Kimberly Mitchell

My biggest achievement was to become the best teacher I could be. And over these 15 years of being a Early Childhood Teacher, I’ve been loving, caring , and nuturing. I have always been able to work with anybody, and the way I have been able to do that was to treat people with LOVE & RESPECT!!

• Community Development Institute Head Start
• Serving CASE AL
• Failure to complete this document may affect your paycheck, information you receive regarding leave, tax data or more.
• Employee (EE): McGhee, Kimberly
• File Number: 90
• Site Location: Autaugaville
• EE Timesheet Approved By: Dor is Tdbert
• Change Reason Weeks per year changed
• Effective Date: 2020-04-27
• When possible, make Employment Compensation Changes' effective at the beginning of a pay period.
• CHANGE PERSONAL INFORMATION: (completed & approved by employee)
• Name Change
• New Address:
• New Telephone:
• Change of Bank or Direct Deposit Info (Attach Completed Forms):
• Change W-4 or State Withholding Form (Attach Completed Forms):
• IMPORTANT
• Benefit changes must be reported on the appropriate benefit documents (deduction form and/or enrollment application) and not on a Payroll Change Notification form. Delays may occur if proper forms are not filled out. Please contact your program staff person responsible for human resources if you have any questions.
• Benefit changes are only accepted due to a qualifying event or during open enrollment.
• Employment compensation changes are considered qualifying events.
• EMPLOYMENT STATUS CHANGE: (completed by supervisor, approved by PD & SM)
• New Hire
• Rehire
• Resignation
• Involuntary Termination Ineligible for Employment
• Deceased
• End of CDI HS Administration
• Suspended Without Pay
• Start: ______ End: ______
• Suspended With Pay
• Leave of Absence (Please Select Leave Type)
• Leave Type
• Miscellaneous Administrative Leave (Health cases must be approved by Benefits in the Denver Office)
• Unpaid (Example: Non FMLA medical leave)
• Paid (Example: Suspension with pay)
• FMLA (must attach Request for Leave of Absence Form for FMLA)
• FMLA cases must be approved through Benefits in the Denver Office
• Continual
• Intermittent
• Workers Compensation (May run concurrent with FMLA)
• WC cases must be approved through Benefits in the Denver Office
• Furlough (One PCN submitted to begin and another PCN submitted to return)
• Please complete this entire section if any changes are being made in compen
• EMPLOYMENT COMPENSATION: (completed by supervisor, approved by PD & SM)
• Job Title: Teacher Infant Toddler
• Status
• Pay Rate $10.74
• (For exempt employees this would be the bi-weekly rate of pay. For non-exempt employees this would be the hourly rate of pay).
• Exempt
• Non-Exempt
• Allocation:
• %HS 100 %EHS
• %Other
• [Other ex: CACFP, state funding Abbott etc.]
• Hours of Employment
• Weeks Per Year: 46
• Hours Per Week: 40
• Daily schedule: 7:45-3:45 (i.e.: M-F, 8 to 5 or T-TH, 7 to 6)
• For Temporary Employees Only (Do not complete otherwise)
• Reason for temporary employment:
• Dates of temporary assignment
• From: ______ To: ______
• Temporary employees are not eligible for any type of employer sponsored benefits but may be subject to certain scheduled hours. Puerto Rican programs are unique in what benefits are available. Please refer to the Puerto Rico employee handbook for guidance.
• This form does not create a contract of employment. Employment is at-will (unless otherwise provided by state law or contract) which means either you or CDI or CDI HS may terminate the relationship at any time, for any reason, or no reason.
• Employee Signature (EE):
• Date:
• Program Director Signature (PD): Gail Surles
• Site Manager Signature (SM): Angela Dixon
• Date: 2020-05-07
• 2010 Community Development Institute. This document is not to be duplicated or given, in part or in whole, to any person, agency or entity not currently employed by CDI or CDI HS without the express written permission from the CDI Board of Directors.