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Listed below are model policies on various topics provided by the JPIA for its members. Feel
free to incorporate their use at your district, make changes to coincide with your district's
policy, or use them for discussion items amongst your management team.
These documents are intended to help members consider various issues associated with workplace
practices. The JPIA is not engaged in rendering legal advice or professional legal services.
Anyone who creates company policy with (or without) the use of this document should consult a
qualified attorney before relying on it. The law is rapidly changing and may vary from
jurisdiction to jurisdiction.
Anti-Fraud Policy - (June 2008)
Cellular Phone Policy - (July 2008)
Discrimination/Sexual Harassment Policy & Complaint Procedures - (August 2008)
Drug & Alcohol Policy - (May 2, 2011)
Electronic Communication - (August 2009)
Firearms, Suggested Guidelines for Use - (July 2000)
Fitness For Duty & Return To Work Evaluations - (August 2008)
Guard Dog Policy - (February 2007)
Heat Illness Prevention Program - (May 2011)
Identity Theft Prevention Policy - Provided by Merced Irrigation District - (November 2008)
Injury/Illness Prevention Program General Statement of Safety Policy - (July 2003)
Interactive Policy - (March 2011)
Internet E-Mail Policy - (November 2003)
Off Duty Conduct - (August 2009)
Powers of Arrest & Issuance of Citations, Suggested Guidelines for Use - (February 2000)
Records Retention Policy - (June 2005)
Recreation/Special Events Policy - (February 2000)
Request for Reasonable Accommodation Policy - (August 2008)
Return to Work Program - (Revised 7/23/10)
FLMA-CFRA Checklist - (Revised 7/23/10)
Authorization for Release of Medical Information - (Revised 7/23/10)
Employee's Acknowledgement of Return to Work Program - (Revised 7/23/10)
FLMA-CFRA Approval Letter - (Revised 7/23/10)
FLMA-CFRA Application Form - (Revised 7/23/10)
FLMA-CFRA Conditional Leave Form - (Revised 7/23/10)
FLMA-CFRA During Workers' Compensation Leave Form - (Revised 7/23/10)
FLMA-CFRA Medical Certification - (Revised 7/23/10)
Letter to Medical Provider Regarding Return to Work Program - (Revised 7/23/10)
Physician's Report-Employee Work Status - (Revised 7/23/10)
Transitional Duty Assignment - (Revised 7/23/10)
Social Media Policy - (August 2009)
Trespassers on District Property Guideline - (February 2000)
Vehicle Backing Policy - (February 2007)
Workplace Violence Policy - (March 2009)
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