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Public Health Nursing


Public Health Nursing

Los Angeles County Public Health Nursing Practice Public Health Nursing Resources Student Nurse Orientation Public Health Nursing Job Opportunities and Benefits Medication Calculation Exam Study Guide University Affiliates Links Public Health Nursing Intranet Site    (DPH Employee's Only)

Contact Information
County of Los Angeles
Department of Public Health
Nursing Administration
241 N. Figueroa Street, Room 347
Phone: (213) 240-8089
Toll Free Phone Number: 1 (866) 307-6877
Fax: (213) 250-0612
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University Affiliates Instructor Forms and Policies

University Affiliation Manual 2009 (Revised 5/2009)

The following instructions and forms will be utilized in processing University Affiliate students and instructors for their clinical rotation with Los Angeles County Department of Public Health (LAC DPH).  All of the forms are new and/or revised. Please discard all previous versions of the forms.  The forms will be updated and revised according to changes in the LAC DPH policies and procedures.  Download forms when needed for each quarter or semester. 

Important Timelines

Student Orientation Schedule 2020

Instructor Information

Thank you for your interest in Los Angeles County Department of Public Health (LAC DPH). We look forward to precepting/mentoring your students. Prior to your students beginning their clinical rotation with LAC DPH, each student must be live scanned and cleared; there are no exceptions. To ensure the process is conducted efficiently and each student is processed in a timely manner, the following steps must be completed.

A. The clinical coordinator/student coordinator completes and submits the following forms to LAC DPH Nursing Administration no later than eight weeks prior to first day of clinical rotation via email 

WOC Request Form Instructor and Student List This form needs to be submitted with the WOC request forms

Without Compensation (WOC) Request Form and Instructions This form is to be completed by instructor or coordinator for each new student and new instructor

LAC-DPH Nursing Administration will notify University's clinical coordinator/student coordinator/person completing the WOC form of student's eligibility to make live scan appointment.

LAC DPH Nursing Administration will notify University's clinical coordinator/student coordinator of all live scan results. Students who have not cleared will not be allowed to rotate through LAC DPH, and the University will have to place the student with a non-LAC DPH facility.

B. Requirements for Practice in Clinical Facilities Form and Instructions: Faculty and students are required to provide all necessary documentation related to the "Requirement for Practice in Clinical Facilities" form. This includes up-to-date vaccinations, current BCLS, current car insurance, valid driver's license/ID, as well as other requirements. This completed form is due to LAC DPH Nursing Administration by the second week of clinical rotation.

C. Clinical Rotation Selection Schedule Form: In order to ensure that each affiliate university receives the best possible experience, the clinical coordinator must complete and submit the B.S.N. Affiliation Clinical Rotation Selection Schedule. Please download the B.S.N. Affiliation Clinical Rotation Selection Schedule and submit the completed form via e-mail to This form must be submitted by May 15, 2019.

D. Evaluations: Annual Year End Evaluation Forms are due to Nursing Administration no later than July 15, of every year. Please disregard previous forms located in the University Affiliates Manual.



University Affiliates New Instructors and Student Forms and Policies

The Live Scan process must be completed by all instructors and students (a minimum of 6 - 7 weeks) prior to the start of clinical rotations.  Students and Instructors must wear LAC ID badges at all times during clinical. Badges will be issued by Nursing Administration at the Public Health Nursing Orientation or the first day of clinical rotation. Lost or stolen badges are $25. Student must notify DPH Human Resources immediately and bring a copy of the police report. Prior to obtaining a badge, students and faculty will pass live scan.

Student Information

A. Live Scan Instructions  

B. Live Scan forms: All forms must be completed and submitted to Human Resources on the day of Live Scan Appointment.

    1. Request for Live Scan Service

     2. Employee Information Sheet

     3. Candidate Conviction History Questionnaire

     4. Background Investigation Policy

     5. Conviction Disclosure Instructions

     6. Work Status Questionnaire

     7. Acknowledgement of Employee Responsibilities

     8. Volunteer Assignment Agreement

     9. Employee Acknowledgment and Receipt of County Policy of Equity

   10. Agreement of Understanding - Non County Workers (policies)

                Elder/Dependent Adult Abuse

                Hand Hygiene in Healthcare Settings

                Confidentiality of Non-Patient Public Health Records

                Safeguards for Protected Health Information

                Possession of a License or Certificate

               Identification badges


                Designation of Sensitive Positions and Requirements for Criminal History Information


                Political Activity

                Threat Management "Zero Tolerance " Policy

                Diversity Policy

               County Policy of Equity

               Public Health Information Technology and Security Policy

                Acceptable Use Policy for County Information Technology Resources

                Exclusion on Individual/Entities from Federal Health Care Programs

                Acceptance of Gifts Prohibitions

                Notice of Child Abuse, Elder/Dependent Adult Abuse, Domestic/Intimate Partner Violence Reporting

     C. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and HIPAA Compliance Electronic Security Module


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Presentations Designed for Nursing Student Orientation
The following handouts are presentations developed by the various Programs in Public Health.  They were  designed to be used in conjunction with a one-day orientation provided to all Public Health university affiliated nursing students.

Orientation to Public Health Nursing     

Acute Communicable Disease Control Program       Presentation HANDOUTS     

Childhood Lead Poisoning Prevention Program        Presentation HANDOUTS     

Children's Medical Services     

Division of HIV & STD Program- DHSP (HIV)     

Division of HIV & STD Program- DHSP (STD)     

Emergency Preparedness Public Health Nursing Program      Presentation HANDOUTS     

Environmental Health     

Immunization Program     

Nurse Family Partnership     

Public Health Investigation     

Public Health Nursing Recruitment & Retention       Presentation HANDOUTS     

Tuberculosis Control Program       Presentation HANDOUTS         

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