Date
MM
DD
YYYY
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Primary Phone
*
(###)
###
####
Secondary Phone
(###)
###
####
Email
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
(###)
###
####
Please list the states you have lived in, worked in, or attended school in during the past 5 years.
References
*
Please list two professional and one personal reference with phone number.
Do you have experience caring for children, other than your own (paid or unpaid)?
*
Your current employer and your job title
Does your employer offer
Name of School/Field of Study
Degrees held/certificates earned/special training
Hobbies/Interests/Special Skills
Interests
Volunteer Opportunities
Please check the Crisis Nursery locations at which you would like to volunteer
*
Required Service Hours
*
Do you need to complete required service hours?
On Call Volunteers
*
As a Crisis Nursery, it is important for us to have a list of volunteers to turn to on short notice. Would you be willing to be on this list of On-Call Volunteers?
What is the best way to reach you for on-call needs?
Statement of Understanding - Please read, then initial and date:
*
In providing volunteer service, I agree to demonstrate concern, and attention to each child in care without favoritism. I agree to commit myself to being an active volunteer, positively engaged with the children and my surroundings, and to follow through with my assigned duties to the best of my ability, within the scope of my volunteer role. I further understand and agree that this commitment includes prompt attendance with regard to my volunteer shifts. If I am unable to attend my volunteer shift, I understand that it is my responsibility to notify the Nursery and I agree to promptly contact the staff so they may seek a replacement. I will refrain from using my cell phone in the Nursery. I understand the Saint Louis Crisis Nurseries is an Equal Opportunity Employer, Drug and Smoke Free, and that concealed weapons are not permitted on the premises, and I will notify a supervisor immediately of any observed violation occurring within the Nursery I will demonstrate cooperation, use good judgment, and uphold the legal and social standards of the Crisis Nursery community, herein written in the volunteer agreements and as provided in orientation. I understand diversity is both embraced and encouraged at the Saint Louis Crisis Nursery and understand that the Crisis Nursery strongly believes in the value of diversity. I further understand that the Nursery is committed to providing an environment of fairness and equitable treatment of everyone, regardless of race, religion, color or creed. Finally, I understand the Crisis Nursery strives to include a diverse Board of Directors, Advisory Board, Young Professionals Board, Parent Advisory Board, and team of volunteers. I will maintain a positive, strengths-based approach in my interaction with the children. I understand it is not within my scope as a volunteer to discipline a child. I will ask the staff for guidance on any questions I may have pertaining to discipline.
Confidentiality - Please read, then initial and date:
*
Volunteers are expected to uphold a high standard of privacy and confidentiality for Crisis Nursery families. As such, volunteers do not have rights to client files or reasons for admission. In addition, volunteers may not disclose, divulge, or make accessible confidential information belonging to, or obtained through their affiliation with the Crisis Nursery to any other person or entity. All records, documents, photos, videos, and general identifying information pertaining to the children and families are considered confidential. Volunteers may not take photos or videos (including on cell phones) that include children or family members, and may not reveal the names or any other identifying information of children or family members using the nursery services. Failure to adhere to this agreement is a serious breach of ethics, as well as a potential civil and criminal offense. I understand I may not disclose, divulge or make accessible confidential information belonging to, or obtained through my affiliation with the Crisis Nursery. I am aware that I may not take photos (even on phones) and/or videos of a child or family using the Nursery. I further understand that under some circumstances staff may disclose identifying information to persons when an appropriate authorization is present, but that will not be my responsibility as a volunteer. I acknowledge my understanding that the principle of confidentiality applies outside of the Nursery, to information I may post on Social Networking Sites.
Volunteer Position Description
*
OUR MISSION: The SAINT LOUIS CRISIS NURSERY is committed to the prevention of child abuse & neglect
and provides trauma-informed emergency intervention, 24-hour respite care and support to families in crisis through:
• Short-term care for young children in a safe and nurturing environment
• Empowering families to resolve crises and build resiliency through culturally responsive interventions
• Equitable access to concrete support, crisis counseling, and parenting education
• Grassroots community outreach and training to build child abuse prevention awareness
• Advocacy for the safety and wellbeing of all children and families in our region
QUALIFICATIONS:
1. Successful completion of Saint Louis Crisis Nursery Volunteer Packet.
2. Must be at least 16 years of age to volunteer without a parent/guardian present, or 14 years of age to volunteer with a parent/guardian present.
3. Child care experience (does not include your own children).
SKILLS AND ABILITIES
1. An understanding of and respect for children, staff, and other volunteers.
2. Non-judgmental attitude towards children and parents.
3. Safely lift and carry children up to 35 lbs.
4. Access & maneuver independently in & out of a variety of rooms within the Nursery, such as bedrooms, bathrooms, and outdoor play areas.
5. Readily attain various positions (i.e. sit on floor, low stool) to work with children or complete household cleaning and laundry. Bend, stoop, squat to clean or retrieve items from the floor.
6. Taking initiative by engaging children in activities and helping with household tasks as needed.
7. Openness to suggestions regarding the Crisis Nursery’s strength-based techniques for working with children.
8. Flexibility in the changing environment of the Crisis Nursery and needs of our children.
KEY RESPONSIBILITIES:
1. Provide emotional support for children by facilitating play, holding, rocking, etc.
2. Engage children in developmentally appropriate activities, such as art projects, story time, creative play, etc.
3. Care for the physical needs of children, such as feeding, snack preparation, etc.
4. Perform household tasks (laundry, washing dishes, organizing, etc.) to promote a tidy & safe Nursery
5. Maintain confidentiality and a positive, strength-based attitude
6. Other duties as asked
NOTE: While our volunteers can participate in most of the activities that take place at the Nursery, there are a few tasks that will only be completed by our staff. These include changing diapers, assisting children with toileting/bathing/dressing, answering the door/phone, talking with parents, providing first aid/CPR and administering medication. Please allow our staff to take care of these tasks while you engage our children in the days’ activities.
REPORTS TO: Volunteer Program Staff; supervised by direct care staff for day to day tasks. If a conflict arises, please contact Volunteer Program Staff. Feedback about performance will come from direct care staff as well as Volunteer Program Staff. Needed evaluations will be completed by Volunteer Program Staff with input from direct care staff. Only hours recorded in the volunteer binder and initialed by staff will be verified. Reference letters include dates and hours of service and duties performed. In order to ensure an on-time completion, all requests for
evaluations, reference letters, and verification of hours need a week’s notice to the Volunteer Program Staff.
HOURS: The Saint Louis Crisis Nursery is open 24/7, and volunteers are welcomed 8am-8pm daily. Volunteers are asked to commit to a minimum of one 2-hour weekly shift for one year.
Hotline Policy
*
Please review the Child Abuse and Neglect Reporting Policy of The Saint Louis Crisis Nursery that is mandatory for all paid staff and sign below. -- (As a volunteer we ask that you review the policy to be aware of the impact on staff and children, and sign the volunteer expectation.)
*All employees of the Crisis Nursery are legally mandated reporters of suspected child abuse or neglect. As such, any employee observing evidence of an incidence of child abuse or neglect, whether before, during, or after a child’s admission to the Nursery, must report their observations to the Children’s Division Hotline and document his/her observations. Staff may consult with the on call/administrative on call/supervisory staff prior to making the hotline call but are not required to do so. Following the hotline call, staff will then report to the on call supervisor as well as the administrative on call staff that a hotline call has been placed, as well as discuss whether it is in the best interest of the child/family to notify the parent of the call. If more than one staff person observes evidence of abuse or neglect at the same time, the senior staff person will place the hotline call. If a child reports the same information to a second staff member at a later time, the incident does not need to be hotlined again. However, if additional information is obtained regarding a suspected incidence of abuse or neglect, an additional call will be made to the hotline to add to the original report. When notifying the parent, attempts will be made to explain the hotline process to the parent and to provide the parent the hotline number should they choose to contact the hotline with any additional information. The person reporting the incident will be protected by confidentiality insofar as possible. By state law, any employee who fails to report a suspected case of child abuse or neglect is subject to prosecution.
Volunteer Expectation:
I understand that as a volunteer of the Nursery I am not considered a mandated reporter, but if I have a suspicion, I need to talk it over with a staff person or Volunteer Program Staff so that they can take action as mandated reporters.
Volunteer Pact
*
As a Volunteer, I have the RIGHT to:
▪ Receive a suitable assignment as well as the opportunity to choose a task from a given list.
▪ Receive pertinent information about the Nursery and environment within the bounds of confidentiality.
▪ Receive continuing education on-the-job as well as updates on new policies/procedures in a timely fashion.
▪ Receive sound guidance and direction by someone who is knowledgeable, patient, & well informed.
▪ Be listened to and treated respectfully.
▪ Receive recognition for my service according to the Crisis Nursery volunteer recognition practices.
As a Volunteer, I have the RESPONSIBILITY to:
▪ Abide by and respect Nursery Rules.
▪ Adhere to the Confidentiality Agreement.
▪ Practice Universal Precautions at all times.
▪ Refrain from taking pictures or videos of the children.
▪ Never release names or identifying information.
▪ Refrain from asking the staff, children, or parents personal questions.
▪ Refrain from using my cell phone in the Nursery.
▪ Be an active volunteer, showing up for my volunteer shift as agreed and providing prompt notice if/when I am unable to present as expected for volunteer shift.
▪ Demonstrate concern, and attention to each child without favoritism.
▪ Arrange a volunteer schedule and shift that is reasonable and during a time when I am at my best.
▪ Be appropriately dressed for the weather and for working with children including wearing closed toe shoes, appropriate fitting shorts, i.e., walking shorts, and modest dress.
▪ Be positive and cooperative, taking directions willingly.
▪ Carry out assigned duties to the best of my ability.
▪ Ask questions if I am unsure of how a task is to be done.
▪ Consider important any task performed.
▪ Understand while I may not receive constant praise, my volunteer time is deeply appreciated.
▪ Engage in a positive manner, and practice strengths-based interaction with children.
▪ Track my volunteer hours for my records.
