Faculty Facility Specific Documents
Please Note: Documents are required every semester/term even if returning to the same facility. Please be aware that some forms are labelled "student" but are required to be completed by both students and faculty.
File type and sizing are important. We encourage faculty 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 convenience in the SON workroom in EC-188. In addition, you can use these scanners to automatically convert images to PDF’s depending on your phone’s operating system: IOS Guide / Android Guide
Anaheim Regional Medical Center (AHMC)
- FACULTY AHMC Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- AHMC Registry and Student Orientation Guidelines
- AHMC Post-Test
- AHMC Answer Sheet
- AHMC Statement of Confidentiality
- AHMC Statement of Responsibility and Orientation Acknowledgement
- AHMC Systems Access Request Form
- AHMC Evaluation forms
Children's Hospital Los Angeles (CHLA)
- PENDING FACULTY CHLA Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- CHLA Policies
- CHLA Required Documents
- CHLA Shuttle Schedule
Rady Children's Health (Formerly CHOC)
- PENDING FACULTY Rady Children's Health Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- Rady Children's Health Parking Map
Corona Regional Medical Center (CRMC)
- FACULTY CRMC Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- CRMC Orientation Packet
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 Downey:
- FACULTY Check-Off Sheet for KP Downey- rotation clinical teaching assignment (BSN/ Undergrad)
- Health Status Information
- KP Downey Student HR Forms
Kaiser Permanente Los Angeles
- FACULTY Check-Off Sheet for KP LA - rotation clinical teaching assignment (BSN / Undergrad)
- KP LA HR Forms
Kaiser Permanente Orange County - Anaheim and Irvine sites:
- FACULTY Check-Off Sheet for KP OC - rotation clinical teaching assignment (BSN / Undergrad)
Kaiser Permanente San Bernardino County- Fontana and Ontario sites:
- Check-Off Sheet for KP SB (pending) - rotation clinical teaching assignment (BSN / Undergrad)
- KP Learn Modules Instructions
Kaiser Permanente South Bay - rotation clinical teaching assignment (BSN/ Undergrad):
- Review and sign the HR Required Forms and Dress Code Attestation
- Submit your LA City Fire Card. Courses can be found here: https://fireandsafetyeducation.com/
- email documents and Fire Card to [email protected]
- Review: Student-Instructor Packet Checklist
-
FACULTY Contact Kaiser Permanente South Bay to Coordinate Faculty Requirements:
- [email protected]
- Please CC [email protected]
Harbor UCLA Medical Center
-
FACULTY Contact Harbor UCLA Medical Center to Coordinate Faculty Requirements:
- Employee Health Services
- Please CC [email protected]
Los Angeles General Medical Center
-
FACULTY Contact Los Angeles General Medical Center to Coordinate Faculty Requirements:
- Affiliate Nursing
- Please CC [email protected]
Orange Coast Memorial Medical Center (OCMMC)
- FACULTY OCMMC Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
PIH - Downey Medical Center
-
FACULTY Contact PIH - Downey Medical Center to Coordinate Faculty Requirements:
- [email protected]
- Please CC [email protected]
- PIH Health Whittier/Downey Hospital Clinical Orientation
PIH - Whittier Medical Center
-
FACULTY Contact PIH - Whittier Medical Center to Coordinate Faculty Requirements:
- [email protected]
- Please CC [email protected]
- PIH Health Whittier/Downey Hospital Clinical Orientation
Pomona Valley Hospital (PV)
- FACULTY PVHMC Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- PV Hospital System Access Request Form
- PV Confidentiality Statement
- PV Basic Orientation and Acknowledgement
Providence Mission Hospital
- FACULTY Providence Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- FACULTY CCPS Registration - rotation clinical teaching assignment (BSN/ Undergrad)
-
FACULTY Contact Mission Hospital to Coordinate Faculty Requirements:
- Genevieve Grable
- Sarra Hem
- Please CC [email protected]
- MyCCPS
- Mission Campus Map
Providence St. Joseph Hospital (SJH)
- FACULTY Providence Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- FACULTY CCPS Registration - rotation clinical teaching assignment (BSN/ Undergrad)
-
FACULTY Contact St. Joseph Hospital to Coordinate Faculty Requirements:
- Sandra Orellana
- Please CC [email protected]
- Sandra Orellana
- MyCCPS
Providence St. Jude Medical Center (SJMC)
- FACULTY Providence Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- FACULTY CCPS Registration - rotation clinical teaching assignment (BSN/ Undergrad)
-
FACULTY Contact St. Jude Hospital to Coordinate Faculty Requirements:
- Patti Campbell
- Please CC [email protected]
- Patti Campbell
- MyCCPS
Saddleback Memorial Medical Center (SMMC)
- FACULTY Saddleback Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- Student Agreements
- Orientation Acknowledgement Form
- Epic Training Instructions
- Contact Staff and Student Hospital Booklet
UCI Health - Los Alamitos
- FACULTY UCI-Los Alamitos Faculty Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- UCI-Los Alamitos Onboarding Documents
- UCI-Los Alamitos Privacy and Security Training
- UCI-Los Alamitos Clinical Profile
- UCI-Los Alamitos Onboarding Instructor Appx.
- UCI-Los Alamitos Nova Flyer
UCI Health- Fountain Valley
- FACULTY UCI FV Check-Off Sheet (pending) - rotation clinical teaching assignment (BSN/ Undergrad)
- UCI FV 2024 Orientation
- UCI FV Student Nurse Co-Signing Process
- UCI FV Confidentiality Agreement
- UCI FV Security Form and Contract Personnel
- UCI FV Information Privacy and Security Education Attestation
- UCI FV COVID Attestation
- UCI FV Orientation Information Acknowledgment
- UCI FV Artificial Nails Policy
UCI Health - Placentia Linda
- FACULTY UCI PLH Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- UCI PLH Orientation Booklet
- UCI PLH Student Sponsor Form
- UCI PLH Student Test
- UCI PLH Student Attestation
- UCI PLH Confidentiality Agreement
- UCI PLH Privacy and Security Training and Acknowledgement Form
UC Irvine Medical Center (UCIMC)
- FACULTY UCIMC Check-Off Sheet - rotation clinical teaching assignment (BSN/ Undergrad)
- UCIMC Confidentiality Form
- UCIMC Nursing Student Orientation
- UCIMC Keeping Family Safe If You Have COVID-19
- UCIMC Monitoring Yourself for Infection Symptoms
- UCIMC Concerns About COVID-19 Exposure
- UCIMC Campus Map
Veterans Affairs, Long Beach (VALB)
- FACULTY Contact Tibor Rubin VA Medical Center to Coordinate Faculty Requirements:
-
Naomi Ceja
-
[email protected]
- Please CC [email protected]
-
[email protected]