Fill - Free fillable Clinical Compliance Manual (Wilmington University) PDF form

Clinical Compliance

I.Criminal Background Check

II.Child Protection Registry

III.PPD/TB Test Results

IV.Health Certification Form

V.Praxis II

W I L M U . D U

W I L M I N G T O N U N I V E R S I T Y

C O L L E G E O F E D U C A T I O N

REV: 9/5/17 DLW

COLLEGE OF EDUCATION

WILMINGTON UNIVERSITY

Student Teaching / Internship: Application &

Registration

Clinical Experience or Student Teaching – A teacher candidate is

afforded the opportunity to complete Capstone Clinical Residency in

the K-12 classroom aligned to their program of study.

Student Internship Application – A required TaskStream application

to be completed by the teacher candidate by the deadline posted per

each semester. Students must complete the application, Praxis, and

all clearances by the deadline or we cannot guarantee placement.

Placements are assigned by the Office of Clinical Studies upon

approval of individual school districts.

Student Internship: CBC, CPR, PPD/TB, and HF

Requirements

CBC – State and Federal Criminal Background Check (DE SBI)

CPR – Child Protection Registry Form (DSCYF)

PPD/TB – Tuberculosis Screening

HF – Health Certification Form with signed voided script, letterhead,

or stamp

*NOTE: All districts require all teacher candidates to have NEW

CBC, CPR, PPD/TB, and HF (regardless of prior submission of CBC,

CPR, and PPD/TB for Practica). The following forms (CPR, PPD/TB

and HF) can be downloaded from the TaskStream Application. For

Spring, clearances

MUST be valid from January 1

until June 11

, and

for Fall, clearances

MUST be valid from August 20

until December

Passing scores and sub-scores of Praxis II of respective content area

Out of State: Need both DE and the state in question.

CBC Requirement for Student Internship

Application Submission Deadline:

Spring – Student Internship Application deadline – August 1

Fall – Student Internship Application deadline – February 1

Summer –

NO PLACEMENTS DURING SUMMER SEMESTER

Registration:

Teacher Candidates in undergraduate programs must register for both

EDU 452 and the respective “Student Teaching” course:

• Birth -2 = ECE 450 and EDU 452

• K-6 and Middle Level (6-8) = EDU 451 and EDU 452

Teacher Candidates in graduate programs must register for these

courses:

• M. Ed. in Elementary Education: MEE 8801

• M. Ed. in Special Education: MSE 8802

• M.A. in Secondary Education: MAS 8801

Practicum: Application & Registration

ield Experience / Placement – A placement in a K-12 classroom

aligned to their program of study is awarded by the district to a

teacher candidate for Practica I, II and III.

Field Placement Application – A required TaskStream application

to be completed by the teacher candidate by the deadline posted

per each semester. Students must complete the application,

Praxis, and all clearances by the deadline or we cannot guarantee

placement. Placements are assigned by the Office of Clinical

Studies upon approval of individual school districts.

Practicum: CBC, CPR and PPD/TB Requirements

CBC – State and Federal Criminal Background Check (DE SBI)

CPR – Child Protection Registry Form (DSCYF)

PPD/TB – Tuberculosis Screening

*NOTE: Clearance items are good for all three Practica classes.

Candidates do NOT need to renew any items until Student

Teaching.

ut of State CBC: Need both DE and the state in question.

State of DE: State Bureau of Identification

Application Submission Deadline:

Spring – Field Placement Application deadline – August 1

Fall – Field Placement Application deadline – February 1

Summer –

NO PLACEMENTS DURING SUMMER SEMESTER

Registration:

Teacher candidates must register by the timeline as scheduled by

the University. Students will view Course Scheduler to determine

Practica course options / sections: Course Schedule

eacher candidates must be aware of Course Location versus

Placement Location. Teacher candidates will be awarded a field

placement in the county in which the course is being held:

• Course Section in New Castle or WGC site = placement in

New Castle County and/or PA, NJ and northern MD

• Course Section in Dover site = placement in Kent County

• Course Section in Georgetown site = placement in Sussex

County and /or lower MD

Office of Clinical Studies Contact Information:

Tyler Wells – Chair Dr. Sylvia Brooks – Asst. Chair Dr. Thelma Hinds – Asst. Chair Mrs. Theresa Carter – Placement Cord.

302-342-8604 302-356-6978 302-356-6983 302-356-6794

tyler.a.wells@wilmu.edu sylvia.j.brooks@wilmu.edu

helma.m.hinds@wilmu.edu theresa.d.carter@wilmu.edu

. Keira Potter – Admin. Assist. Ms. Debra Wylie – Placement Cord.

302-342-8608 302-342-8625

eira.m.potter@wilmu.edu

ebra.l.wylie@wilmu.edu

Yearlong Residency:

The Yearlong Residency option provides candidates the opportunity to experience all facets of the entire school year while collaborating

with peers and a team of high quality mentor teachers, in pursuit of building skills and knowledge in the teaching profession. Candidates

are provided the unique opportunity to explore the school year, from starting the first teacher day to ending the school year. This

residency allows interns the opportunity to serve as a co-teacher in a classroom setting, mastering the teaching standards and expanding

their techniques and strategies with the guidance of a high quality Delaware teacher. If interested, please contact Mr. Tyler Wells at

tyler.a.wells@wilmu.edu.

CLINICAL COMPLIANCE STEPS

REV: 11/09/2018 DLW

Step Required For

Documentation Instructions / Descriptions

Step 1

Prior to

Practicum I &

prior to Student

Teaching

Criminal

Background

Check (CBC)

A valid Delaware Criminal Background Check in a

sealed envelope with the original label (to be opened by

WilmU only) and sent to the Office of Clinical Studies

MUST be submitted. Please do one of the following:

1. Hand deliver your results to Dover,

Georgetown or the main New Castle campus

(Attn. Tyler Wells) OR

2. Mail your results to the Office of Clinical Studies

(with an official tracking method) to the Dover

Site (Attn. Tyler Wells).

Guidelines on this process can be found here.

Step 2

Prior to

Practicum I &

prior to Student

Teaching

Child Protective

Registry (CPR)

School districts require this clearance for any person

working or observing in its schools.

The Child Protection Registry will check your name

against its records searching for any substantiated cases

of child abuse or neglect.

All information provided in the form is confidential.

There is no cost associated with this registry check.

wnload the CPR form. The CPR form must be

completed and submitted to the Office of Clinical

Studies to forward to DSCYF: no electronic signatures

are accepted. Results are then sent to the Office of

Clinical Studies.

mplete the CPR form; save it to your computer under

the name CPR"your last name" "your first name" (for

example CPRwellstyler); submit the completed

form to the Clinical Compliance Module. Be sure

to sign the form prior to uploading (no electronic

signatures will be accepted).

Step 3

Prior to

Practicum I &

prior to Student

Teaching

PPD/TB Test

Results

Download the PPD/TB form. Have your physician

complete the form. Scan and upload the results as part

of the clearance process.

mplete the PPD/TB form; save it to your computer

under the name PPD.TB "your last name" "your first

name" (for example PPD.TBwellstyler); submit a

scanned image of your PPD/TB Test. Attach the

document to the application prior to

submitting the application.

CLINICAL COMPLIANCE STEPS

REV: 11/09/2018 DLW

Step 4

Prior to Student

Teaching Only

Health

Certification Form

AND Physician’s

Script, Letterhead,

or stamp (HF)

Download the Health Certification Form and have

your physician complete the form. Attach a signed

voided doctor’s script, letterhead, or stamp.

mplete the Heath Form; scan it to your computer

under the name HF "your last name" "your first

name" (for example HFwellstyler). Upload the

completed and signed Health Certification Form with

a signed voided doctor’s script, letterhead, or stamp

to the application prior to submitting. Attach the

document to the application prior to

submitting the application.

Step 5

Praxis II

prior to

Student

Teaching

Only

Praxis II Score

Results

(including Sub

Scores)

Praxis II passing scores must be submitted prior to

Student Teaching. Tests required for specific

Licensure areas can be found at the following sites

per ETS.org:

•

Delaware

•

Maryland

•

New Jersey

•

Pennsylvania

If Wilmington University was not identified as a score

recipient through ETS, a score report including the

detailed sub score page MUST be submitted to the

application.

REV: 11/09/2018 DLW

I. Criminal Background Check

Where to Complete the Criminal Background Check

Any student may travel to the Dover State Police Headquarters where no appointment is

necessary.

Kent County

Criminal background checks are administered at:

Blue Hen Corporate Center and Mall

Suite 1B

655 Bay Road (US 113)

Dover, DE

302-739-5884

WALK IN AVAILABILE

HOURS OF OPERATION:

Monday, 8:30 a.m. – 6:30 p.m.

Tuesday through Friday, 8:30 a.m. – 3:30 p.m.

New Castle County

Criminal background checks are administered at:

State Police Headquarters Troop II

100 Lagrange Ave.

Newark, De 19702

302-739-2528

BY APPOINTMENT ONLY

HOURS OF OPERATION:

Mon., Wed., Thurs., Fri. 8:30 a.m. – 3:15 p.m.

Tues. 11:30 a.m. to 6:15 p.m.

Sussex County

Criminal background checks are administered at:

State Police Headquarters Troop IV

Thurman Adams State Service Center

546 S. Bedford Street (Room 202)

Georgetown, DE 19947

302-739-2528

BY APPOINTMENT ONLY

HOURS OF OPERATION:

Monday – Thursday 8:30 a.m. – 3:30 p.m.

REV: 11/09/2018 DLW

General Instructions for the Criminal Background Check

• The student must indicate, when requesting the CBC, that he/she is a student teacher

candidate and request that the copy be sent to the student. The sealed envelope with the

WILMU label, when received, must be delivered to the appropriate Clinical Studies Office

in the College of Education. Note: a reduced fee is charged for student teachers for the

CBC.

• The University will send a confirmation to the teacher candidate verifying the receipt of

the CBC and the CPR within five (5) business days of receipt of both reports.

• The CBC and the CPR will be reviewed by the Office of Clinical Studies for a

determination of whether or not the candidate is deemed suitable for student teaching

placement, and notification of such determination will be mailed within seven (7)

business days of the date the University notifies the student of receipt of the reports. The

Clinical Placement Coordinator may consult with the Dean of Education or the Dean’s

designee, if needed, for guidance, typically on an anonymous basis.

• If the determination is that the teacher candidate is NOT suitable, the teacher candidate

will receive a copy of the University’s Suitability Appeal Process.

• Please note: placement is contingent on a suitability determination both by the

University AND the district or charter school in which the University is attempting to

place the teacher candidate, in addition to meeting all other eligibility requirements. If

deemed suitable by the University, the school district/charter school in which the

University is attempting to place a student will receive a copy of the reports and a

statement that the teacher candidate was determined suitable according to the

Wilmington University Guidelines. The district/charter school will then review the

reports to determine in its sole discretion if it will place the teacher candidate in a

student teaching position. Such decision is final; the teacher candidate is not afforded an

appeal process by the school district or charter school.

REV: 11/09/2018 DLW

II. Child Protection Registry

The Clinical Compliance Tool:

How do I submit my CPR form?

REV: 11/09/2018 DLW

Uploading Documents:

Access the Clinical Compliance

tool by logging into

TaskStream and clicking the

“Clinical Compliance” link in

the Additional Links sections

The system will present you with a list of all of

the requirements that must be submitted, and

the status of each. They will all say “Not

Submitted” initially, until you begin uploading

documents.

To upload a document, click the

“Upload” button.

Click the “Add File” button and

browse to the file you wish to

upload. Alternatively, you may drag

the file onto the window.

Limitations:

Files must have one of the

following extensions:

.pdf, .bmp, .gif, .jpg, .jpeg,

.png, .tif, .tiff

Files must be 10 MB or less

You may only select one

file at a time

The Clinical Compliance Tool:

How do I submit my CPR form?

REV: 11/09/2018 DLW

Checking Status:

Rejected evidence:

Check the requirements that the

document being uploaded

applies to, and click “Upload

and Submit” (CPR Only).

After you have begun to

upload documents and we

have begun to evaluate

those documents, you will

notice the status begin to

change for your

requirements.

You may also notice a red box

at the top of your screen. This

will appear when you have

submitted a requirement that

was rejected by the evaluator.

When this happens, there will

be some comments from the

evaluator explaining why the

evidence was rejected.

To remedy this, simply upload a new document. Once the requirement is Pending Evaluation it will no longer appear

in this box.

The Clinical Compliance Tool:

How do I submit my CPR form?

REV: 11/09/2018 DLW

Automated Email Notifications for Teacher Candidates:

Teacher candidates will receive automated email notifications under the following circumstances:

• When an evaluation is completed with comments for the student

• When evidence will be expiring soon

When new evaluations are completed, an email notification (with comments as necessary) will be sent

to the teacher candidate. When a completed evaluation is edited, an email notification will only be

sent to the student with updated comments.

Upon approaching a clearance’s expiration date, an email notification will be sent out 90 days prior to

a clearance’s expiration date and between 1-60 days (ie 1, 7, 15, 30, and 60) prior to expiration.

U:\DFS\CHU\FORMS & BROCHURES\CPR FORMS\CPR CSV blank-rev. 8-31-17.doc

DELAWARE CHILD PROTECTION REGISTRY REQUEST FORM

When requesting Child Protection Registry checks:

 Allow 15 working days for results to be processed

 Form must be submitted to DSCYF within 90 days of signature date in order to be processed

PART I. APPLICANT INFORMATION (PLEASE PRINT CLEARLY)

Name:__ _____________________________________________________________________________________

Last First Middle

Other Name(s) used: ______________________________________________ DE Driver’s License #________________

Social Security # ___ ___ ___ ___ ___ ___ ___ ___ ___ Date of Birth: _____________ Gender:____ Race:_________

yyyymmdd

Address:__________________________________________________________________________________________

(Street) (City) (State) (Zip)

Are you on the Delaware child protection registry for any substantiated cases of child abuse/neglect? [ ] Yes [ ] No

If yes, explain: _____________________________________________________________________________________

__________________________________________________________________________________________________

I hereby authorize The Delaware Department of Services for Children, Youth and Their Families to provide the below named

agency/organization with all substantiated cases of child abuse or neglect concerning me contained in the Delaware child protection

registry. I further release the Delaware Department of Services for Children, Youth and Their Families, its officers and employees

from any and all claims arising out of or in any way connected to the release or dissemination of any information concerning me.

Signature:________________________________________________________ Date:___________________________

Parent / Guardian Signature (If applicant is under the age of 18) ______________________________________________

PART II. AGENCY INFORMATION - (MUST BE COMPLETED IN ORDER TO PROCESS)

Agency Identification Number (if applicable): ___1262_

Contact ID: __2725_

Requesting Agency Name: ___Wilmington University – Dover – Clinical Studies

Address: 3282 North DuPont Highway, Bldg. 1, Dover, DE 19901

Phone: _(302)342-8608 Fax: _(302)734-1331 Contact Person: _Keira Potter

Contact Email: _keira.m.potter@wilmu.edu

DSCYF USE ONLY:

The individual listed above (__ is listed) ( ___ is NOT listed) on the Delaware Child Protection Registry.

Date: ____________ DSCYF Criminal History Unit ________________________________________________________________

REV: 11/09/2018 DLW

III. PPD/TB Test Results

Wilmington University

College of Education

TO: Applicants for Fieldwork and Student Teaching

FROM: Tyler Wells, Chair

Office of Clinical Studies

RE: PPD (Mantoux) Tuberculin Test

State health regulations require that all applicants for school-based fieldwork provide

written proof of a current, negative PPD (Mantoux) Tuberculin Test. Please note that a

Tine or Monovac Test may not be substituted for the PPD Test. The test can be

performed by your personal physician or at any health clinic.

Verification of this test should be presented to the nurse at your placement school. The

results must be reported as positive or negative, recorded in millimeters (mm), and

certified by a health care provider.

Applicants must be able to provide proof of a negative tuberculin test that was

administered within 12 months by the beginning of the semester for the enrolled

Practicum course.

Applicants should retain a copy of test results for future use.

PPD (MANTOUX) TUBERCULIN SKIN TEST

(Tine or Monovac is not acceptable)

RINT Name:

ast First M.I.

tudent ID:

PPD (Mantoux) Test Result: Negative Positive Induration (mm.):

Date administered: Date read:

Signature of Health Care Provider:

Date

REV: 11/09/2018 DLW

IV. Health Certification

Form

Wilmington University

College of Education

TO BE COMPLETED BY A PHYSICIAN OR HEALTH CARE PROVIDER

Dear Physician/Health Care Provider:

This candidate is applying to enroll in student teaching. This is the long-term, school-

based, supervised field experience that occurs at the end of a teacher preparation

program. A student teacher is required to assume an active role in the instruction of

children/youth over a period of several months. In addition to the technical and

intellectual abilities required, a student teacher must also possess the physical stamina

and emotional stability required of a classroom teacher.

Due to the length of the experience and the level of responsibility that must be assumed,

all student teachers must be screened before they are given final approval to begin

working in schools. The Health Certificate below is part of the screening process. Thank

you for your assistance.

**************************************************************************************************

EALTH CERTIFICATE FOR TEACHER PREPARATION STUDENTS

his is to certify that the applicant, _______________________________ , has been examined and

is known by me to be free from any physical or emotional condition that might interfere with his/her success

as a student teacher.

Restrictions: ________________________________________________________________

Date: _________________ Signed: _____________________________________________

MPORTANT PLEASE READ THE FOLLOWING:

For identification, the health care provider signing this certificate should also sign the top of his/her

prescription form or letterhead. Please return the signed certificate to the applicant, or mail directly to:

Mr. Tyler Wells, Chair

Office of Clinical Studies

Wilmington University

3282 N. DuPont Hwy. Bldg. B

Dover, DE 19901

elephone: (302) 343-8604

Fax: (302) 734-1331

E-mail:tyler.a.wells@wilmu.edu

HEALTH CERTIFICATE MUST BE SIGNED BY A HEALTH CARE PROVIDER

REV: 11/09/2018 DLW

V. Praxis II

REV: 11/09/2018 DLW

Praxis II passing scores must be submitted prior to Student Teaching. Tests

required for specific Licensure areas can be found at ETS.org

•

Delaware

•

Maryland

•

New Jersey

•

Pennsylvania

If Wilmington University was not identified as a score recipient through

ETS, a score report including the detailed sub score page MUST be

submitted to the application.

hould any questions arise, please contact the Office of Clinical Studies.

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