HSDB STAFF OPENING OF 2018-2019 SCHOOL YEAR

CHECKLIST AND DOCUMENTATION FORM

Please utilize the checklist below to document read/reviewed relevant material and/or viewed videos as indicated.
Once you understand information for each please initial next to the appropriate statement of understanding. Please
submit completed check in sheet to the Vice Principal for proper filing under DOE and HIOSH requirements.

VIDEOS (ALL EMPLOYEES)

_____ Bloodborne Pathogens (19:54) I have viewed the video, and understand the precautions and safety procedures.
http://vimeo.com/6578874
_____ Child Abuse Reporting (4:20) I have viewed the video, and understand my responsibilities and procedures in
reporting suspected child abuse. http://vimeo.com/27953701
_____ HAZCOM (19:46) I have viewed the video, understand my responsibilities and procedures regarding Hazardous
Communication. http://vimeo.com/71444198
_____ PASSing with School Fire Extinguisher (11:08) I have viewed the video, and understand my responsibilities and
procedures regarding School Fire Extinguishers. http://vimeo.com/34804564
_____ School Communities (8:22) I have viewed the video, understand my responsibilities and procedures regarding School
Communities. http://vimeo.com/27952194
_____ Workplace Violence (10:17) I have viewed the video, understand my responsibilities and procedures regarding
WorkplaceViolence. http://vimeo.com/54326956
_____ Special Education Referrals(8:24)I have viewed the video, understand my responsibilities and procedures regarding
Special Education Referrals. Special Education Referrals
_____ Tsunami Awareness Video (13:21) I have viewed the video, understand my responsibilities and procedures regarding
Tsunami Awareness. Tsunami Awareness Video
_____ FERPA I have watched the video, received, and reviewed the FERPA brochure and signed Attachment E and turned it
in to the Vice Principal FERPA

VIDEOS (CERTIFICATED ONLY)

_____ Educator Effectiveness System (13:20) I have watched the video and understand my responsibilities and procedures
regarding Educator Effectiveness System (EES). Educator Effectiveness System

DOCUMENTS (All Employees)

_____ Faculty Handbook (HSDB Website only) I have read and understand my responsibility as it relates to the online
handbook contents.
_____ Non-Discrimination Policy I am aware of and understand my role in the prevention of workplace harassment and
discrimination (Pamphlet)
_____ Requests for Reasonable Accommodations Due to a Disability I am aware of and understand my rights and
responsibilities under the Department of Education’s Request for Reasonable Accommodations due to a Disability from
Disabled Employees and Job Applicants. (Pamphlet)
_______DOE Opening of School Year 2018-19 Packet for ALL Employees I have received and reviewed the opening of
school year packet and understand its contents as related to my duties and scope of responsibilities.

Opening of School Packet Contents:

Internet Access Regulations: I have read and understand my responsibility as it relates to BOE policy 2170.1
regulations, in conjunction with BOE Policy 2170.
DOE Network and Internet - Acceptable Use Guidelines: I have read and understand my responsibility as it
relates to BOE Policy 111012, Student Internet Use Policy.
Leaves of Absence: I have read and understand my responsibility as it relates to the process to apply for a leave of
absence, with links to forms.
Chapter 19 Annual Notice: I have read and understand my responsibility as it relates to annual reminder to all
schools and offices that failure to report Hawaii Administrative Rules (HAR), 81919 Class A or Class B offenses
may result in disciplinary action. Includes links to lists of reporting offenses and current listing of class offenses.
 Accountability, Ethics and Conflict of Interest Policy: I have read and understand my responsibility as it relates
to the annual memo about responsibilities of state employees toward an ethical workplace, with links to key policies
and guidelines.
Statement on Equity for Students of All Socioeconomic Backgrounds: I have read and understand my
responsibility as it relates to the annual memo regarding concerns about students being required to bring in items or
cash for grades or extra credit.
Scope of Duties and Responsibilities: I have read and understand my responsibility as it relates to the annual
notification of prohibited behavior by DOE employees.
DOE Drug-Free Workplace Statement: I have read and understand my responsibility as it relates to the annual
memo with Drug-Free Workplace Notification to Employees.
Key BOE Policies: I have read and understand my responsibility as it relates to the many BOE policies that govern
and direct the public school system. These are the policies deemed essential for every DOE employee to know and
understand. Please review all of them.
Hawaii State Department of Education Acknowledgment of General Confidentiality Expectations: I have read
and understand my responsibility as it relates to DOE general confidentiality expectations.

OPENING OF THE YEAR ‘TO DO’ LIST:

_____ Employee Emergency Card Updates (ALL STAFF): I have filled out, updated and returned my employee
emergency card to the SASA by August 3, 2018.
_____ Student Emergency Cards and 2018-19 Student Handouts (Teachers): I have distributed the required paperwork
to my homeroom students. I have also collected all of the emergency cards from my homeroom students and have forwarded
them to the School Nurse.
_____ Parent Contact Logs (Teachers): I have established a system for logging my attempts and verified contacts with
parents.
_____ Acceptable Use Policy (AUP) (Teachers): I understand that I need to remind students to turn in the AUP to the
SASA, ASAP. I have read and understand the AUP and Internet permission form and understand my role in supporting
the AUP.

By signing this form, I am acknowledging that I have completed all the above tasks.

____________________________________ ______________________________ _____________

Print Name Signature Date