sylvia calderon

Upbeat, organized, and creative individual with knack for planning and coordinating engaging activities. Possesses solid understanding of program development and event management, coupled with strong skills in communication and time management. Committed to fostering vibrant and inclusive environment that enriches participants' lives.

• Dear Health Care Provider
• Below is a list of essential job functions that the student MUST be able to execute in order to perform successfully in the role of a Nursing Assistant or Home Health Aide. Please sign and complete ALL 3 (three) pages.
• Must be able to work at various clinical sites, including skilled nursing homes, patient homes, and hospitals, at least 5 - 10 hours a day 5 days a week.
• Must be able to take theory classes lasting as long as 8 hours a day.
• Must be medically cleared to complete all physical demands required of a Nursing Assistant/Home Health Aide in a healthcare/residential setting.
• Must be able to use all senses, i.e., seeing, hearing, feeling, smelling in a manner that allows the student to accurately perform their duties as a nursing assistant/home health aide.
• Must be able to use fine motor skills of the hands to carry out clinical procedures accurately and safely.
• Must be able to operate carried medical equipment.
• Must be able to perform such duties as, but not limited to:
• Transfer patients of various sizes and weights into/onto and out of bed, chairs, stretchers, wheelchairs, and other surfaces.
• Lifting, pushing, or pulling at least 20-50 pounds.
• Maneuvering, pulling pushing, lighting, and turning patients in awkward positions.
• Performing related tasks which require the use of hands, arms, shoulders, legs, and feet.
• Participating in work related activities that require extensive bending, kneeling, crouching, stooping, standing, and critical movements.
• Must be able to recognize potential risks in health care settings which require the wearing of safety equipment such as masks, gowns, glasses, googles, latex or non-latex gloves, shoe coverings, etc.
• Must be able to meet the clinical site and college performance standards.
• Must be able to travel to and from academic and clinical training sites.
• Must be able to understand and work from written and verbal orders.
• Must possess problem solving skills.
• Must possess effective verbal and written communication skills in English sufficient to safely work in academic and clinical settings.
• Must possess technical competency.
• Must be in a functional state of mental health.
• Must not have any disability that would interfere with cognitive, physical or sensate ability to function safely in patient care (nursing) situations.
• Must possess the ability to adapt quickly to changes renascent of the health care environment.
• By signing below you acknowledge that to the best of your knowledge, there are no reasons you are aware of that would prohibit a student from accomplishing any of the following functions within normal expectations.
• The student does not have a health condition that would create a hazard to him/herself, fellow classmates, instructors, clinical facility staff, or patients/residents. Attach comments if any.
• M.D., N.P., C.N.M., or P.A. Signature: ___________________________ Date:________________
• Printed Name and Stamp: ___________________________
• Office/Clinic Stamp
• Page 1 of 3
• Each Nursing Assistant/ Home Health Aide Student must have a licensed M.D., N.P., C.N.M., or P.A. complete the form below and document that you are able to fulfill the ESSENTIAL JOB FUNCTIONS of a Nursing Assistant/Home Health Aide listed on PAGE 1.
• Provider: Please note that ALL sections must be completed and all checkboxes checked either yes or no. DO NOT leave anything blank. This is meant as a snapshot of a student's overall health and their ability to function properly in a clinical setting.
• Student Name: ___________________________ Date of Birth: _______________ Gender: Male Female
• Height: _______ Weight: _______ Vital Signs: B/P: _______/_______ Pulse: _______ Respirations: _______
• Temperature: _______ Vision OS: _______ OD: _______ OU: _______ Hearing R: _______ L: _______
• Physical Assessment
• Function WNL (please provide additional documentation if not WNL)
• System Yes No Comment
• General
• HEENT
• CV
• Pulmonary
• GI
• GU
• Neurological
• Integument
• Musculoskeletal
• Immune System
• Endocrine
• Mental Health
• By signing below you acknowledge that to the best of your knowledge, there are no reasons you are aware of that would prohibit a student from accomplishing any of the following functions within normal expectations. The student does not have a health condition that would create a hazard to him/herself, fellow classmates, instructors, clinical facility staff, or patients/residents. Attach comments if any.
• Page 2 of 3
• Ability to Perform (please provide additional documentation if needed)
• Function Yes No Comment
• Able to work standing, sitting, bending, lifting
• Able to use all physical senses
• Able to perform fine motor skills
• Able to communicate physical and mental activities to perform tasks or skills safely
• Able to communicate effectively in English
• Possess sound mental health
• Does not have any disability that would interfere with cognitive, physical, or sensate ability to function safely in patient care situations
• Tuberculosis (TB) Screening must be performed by a licensed health care provider whose legally authorized scope of practice allows them to conduct medical examinations and or tuberculin skin test in accordance with the recommendations of the Centers for Disease Control and Prevention to determine if a person has latent TB infection or TB disease.
• TB Skin Test Date Received
• TST Date Lot # Expiration Date Injection Site
• TB Skin Test Result Date Read
• Induration mm Result
• If TST result is positive, chest x-ray or IGRA (QuantiFERON) Blood Test is needed.
• Please provide a copy of these records once results are interpreted.
• Page 3 of 3

I am a social person, Kind hearted, loving ,good listener hard working, When i start a project i finish it. I treat everyone like i like to be treated. I am a positive person.

I also speak Spanish.