Facility Specific Documents
Facilities are listed below in alphabetical order. If you do not see your clinical or preceptor site listed, there are no additional requirements at this time.
The check-off sheets listed below for each specific facility are to be completed by students placed at the corresponding site for an upcomming clinical/practicum. Submit all facility requirements via PDF email to firstname.lastname@example.org.
File type and sizing are important. We encourage students to scan Facility documents into one PDF, ideally keeping your document packet to a minimium file size of 2MB or less.
A scanner is available for student convenience at the Nursing Simulation Center Student Library
In addition, you can use these scanners to automatically convert images to PDF’s depending on your phone’s operating system.
Anaheim Regional Medical Center (AHMC)
Please review the check off sheet to access the AHMC website and all required documents.
Kaiser Permanente (KP)
If you have not yet been assigned an NUID number, please leave this area blank on your KP forms when asked for an Employee ID or an NUID.
Kaiser Permanente Orange County - Anaheim and Irvine sites:
- Check-Off Sheet for KP OC - Rotation Students (BSN / Undergrad students)
Kaiser Permanente San Bernardino County- Fontana and Ontario sites:
- Check-Off Sheet for KP SB - Rotation Students (BSN / Undergrad students)
- KP Learn Modules Instructions
Kaiser Permanente Downey:
- Check-Off Sheet for KP Downey- Rotation Students (BSN/ Undergrad students)
- Alaris IV Pump Education Attestation
Los Alamitos Medical Center (LAMC)
Orange Coast Memorial Medical Center (OCMMC)
OCMMC Check-Off Sheet
(Review check-off sheet to access all OCMMC documents)
Placentia-Linda Hospital (PLH)
San Bernardino County Department of Public Health (SBCDPH)
Please ensure to review all items below:
- SBCDPH Check-Off Sheet
- Transportation of Protected Health Information Report
- Acknowledgment Form (Page 4 of PHI Report above. Print out and complete.)
- Volunteer Services Program (VSP) Packet
- Important! All students are required to come in person to the School of Nursing main office in EC-190 to pick up your Life Scan Voucher. Due to strict policy per SBCDPH these vouchers cannot be mailed and must be distributed in person. Please bring a valid, current form of ID when picking up your Live Scan Voucher at the front desk.