Page 117 - Compliance Workbook June

NEW HIRE EMPLOYEE CHECKLIST

Employee Name ___________ Dept. _____ Hire Date: ___ _

Social Security# _________ _

Check each line to show completion of the form. This is to keep in a pending file until all forms
are completed.

_ Employment Application

_ Phone Reference Check/Release Forms (2) Signed by Department Supervisor

_ Criminal Background Check and Consent Form Completed

_ Office of Inspector General (OIG) Completed

_ Computer verification of License from State, if applicable

_ Abuse Registry

_ Exchange Notice Distributed (all p/t and flt employees)

_ Copy of License/ Certification, if applicable

_ Copy of 2 forms of Identification

_ Federal Tax Forms and State Forms (if applicable)

_ 1-9 (Employee Eligibility Verification)

_ Confidentiality and HIPP A Agreements

_ Signed Page TSC Personnel Policies/ Procedures Handbook

_ Signed Page of Certificate of Compliance of TSC

_ Employee Maintenance Form

Attestation Statement