All information in this document is confidential.
Peppermint Ridge acknowledges that equal opportunity for all persons is a fundamental human value. Each volunteer applicant will be considered on the basis of individual ability and merit, without regard to race, color, age, religion, national origin, disability, sexual orientation, sex, or marital status.
Peppermint Ridge Has ZERO Tolerance for Abuse, Neglect and/or Exploitation.
Any staff or volunteer witnessing abuse, neglect and/or exploitation MUST:
- STOP the abuse, neglect and/or exploitation.
- PROTECT and PROVIDE support, including comfort and aid to the victim.
- REMOVE the alleged abuser from all client contact IMMEDIATELY.
- CALL the RN to assess the individual. (This will include a physical for the victim and other potential victims).
- CALL the FM/Q/Administrator to inform and assist with covering the shift.
- ASSESS and PROVIDE comfort, aid and/or support, continually while working with the individual.
- REPORT and DOCUMENT to the appropriate entities.
All Peppermint Ridge Staff are MANDATED REPORTERS (Per W&I Code 15630). All suspected or known abuse must be reported to Licensing, the Regional Center and the Ombudsman.
Peppermint Ridge’s Standard Policy and Procedure on abuse, neglect, and/or exploitation (SPP #201), states that it is expected that all Peppermint Ridge staff assist in promoting an environment for the individuals in our care that ensures their physical and emotional well-being, is not endangered in any way, and that protection from harm measures are in place at all times. This includes being vigilant and constantly alert to any and all potential harm to the residents of Peppermint Ridge, and to immediately take action if suspected harm has occurred to someone.
The policy also includes the requirement of a clear understanding by all staff, and between staff and volunteers, of our ZERO TOLERANCE of abuse, and that there are consequences/penalties, including possible conviction of a misdemeanor resulting in time in county jail and/or a fine from $1,000 to $5,000 when a mandated reporter fails to promptly act and/or report suspected or alleged mistreatment, abuse or neglect.
By signing this form, you acknowledge that you have read SPP #201- Alleged Abuse, Neglect and/or Exploitation, and have assumed the responsibility of being fully informed about Peppermint Ridge’s Zero Tolerance Policy regarding Client Abuse, Neglect and Exploitation.
STATEMENT OF CONFIDENTIALITY OF CLIENTS
I have been properly informed that I must respect the rights of all Residents at Peppermint Ridge. I have also been informed of the manner and importance of confidentiality in my contact with these Residents.
I understand that in my position, I may have or be given, information of a confidential nature. I agree that I will not divulge this information to anyone and I understand that I must not discuss such information outside Peppermint Ridge.
I acknowledge and agree that if I do not fully comply with this rule during my volunteer activity that I may be subject to appropriate actions.
Today's Date: December 6, 2022
COVID 19 AWARENESS
As a Ridge volunteer, I agree to abide by the Center for Disease Control (CDC)'s recommendations for the prevention of the spread of COVID-19 and attest to having read the CDC's guidance at : https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I agree to abide by any COVID-19 distancing and other safety guidelines issued by the state.