SAMPLE EMPLOYEE/SUPERVISOR CHECKLIST

The following checklist is designed to ensure that employees participating in flexiplace are properly oriented to the policies and procedures of the project.

1. Employee has read guidelines outlining policies and procedures for flexiplace participation.

Date:

2. Equipment has been issued to the employee and has been documented.

Issue Date:

Documented Date:

ComputerModemFax machineTelephoneDeskChairOther (Please note that employees should bring any supplies they need with them, including items such as scissors, stapler & staples, tape, pens, pencils, note pads, envelopes, hanging files, etc.)

3. Policies and procedures for care of equipment issued by the agency have been explained and are clearly understood.

Date:

4. Policies and procedures covering classified, secure, and privacy act data have been discussed and are clearly understood.

Date:

5. Requirements for an adequate and safe office space and/or area have been discussed and certified.

Date:

6. Performance expectations have been discussed and are clearly understood.

Date:

7. Employee understands that participation may be terminated by supervisor at any time.

Date:

8. Employee has participated in USDA flexiplace training.

Date:

Supervisor signature:Date:

Employee signature:Date: