
I will always make Spherion aware of any discrimination, sexual harassment or any other problems I may experience while on assignment. (A copy of Spherion's Workplace Harassment Policy follows this form 22)
I have read and consented to Spherion's Drug-Free Workplace Policy. I understand failure to comply with such policy makes me ineligible for continued employment and is considered a voluntary quit.
I will not unlawfully manufacture, distribute, possess, use or be under the influence of any controlled substance while working in the client's business facilities. I understand that any violation of the policy may result in immediate termination depending on State Law.
Drug, credit history, motor vehicle, and criminal background screening may be required as a condition of a flexible assignment or a full-time position with some clients, continued employment, or employment with Spherion.
WORKPLACE HARASSMENT POLICY
Spherion Corporation, including all of its divisions, business groups and subsidiaries (Spherion), is committed to providing a work environment free of unlawful harassment, Harassment based on an individual's race, religion, color, national origin, citizenship, marital status, sex, age, sexual orientation, veteran status, disability or any other legally protected status is strictly prohibited and will not be tolerated at Spherion.*
Employees have a right to be free from unlawful harassment from managers, coworkers and non-employees with whom Spherion employees have a business, service or professional relationship, including, but not limited to, vendors, clients and client employees. Every Spherion manager and supervisor is responsible for ensuring that the spirit, intent and goals of the anti-harassment policy are achieved.
DEFINITION Prohibited harassment includes, but is not limited to, verbal or physical conduct that shows hostility toward an individual, epithets, abusive language, comments, slurs, jokes, displays, innuendos, cartoons, pranks or physical harassment which are based on individual's protected class membership or an individual's participation in activities identified with or promoting the activities of a protected group and that creates an intimidating, hostile or offensive working environment.
Unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct that is based on an individual's sex or is of a sexual nature constitutes sexual harassment when any of the following occur or are present: - Submission to such conduct is made either explicitly or implicitly a term or condition of employment. - Submitting to or rejection of such conduct is used as the basis for employment decisions. - Such conduct has the purpose or effect of unreasonably interfering with an individual's work or performance or creating an intimidating, hostile or offensive working environment.
INVESTIGATIVE & COMPLAINT PROCEDURES All employees must report incidents of harassment. Any employee who believes that he or she is being harassed by a coworker, supervisor, manager or other individual at the workplace-wether employed by Spherion or not-or believes that his or her employment is being adversely affected by such conduct, should immediately report such concerns to his or her supervisor, next-level manager, another manager or the HR department. A human resources representative may be contacted at - Human Resources, c/o Spherion Corporation, 5580 Mill Street Suite 100, Reno, NV, 89502, 775-829-8367 or contact@spherion.com
After a complaint of harassment is received, a prompt and impartial investigation will be conducted and, in the event the complaint is found to have merit, appropriate corrective steps will be taken which may include disciplinary action up to and including discharge. All complaints of harassment will be handled in a discreet manner and information will be limited to those personnel with a need to know. Managers who receive complaints or who observe harassing conduct should inform the HR Representative responsible for his or her group. If it is determined that harassment has occured, Spherion will take prompt and appropriate action corrective action. Any employee who violates Spherion's policy against workplace harassment will be subject to disciplinary action up to and including termination of employment.
PROTECTION AGAINST RETALIATION Spherion also emphasizes that it will not tolerate retaliation against any employee for cooperating in an investigation or for making a complaint of harassment. If you believe you have been retaliated against for reporting harassment, for making a complaint of harassment or for participating in an investigation related to harassment, you must immediately report the retaliatory action to the director of HR or a member of the executive staff.
I AGREE TO THE ABOVE TERMS YES NO
Employees in CA, CT, MA,VT, WI and ME should refer to postings of state harassment policies for additional information.
APPLICANT EEO SELF-IDENTIFICATION FORM (Completion of this section of the Application for Employment is voluntary)
Spherion is an equal employment opportunity/affirmative action employer. It does not discriminate on the basis of race, color, national origin, sex, religion, ancestry, age, sexual orientation, marital status, disability, veteran status, citizenship status, or any other protected characteristic. Certain Laws and regulations regarding equal employment opportunity, and/or affirmative action require us to compile, maintain, and report certain information on employees. In order to comply with these laws and regulations, we are requesting your cooperation in completing this voluntary EEO Self-Identification Form.
The Information on this EEO Self-Identification Form is being requested and will be used solely for record keeping and reporting purposes. We encourage you to provide us with the following self-identification information. However, you are not required to do so, and wether you respond or not will not affect any employment decision. In the event that you do provide the information requested, the information and this form will be processed and maintained separately from your employment application forms and your personnel file.
ETHNIC/MINORITY IDENTIFICATION American Indian or Alaska Native
Asian or Pacific Islander
Black or African American
Hispanic or Latino
White
GENDER
Female
Male HOW WERE YOU REFERRED TO US? Direct Recruit Electronic Media (TV or Radio) Recruiting Event (Job Fair) Internet Print Advertising Referral Walk-In or Call-In
POSITION APPLIED FOR
DATE
NOTICE OF NEW TIME REPORTING PERIOD FOR WORKERS' COMPENSATION. Effective July 1, 1995, the legislature has changed the time limit for the reporting of accidents/incidents for workers' compensation claims. The time limit has changed from 30 day to 7 days.
If you have an on the job injury and wish to report it as an incident for record purposes only, you will use the C-1 form.
If medical treatment or lost time is anticipated at the time of the injury, you must use the Employer's First Report of Accident, Form C-3.
Please remember: This 7-day time limit applies to the filing of either form.
Failure to notify your employer of an accident in writing, within 7 days, on either the C-1 or C-3 forms may result in loss of workers' compensation benefits.
Filing of the C-1 or C-3 forms with the required 7 days satisfies the reporting requirement as outlined by the Nevada Revised Statutes.
I have read and understand the new time reporting period for workers' compensation.
Drug Free Work Place Policy
Drug and alcohol use in the workplace poses a danger to us all. We cannot tolerate drug and alcohol abuse by any of our employees. It is this company's policy to employ a workforce free from drugs and alcohol. Accordingly, the following conduct is prohibited.
A. the use, possession, solicitation for or sale of illegal drugs, alcohol or prescription medication without a without a prescription on company or customer premises or while on assignment.
B. being under the influence of illegal drugs, alcohol or prescription medication without a prescription on company or customer premises or while on assignment.
C. the use, possession, solicitation for or sale of illegal drugs, alcohol or prescription medication without a prescription off company or customer premises that adversely affects the employee's work performance, his or her own or another's safety or our reputation.
If you are found to engage in any of the above prohibited conduct you will be subject to disciplinary action up to and including termination. You will be deemed to be under the influence if a drug or any of its metabolics or alcohol is present in any detectable amount. In accordance with our company policy and the Federal Drug Free Workplace Act employees are required to agree to 1)abide by the terms of this Drug Free Workplace policy; and 2) advise us within (5) days of any criminal conviction for substance violations in the workplace.
DRUG AND ALCOHOL TESTING POLICY As a condition of assignment, continued assignment or a permanent position with some of our customers, you may be required to undergo drug and/or alcohol testing. Submission to such testing is not mandatory unless you wish to be considered for the assignment, continued assignment or permanent position.
Post-Accident testing- any employee who has a work-related accident or an incident in which safety precautions were violated or unusually careless acts were performed while on assignment may be requested to undergo drug and/or alcohol testing immediately following the accident, if required by office policy or customer policy.
Reasonable suspicion- where there is reasonable suspicion that you are using or are under the influence of illegal drugs, alcohol, or prescription medication without a prescription, you may be requested to undergo drug and/or alcohol testing.
Random- random drug testing may be conducted if permitted by state law. If the results of the drug and/or alcohol test indicate the presence of illegal drugs, alcohol or prescription, the following will occur
1) If an applicant, you will be ineligible for employment. If already employed or on an assignment, you may be subject to disciplinary action up to and including termination. 2) Pursuant to state law, unemployment and workers' compensation benefits may be denied.
If you disagree with the results, you may have the same sample retested at your own expense by a laboratory certified by the Federal Department of Health and Human Services or similar state agency. You must notify us within 24 hours of receipt of the results if you want to do this. If an on-site test is used, you may submit to a drug test conducted by a laboratory certified as above at your own expense within 24 hours of the on-site test. You may submit a written statement explaining a positive test result. We will reconsider hire or rehire upon submission of evidence of rehabilitation or submission to another test by a laboratory certified as above with a negative result for drugs and/or alcohol, at you own expense.
If you refuse to submit to testing immediately after work-related accident or upon reasonable suspicion or random testing, you will be considered to have voluntarily terminated your employment. If you interfere with the administration of the test or refuse to submit to testing as a condition of assignment, continued assignment or a permanent position after previously agreeing to submit to such testing you will be ineligible for employment or continued employment.
Acceptance of this policy is a condition of employment or continued employment.
We reserve the right to interpret, change, suspend,cancel, or dispute, with or without notice, all or any part of this policy. Nothing contained in this policy alters the at-will status of employment, or is intended or should be construed as contract, expressed or implied.
CONSENT AND RELEASE I have received a copy of the drug and alcohol testing policy and voluntarily give my consent to Spherion Pacific Enterprises, LLC its subsidiaries and franchised and licensed offices "employer" to perform drug and/or alcohol testing. I authorize release to, and use and evaluation of the test results by my employer, its customers, a medical review officer or other health care professional, my employer's workers compensation insurer and to any person or entity who may have cause to review my personnel file and understand that such results may be used in any administrative or legal proceeding associated with my employment.
I release and hold harmless employer, its employees, agents, shareholders, officers, directors, affiliates, and licensors or franchisors from any claim, demand cause of action I may now or in the future have against any or all of them which results from my submission to or my refusal to submit to drug and or alcohol testing or the use of such test results as described above.
ACKNOWLEDGMENT I HAVE READ THE FOREGOING AND AGREE TO BE BOUND BY ITS ITEMS IF I REFUSE TO AGREE TO THE POLICY I UNDERSTAND THAT AS A RESULT, IF I AM AN APPLICANT I WIL NOT BE OFFERED EMPLOYMENT AND IF I AM ALREADY EMPLOYED, I AM INELIGIBLE FOR CONTINUED EMPLOYMENT AND HAVE VOLUNTARILY TERMINATED MY EMPLOYMENT.
I AGREE TO THESE TERMS YES NO