Head Start WV Childcare Licensing Physical Examination Acknowledgement


 

ATTENTION : NEW EMPLOYEES

 

The Head Start Performance Standards and WV Childcare Licensing requires that anyone working with children be healthy and physically fit to perform their job functions.

 

North Central WV Community Action Head Start employees must obtain a pre-employment physical examination upon hiring and follow-up exam every other year on or near the anniversary date of initial examination.

 

I,  ,  understand that my continued employment is contingent upon a physical examination that meets the functional responsibilities of the job.

 

 

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Document name: Head Start WV Childcare Licensing Physical Examination Acknowledgement
lock iconUnique Document ID: 66012c6b7f1679a14e3c463575a616f5c69dcda7
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June 5, 2019 10:53 am EDTHead Start WV Childcare Licensing Physical Examination Acknowledgement Uploaded by Rob Everly - itadmin@ncwvcaa.org IP 73.236.131.99