Jenkins Academy of Applied Technology · RK-001 · v1.0.0
Employer workplace connection
Course developed by Todd Jerome Jenkins, MS, CSP.
Use fictional facts for classroom practice. Actual medical, personnel and complaint records belong in authorized secure systems. This worksheet does not submit anything to the employer or an agency. Entries remain in this browser page only; print a completed copy before closing. Blank forms and course scores do not verify workplace implementation.
| Component | Separate employer evidence |
|---|---|
| Scope and contacts | Verify jurisdiction, establishment structure, company employment, industry, agency directions and primary/alternate responsible contacts. |
| Severe-event readiness | Verify actual agency channels and state-specific triggers, deadline calculations and confirmation arrangements. |
| Case and form practice | Review fictional case decisions, first-aid distinctions, day counts, privacy handling and completed mock 300/301 entries with a knowledgeable reviewer. |
| Annual cycle and access | Verify executive certification, posting, ITA decision, retention, secure retrieval and requester-specific access periods. |
| Reporting and improvement | Explain usable reporting routes, nonretaliation protections and how findings lead to verified improvements. |
Explain and demonstrate understanding
Use the actual employer procedures, knowledgeable reviewer and understandable language. Have the learner explain the reporting route and relevant decisions using fictional facts; correct gaps before relying on the arrangement. Record the actual instructor, learner, date, topics, evidence, corrections and limits in the employer’s secure system.