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 all students. Please note that all students need to submit these facility specific documents, in addition to all School of Nursing (SON) core required documents, which are uploaded to your Castle Branch Document Manager. 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. Are you having trouble creating, resizing,
or combining your files into one PDF? The Adobe website is a good place to start to find online tutorials and videos should you need assistance: https://acrobat.adobe.com/us/en/acrobat/pdf-creator-create-pdf-files.html
NOTE: If you are having trouble viewing any of the documents below, please see our Technical Resources page for assistance.
Anaheim Regional Medical Center (AHMC)
Please review the check off sheet to access the AHMC website and all required documents.
Children's Hospital Los Angeles (CHLA)
- CHLA Check-Off Sheet
- CHLA Orientation Booklet
- CHLA Emergency Response Codes
- CHLA Safe Patient Handling
- CHLA Social Computing Policy
- CHLA Social Media - Keep Your Status Healthy
- CHLA Safe and Sound: Aim for Zero Harm
- CHLA Acknowledgement of Confidentiality
- CHLA Trainee Role in Environment of Care
- CHLA HIPAA Competency Test
CHLA Social Computing Acknowledgement
- CHLA Identification Badge Application
- CHLA Parking Application
- CHLA Shuttle Schedule
Fountain Valley Regional Hospital & Medical Center (FVRHMC)
- Hoag Check-Off Sheet
- Hoag Student Preceptorship Request
- Hoag Orientation
- Hoag Confidentiality Agreement
- Hoag Non-Hire Form
- Hoag Student Non-Hire Form
- Hoag Student Influenza Form
Documents are temporarily unavailable.
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)
- Check-Off Sheet for KP OC - Preceptorship Students (MSN students)
Kaiser Permanente San Bernardino County- Fontana and Ontario sites:
- Check-Off Sheet for KP SB - Rotation Students (BSN / Undergrad students)
- Check-Off Sheet for KP SB - Preceptorship Students (MSN students) - not available at this time.
Kaiser Permanente South Bay(Harbor City, Long Beach) sites:
- Check-Off Sheet for KP South Bay - Preceptorship Students (MSN students) - not available at this time.
- Mission Check-Off Sheet
- Mission Student Orientation Manual
- Mission Corporate Responsibility Handbook
- Mission Directions for Accessing and Completing Student E-Learning
- Mission Campus Map
- Mission Parking Map
- Mission Student Training Attestation Form
- Mission Acknowledgement and Confidentiality Form
- Mission Student Orientation Confirmation
- Mission Student Orientation Post-Test
Orange Coast Memorial Medical Center (OCMMC)
OCMMC Check-Off Sheet
(Review check-off sheet to access all OCMMC documents)
Riverside County Department of Public Health (RCDPH)
Saddleback Memorial Medical Center (SMMC)
SMMC Check-Off Sheet
Documents are now available through the SMMC website. Please refer to the Check-Off Sheet above
to access all required items.
- SMMC EPIC Training Instructions for Student Nurses
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 Live 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.
St. Joseph Hospital (SJH)
- SJH Check-Off Sheet
- SJH Student Orientation Manual
- SJH Directions for Accessing and Completing Student E-Learning
- SJH E-Learning Lessons Outline
- SJH Easy Pass (Badge Enrollment Procedure)
- SJH Student Parking Information
- SJH General Orientation Confirmation for Students
- SJH Student Training Attestation Form
SJH Flu-Vaccinated Elsewhere Form
This form is not yet available for the 2017-2018 Flu season. Please check back in early October.
St. Jude Medical Center (SJMC)
Veterans Affairs, Long Beach (VALB)
VALB CHECK-OFF SHEET PART 1
To be submitted directly to the SON Document Team at: email@example.com .
Please refer to the Check-Off Sheet above to access all required documents and instructions.
VALB CHECK-OFF SHEET PART 2
To be submitted directly to your Clinical Instructor. See Check-Off Sheet Part 2 for your instructor's contact information and to access the required documents.
- CPRS Tab-by-Tab Training Modules Instruction Sheet (to submit to Clinical Instructor)