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DocuSign Envelope ID:9C771219-CEEB-46F8-B1D1-540A276BB81A <br /> 2) Clinical evaluation and attendance forms. <br /> 3) Clinical objectives for the rotation period. <br /> 4) Expectations of student performances. <br /> 5) A list of skills that students are expected to perform where applicable. <br /> e. Require the students to obtain and maintain professional liability insurance and <br /> student accident insurance at all times during any clinical rotation with Agency. <br /> f. Assure that all students are in compliance with OSHA Standard on Bloodborne <br /> Pathogens, the Service Agency Infection Control Standards, and the Health <br /> Insurance Portability and Accountability Act (HIPAA) Guidelines. The students <br /> will receive annual instruction on universal precautions and the issues relating <br /> to Bloodborne pathogens. All students will receive a TB skin test and be <br /> immunized for Tetanus Rubella, Rubeola, Varicella, and Hepatitis B <br /> vaccinations or have an acceptable titer level prior to attending clinical <br /> rotations. FTCC or the student will provide immunization records and results <br /> of the annual TB skin test or chest x-ray if requested. <br /> g. Assure consistent follow-up communication with the Agency regarding any <br /> student who has received treatment and/or services by the Agency resulting <br /> from infectious exposure. <br /> h. Ensure that all information acquired as a result of the clinical rotation be <br /> considered privileged information and shall be held in strictest confidence. This <br /> includes information regarding patients, patient care, and patient's families and <br /> homes, and the employees of the Agency. <br /> i. Maintain ultimate responsibility for the evaluation of students and to keep all <br /> permanent records and reports of the students' clinical performances. <br /> j. Maintain and enforce all policies of FTCC. <br /> k. Assure currency of students' CPR certification. <br /> I. Terminate when requested by the Agency, privileges afforded to any student <br /> and/or instructor who violates terms of this agreement or the policies and <br /> procedures of the Agency. <br /> m. In the event that Agency notifies FTCC of its requirement that criminal and/or <br /> other background checks be conducted prior to a Student's entry into clinical <br /> site, FTCC shall notify Students of such requirement and shall provide <br /> Student's with information on obtaining said background checks. <br /> FTCC Affiliation Agreement Page 4 of 6 <br /> Format revised:11/2015 <br />