VisionQwest Healthcare Telephone/Fax Telephone: (818) 547-0497 Ext 2 ------------------------------- Fax Resume's To:  (818) 547-0449 Fax Time Sheets To: (310) 861-5558 Night On-Call Line:  818.334-9877 Staffing Coordinators Dee Baiden Phone:  818.547.0497 Ext 8 dbaiden@vqstaff.com Michael Lodge Phone:  818.547.0497 Ext 2 mlodge@vqrginc.com   Mailing Address VisionQwest Healthcare 500 N Central, Suite 740 Glendale  CA  91203

VISIONQWEST EMPLOYMENT FORMS EMPLOYMENT FORMS & CHECK LISTS     Staffing Checklist Check List   RN Application RN Application - 2010   LVN Application LVN Application - 2010   CNA Application CNA Application - 2010   Caregiver Application CG Application - 2010   Employment Agreement Client Protection Agreement   Education / Credential Verification Form Ed / Cred Verify   I-9 I-9   W-4 W-4   Time Sheet - RN, LVNs, CNAs Time Sheets   Time Sheet - Caregiver Caregiver Time Sheet   Employee Handbook Employee Handbook   Sexual Harassment Policy Sexual Harassment Policy   Joint Commission Policy Statement Joint Commission Policy Statement   SS / Background Check Policy Policy Document   Background Checks (SSN Verification / Fed/State Criminal Records) SS & Criminal   HHS / OIG (List of Excluded Individuals/Entities) Excluded Individuals/Entities Check   General Services Administration (List of Parties Excluded from     Federal Programs) General Services Administration   RN - CA License Verification License Verification   LVN - CA License Verification License Verification   CNA - CA Certification Verification Certification Verification     SKILLS CHECKLIST FORMS     Critical Care / Intensive Care Skills Checklist Form Critical Care and Intensive Care   Dialysis Skills checklist Form Dialysis   Emergency Room Skills checklist form Emergency Room   Labor and Delivery Skills checklist Form Labor and Delivery   Long Term Care Skills Checklist form Long Term Care   Medical / Surgical Skills checklist Form Medical Surgical   Neonatal Intensive Care Skills Checklist Form     OR Skills Checklist Form Operating Room   Pediatric Care Skills Checklist Form Pediatrics   Psychiatric Care Skills checklist Form Psychiatric   Surgical Technicial Skills Checklist Form Surgical Technicial   Telemetry / Intermediate Care Skills Checklist Form Telemetry and Intermediate Care     OTHER EMPLOYMENT DOCUMENTATION     Placement Form Placement Form   Incident Report Incident Report - 1 Incident Report - 2   Performance Review Evaluation Form   Home Health Visit Log Home Health Visit Log   Caregiver Patient Intake Form Patient Intake Form     Training Materials       HIPAA HIPAA Training     Wound Care - Pressure Ulcer Staging  Pressure Ulcer Staging     Wound Care - Differentiating Lower Extremity Ulsers Lower Extremity