mortuary science program 1819 n. main ave. nail technical ......forth by the alamo colleges, the...

1819 N. Main Avenue | San Antonio, TX 78212 | (210) 486-0000| alamo.edu/sac

Mortuary Science Program 1819 N. Main Ave.

Nail Technical Center, Room 238 San Antonio Texas 78212

www.alamo.edu/sac/mortuary 210- 486-1137


Table of Contents Manual Introduction………………………………………………………………….Section I MRTS 1330……………………………………………………………………………Section 2 Student Data Sheet Department Dress Code Acknowledgement of Required Dress Code Confidentiality Agreement for Students of the MRTS Department Sexual Harassment Internship Site Documentation Form MRTS 1330 Weekly Time Log OSHA Training Certificate SAMPLE letter MRTS 1286……………………………………………………………………………Section 3 Student Data Sheet Department Dress Code Confidentiality Agreement for Students of the MRTS Department Sexual Harassment Site Preference Form Weekly Time Log Student Funeral Director Training Report Student Embalmer Training Report Embalming Report SAMPLE Employer Satisfaction Survey SAMPLE Letter MRTS 2286……………………………………………………………………………Section 4 Student Data Sheet Department Dress Code Confidentiality Agreement for Students of the MRTS Department Sexual Harassment Site Preference Form Weekly Time Log Student Funeral Director Training Report Student Embalmer Training Report Embalming Report SAMPLE Employer Satisfaction Survey SAMPLE Letter

Signature of Acknowledgement …………………………………………Section 5 Funeral Home Copy Department Copy Resources………………………………………………………………….Section 6


SECTION 1 Manual Introduction


Introduction:

This manual has been prepared by the San Antonio College Mortuary Science Program and is intended to be used by selected sites – i.e. funeral homes, cemeteries, crematories that have a current Memorandum of Agreement with the Program.

Purpose: The intent of this manual is to provide detailed information for the purpose(s) of:

Distinguishing MRTS 1330 Internship Orientation students from MRTS 1286 Funeral Service students (Internship I) and MRTS 2286 Funeral Service students (Internship II) students.

Familiarizing funeral home, crematory, and cemetery staff with student expectations, responsibilities, and limitations.

Familiarizing the funeral home, crematory, and cemetery staff with their expectations, responsibilities, and limitations when working with students.

Familiarizing funeral home, crematory, and cemetery staff with student paperwork as it applies to; MRTS 1330, MRTS 1286, MRTS 2286. SAMPLE documents and/or forms that may be presented by the student for signature(s) are provided.

Supporting the San Antonio College Mortuary Science Program with its efforts in complying with the American Board of Funeral Service Education (ABFSE) guidelines.

Roles and Responsibilities: The San Antonio College Mortuary Science Program, students enrolled in the Program, and the selected sites share in the responsibility for complying with laws and rules set forth by the Alamo Colleges, the Texas Funeral Service Commission, and the ABFSE. The Program will provide independent inspections ensuring that all selected sites are currently licensed establishments.

Distribution: The San Antonio College Mortuary Science Program will periodically review this manual and will present the revised/amended/updated version to the funeral homes, cemeteries, crematories that have a current Memorandum of Agreement with the Program.

Thank you for supporting the San Antonio College Mortuary Science Program!


SECTION 2 MRTS 1330

Funeral Service Internship Orientation


MRTS 1330 Funeral Service Internship Orientation

During the scheduled visits to the funeral home, some of the tasks the student may observe or assists with include:

First call (notification or removal) Graveside/funeral service Chapel/parlor equipment set-up Clerical functions Dressing, cosmetizing, casketing Embalming procedures (students are forbidden by Program policy to assist

unless written authorization exists. ***See MRTS 1330 Internship Site Documentation for a more detailed listing.


FUNERAL SERVICE INTERNSHIP ORIENTATION MRTS-1330

______________________________________________________________________

CONTACT INFORMATION:

Professor: Mary Mena Email: [email protected] Office: NTC 237 Phone: 486-1136 Department Contact Information: Mortuary Science Department Phone Number: 210-486-1137

Mortuary Science Department Office- Nail Technical Center Room 238

Mortuary Science Website: www.alamo.edu/sac/mortuary

Course Description:

Preparation for a funeral service career facilitated with on-site observation and participation. Instruction in equipment use, procedures, and functions in the daily operation of a funeral home.

Objectives:

Upon completion of this course, the student shall be able to do the following with not less than the minimum number of points equivalent to a letter grade of C: 1. To explain OSHA's hazard communication standard, formaldehyde standard, and bloodborne pathogens standard; 2. To define funeral terminology; 3. To recognize needs within the accepted modes of disposition of human remains; 4. To reconcile theoretical instruction with actual industry practice; 5. To discuss issues relating to death and funeralization; 6. To identify procedures in the disposition of human remains; 7. To observe functions of funeral service personnel and their relation to activites in allied areas; 8. To demonstrate psychomotor skills.

Course Outcomes:

1 Relate theoretical instruction to industry practice

2 Compare procedures among specified industry sites.

3 Demonstrate psychomotor tasks.

4 Describe procedures to accomplish disposition of remains.

5 Discover expectations of an industry professional.

Evaluation: Letter grades are based on percentage values as follows:

93 - 100 pts.= A

89 - 92 pts.= B

84 - 88 pts.= C

78 – 83 pts. = D

00 – 77 pts. = F

A grade of C is established as the minimum grade in any course whose number and title are preceded by the letters MRTS.

SAMPLE

San Antonio College MORTUARY SCIENCE DEPARTMENT

STUDENT DATA SHEET

Name: ___________________________________________________ Banner ID: __________________________ Street Address: _____________________________________________ City, State, ZIP: _______________________________________________________________________ Home Telephone #: (_______) _______-______________ cell: (_______) _______-____________ Drivers License #: __________________________ State: ____________________ Expires: _________________________________ DOB:_________________________ In the event of an emergency, contact: ______________________________________________________ Relationship: _____________________________________ Phone: (_______) ________-__________

M E M O R A N D U M To: All Mortuary Science Students FROM: Dr. Jose Luis Moreno Program Coordinator SUBJ: Dress Code Effective immediately, all students enrolled in a course that includes off-campus activity will observe the dress code below. The only exception to this policy is if an appropriate authority indicates otherwise. MALES: FEMALES: Business suit Business suit (coat & pants) White shirt (preferably long sleeves) White blouse (preferably long sleeves) Dress shoes Dress shoes (heels a maximum of 2”) Dark socks Hosiery (seamless, untextured) Conservative tie (no bow ties)

Unacceptable: Vivid colors, white hose or socks

Grooming: Grooming: Conservative, natural color Conservative, businesslike, natural color Length above shirt collar preferably short, low maintenance No wigs; height < 1.5 inches No wigs; height < 1.5 inches No facial hair; sideburns not lower than mid-tragus

General: 1. Fingernails should be short, clean, and not painted vividly. 2. Cosmetics, when used, should be moderately applied, natural colors. 3. Fragrances are discouraged; environmental odors should suffice. 4. Visible tattoos are not allowed. 5. Rings are limited to two fingers, two rings per finger, one finger per hand. 6. No anklets, bracelets, or necklaces will be worn in the preparation room, except for medical emergency identifiers. 7. Men are not to wear any jewelry in any visible body piercings; plug or tunnel gauges are not allowed for either males or females. 8. Women will restrict visible body piercings to their ears only, one item per ear, and a maximum length of 1 inch from the aperture.

9. Tongue piercings are considered visible and are unacceptable. 10. Preparation room shoes are required when in the preparation room and must be General: ►The funeral service industry is an extremely conservative one. Adherence to this dress code is mandatory as indicated above. ►Please remember that, in general, if you have to ask if something is acceptable or appropriate it most likely is unacceptable or inappropriate. ►Failure to adhere to this dress code may cause an affiliated clinical and/or internship site to refuse your admittance to their location. Therefore, you have not fulfilled the time requirements that are a part of clinical and/or internship courses. ►Any questions or concerns about the information contained in the memorandum must be addressed to the instructor in charge of the off-campus activity affected. ►This policy is subject to revision and/or modification.

SAMPLE

REQUIRED DRESS CODE MRTS 1330

INTERNSHIP ORIENTATION

I _____________________ do herby acknowledge that I have read the required dress code for MRTS 1330 Internship Orientation and I understand the following:

1. I am required to be appropriately dressed for each of my internship sights (6). I am required to get any change in my internship dress approved BEFORE attending a sight. I know that will be required to leave my internship site if I am not properly dressed and that I will be dropped from the course.

2. I am also required to be appropriately dressed for each class wherein the dress

code is required. The class dates which require the dress code are listed on the agenda for this class and that agenda is posted on the internet. I have seen and read that agenda and have been instructed to download that agenda for my personal retention. I understand that if I am not properly dressed for class the instructor will deduct 100pts from my overall grade in the course each time I am not properly dressed.

___________________________________ ____________________________ Student’s Signature Date Instructor’s Signature Date

CONFIDENTIALITY AGREEMENT FOR STUDENTS

OF THE MORTUARY SCIENCE DEPARTMENT

This Confidentiality Agreement (agreement) is made effective this _____ day of ________________,

20____, by and between the Mortuary Science Department (Department) of San Antonio College

(College) and _______________________________, a student enrolled in the Mortuary Science

(student) Department curriculum. WITNESSETH: WHEREAS, a Department student may, in the course of his/her instruction and/or training, have access to, be exposed to, or acquire knowledge of private and confidential information and data which may contain such information; and WHEREAS, such private and confidential information and data may have its origins in an on-campus setting such as a laboratory or classroom, or an off-campus setting such as a laboratory or internship setting; and WHEREAS, any disclosure of said information or data may violate ethical considerations and even constitute a breach of state and/or federal law(s): NOW, THEREFORE, the parties hereto agree as follows: “Private and confidential information and data” shall mean any form of information including but not limited to documents containing data, health-related information, images, computer programs and/or data issuing therefrom. Student agrees that s/he shall neither exploit nor use any form of private and confidential information and data in any manner except as allowed by the Department or its participating off-campus training affiliate. While receiving instruction and/or training, student agrees to: -perform all work allocated to the best of his/her ability; -exercise all due care, diligence, and skill; -comply with all lawful and reasonable directions and instructions received; -comply with all College and Department policies and procedures that apply; -comply with any and all legislation, codes, or guidelines in whatever form apply; - undergo any/all training deemed necessary to effect safe and efficient performance of duties; -forego the use of any electronic medium that is capable of capturing or transmitting data. IN WITNESS WHEREOF, the parties hereto have executed this agreement. ________________________________ ______________________________ Student Chair Date: ___________________________ Date: _________________________

SEXUAL HARASSMENT

A form of sex discrimination that involves unwelcome sexual advances, requests for sexual favors or other verbal or physical conduct of a sexual nature, when submission to or rejection of such conduct is a term or condition of a person's job, pay, or career, or submission to or rejection of such conducts used as a basis for career or employment decisions or such conduct interferes with an individual's performance or creates an intimidating, hostile or offensive environment, or any person in a supervisory or command uses or condones implicit or explicit sexual behavior to control, influence or affect the career, pay or job of a member, or any member makes deliberate or repeated unwelcome verbal comments, gestures or physical contact of a sexual nature.

S A M P L E

Funeral Service Internship Orientation 1330 Internship Site Documentation

Student:__________________ Scheduled from ___ ___- ___ ___ Internship Site:________________

Date: ___/___/___

To the internship site staff: The student who is assigned today to your facility must meet all criteria below in order to be admitted on-premises. Please indicate compliance by marking each appropriate box with a check mark. (Use ink for all entries.) If any criterion is marked "no", please ask the student to leave. A call to our office (486-1137) will be appreciated.

1. Student arrived as expected...................... 2. Student is attired appropriately..................

If "no", please remark:

Yes No [ ] [ ]

[ ] [ ]

[ ] [ ] 3. Student is groomed appropriately........... If "no", please remark:

_______________________ ____________ ___________ _____:_____ AM PM

(Signature of site personnel (Position/Title) (License No.) (Time of Arrival) (Indicate) (S f )Student: Before you leave the site, (a) indicate areas in which you observed or assisted by placinga check mark in front of the number of the area; (b) briefly comment on your observation and/orparticipation.

__ 1. First call (notification or removal) ______________________________ 2. Evening (e.g., visitation, rosary, etc.) ____________________________ __ 3. Floral tributes (delivered, arranged, etc.) ____________________________ __ 4. Graveside service ____________________________ __ 5. Funeral service (e.g., church, chapel) ____________________________ __ 6. Chapel/parlor equipment set-up ____________________________ __ 7. Scheduling personnel and livery ____________________________ __ 8. Procession (e.g., formation, ride, etc.) ____________________________ __ 9. Clerical functions ____________________________ __10. Dressing, cosmetizing, casketing ____________________________ __11. Embalming procedures* ____________________________

*(Note: State law requires that proper embalming authorization must be obtained if students are to observe or assist. Students are forbidden by Program policy to observe or assist unless written authorization exists.

__12. Other:____________________ ____________________________

I hereby certify that the foregoing entries are true and correct. I also certify that the proper authorization to embalm is attached to this document if I observed or assisted during embalmingprocedures.

___________________________________

(Student signature)

I hereby certify that the foregoing information is true and correct.

__________________________ ___________ _________ ____:____ AM PM (Signature of site personnel) (Position/Title) (License No.) (Time of Departure) (Indicate)

Assessment Criteria for Internship Site Observation and Documentation

Area Points are deducted from the maximum if: Obs. 25 Doc.25 Student student name is omitted 2

data

date is indicated incorrectly or omitted 2

clinical site name is incorrect or omitted 2

times are incorrect or omitted 2

Admittance student arrived late, but was admitted (*per 1/4 hr. or fraction 10

of)

student was inappropriately attired, but admitted 10

student was 'inappropriately groomed, but admitted

10

Admittance student was refused admittance based on any admittance 25 25

criteria

Verification site personnel signature is not provided 15 15

Position/Title is omitted 2

license number (if applicable) is not indicated 2

time of arrival is not stated 5 5

Activities there are no activities indicated 15 15

for any of #1-#12 there is a check mark, but no comment 2

for any of #1-#12 there is a- comment, but no check mark 2

in area #11: "

written authorization to embalm is incorrect or lacking 25 25

TFSC Form 9.1.97 is incorrect or lacking 25 25

Verification student does not sign form 15

site personnel signature is not provided 15 15

, ' Position/Title is omitted

2

license number (if applicable) is not indicated 2

time of departure is not stated 5 5

S A M P L E MORTUARY SCIENCE DEPARTMENT MRTS 1330 Funeral Service Internship Orientation Weekly Time Log and Assessment Record Student: SSN: - -

Day

Date

lnternship Site In Out Total

Hours

Ack. by

Instructor Points: Obs.

Points: Doc.

- -

- -

- -

- -

- -

- -

- -

- -

Totals

XXXXXXX

XXXXXXXXXXXXXXXXXXXXXXXXXX

XXXX XXXX XXXXXX

I hereby affirm that the entries made in the foregoing document are true and accurate. Furthermore, I understand and acknowledge by virtue of my signature that any misinformation given willfully constitutes fraud, the consequence of which will be the maximum penalty allowed by established Alamo Community College District and San Antonio College policies. Student Signature:______________________________ Date:_____-_____-_____

Instructions for Completing Weekly Time Lag and Assessment Record

Pease type or neatly print all entries except your signature

Day: Abbreviate the day (using the first three letters followed by a period) on which you

observed.

Date: Enter numeric date (MM‐DD‐YY); e.g. 09‐29‐98).

Clinical Site: Use the full, correct name as listed in “Schedule of Option Availability”.

In: Enter the time recorded by site personnel from the appropriate “Clinical Site

Documentation” form. Be sure to indicate AM or PM.

Out: Same as “In”.

Total Hours: Enter the total hours observed that day.

Student Signature: Use your usual signature.

Date under your signature: Enter numeric date (MM‐DD‐YY).

Do not make any entries in the last three columns of the table.

Note:

Read and understand the two statements preceding the signature blank before signing the

document. The Academic Dishonesty Policy will be stringently enforced.

MORTUARY SCIENCE DEPARTMENTThis certifies that:

_______________________________a student enrolled in MRTS 1330

has met the requirements for training in

Hazard Communication StandardBlood-Borne Pathogens Standard

Formaldehyde Standard

and that there is in our office evidence of[ ]Hepatitis-B Vaccination

[ ] A Waiver of liability

Attesting thereto, the instructor’s signature is subscribed thisJanuary 2017

Mary Mena Professor

FACS. TRANSMITTAL

TO: _______________ Funeral Home

FROM: Mary Mena, Internship Coordinator

SUBJ: Funeral Service Orientation Student Assignments

DATE: February 10, 2017 We ask that you admit the student(s) as scheduled below. Let us know as soon as possible if there are any questions or conflicts, or if any scheduled student fails to show. Please post and share with affected personnel. I can be reached as follows:

office: 486‐1136

home: 674‐8301

Day Date 8am — 4:30pm

Mon. Feb. 13

Tue. Feb. 14

Wed. Feb. 15

Thur. Feb. 16

Fri. Feb. 17

Sat.

Sun.


SECTION 3 MRTS 1286

Internship Funeral Services


MRTS 1286

Internship Funeral Services (Internship I)

A student enrolled in MRTS 1286 is required to complete 15 funeral directing cases under the direction of a licensee. Some of the tasks that Internship Funeral Services students are expected to participate in include:

Assisting in the arrangement office with an authorizing agent First call removal of remains Dressing, casketing, cosmetizing of remains Assists at funeral/memorial/viewing services Assist at gravesite service

***See Student Funeral Director Training Report for a more detailed listing.


INTERNSHIP FUNERAL SERVICES MRTS-1286

______________________________________________________________________





Course Description:

This course is a work-based learning experience that enables the student to apply specialized skills and concepts. A learning plan (Student Training Report) is developed by the college and the funeral home. This is a capstone course for Level I Certificate in Funeral Directing. A student is required to complete 15 funeral directing cases under the direction of a licensee.

Course Outcomes: 1. As outlined in the learning plan (Student Training Report), apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry.

2. Demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry.

Learning Outcomes

1. Observe receipt of the notification of death 2. Assist with removal of remains 3. Observe arrangements for disposal of remains 4. Dress/Casket remains 5. Prepare/File required forms and documents 6. Handle floral tributes 7. Usher attendees at services 8. Supervise pallbearers 9. Assist with cortege formation 10. Assist with graveside/committal services 11. Set up facilities for viewing 12. Assist in the selection room 13. Become familiar with selection room pricing and merchandising 14. Relate the implications of the types of death to embalming 15. Employ the necessary terminology to facilitate communication with members of

allied professions and the public 16. Employ adequate methods of self-protection from communicable and infectious

diseases and hazardous chemicals 17. Observe those conditions whereby notification of death to public officials is required 18. Discuss how handling, treatment and disposition of the dead human body meet the

sociological, psychological, theological, physical and legal requirements of family and community.

Evaluation: Letter grades are based on percentage values as follow:

A= 93-100% B = 89-92% C = 84-88% D = 78-83% F = 00-77%


SAMPLE


STUDENT DATA SHEET


SEXUAL HARASSMENT



SAMPLE

Site Preference Form MRTS 1286/MRTS 2286

To: Funeral Service Internship I MRTS 1286 Funeral Service Internship II MRTS 2286 From: Mary Mena, Professor Date: Semester______________ Year:______________ Subj: Student preference of internship site Please complete the form below and return it NOW. Name: ______________________________ My choices of internship sites are in the order I prefer: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ On what days for a total of 16 hours per week will you be able to devote 8 hours a day (excluding a meal time) to your college internship career? Internship students will be extended the flexibility of a 24 hour clock, 7 days a week. Day 1: ______________________________ Time: _________________________ Day 2: ______________________________ Time: _________________________ Please be advised that you are limited to one absence. The student understands that failure to show up to the assigned funeral home on the above days and times may result in being dropped from this course. Please initial here __________ that you understand the attendance policy and demands of this course and the consequences of not following the attendance policy.


MRTS ____________

______________ 20_________

Semester

Weekly Time Log

Student: _______________________________________ Banner ID:________________________________

Internship Site: ___________________________________ From: ________________ To:_____________

Day Date In Out to lunch In from lunch Out Total Hours Initials

Total I hereby affirm that the entrees made in the foregoing Internship Programs' Time Log are true and accurate. Furthermore, I understand and acknowledge by virtue of my signature that any willful misinformation made constitutes fraud the consequence of which will be the maximum penalty allowed by established Alamo Colleges policy.

Student Signature:___________________________________________________________________________ Attest: _______________________________________________ Date:_______________________________

San Antonio College

STUDENT

FUNERAL DIRECTOR TRAINING REPORT I. Instructions: Please fill out completely. Any incomplete reports will be invalid and will not count towards

the student requirements.

____________________________________________ ________________________________

Printed Name Semester/Year

____________________________________________ ________________________________

Establishment Name Establishment License Number

_______________________________________________________________________________________________________________________

Establishment Address City State Zip Phone

__________________________________________________________________________________________ II. Report for CASES DURING the MONTH of: _______________________ in the year 20________

III. Activities Performed:

1.* Arrangement Conference with Authorizing

Agent

15. Set Up Equipment

2.* Present “Facts About Funerals” Publication

Information

16. Arranged Flowers

3.* Presented Funeral Merchandise 17. Arranged for Clergy/Fraternal Organization

4.* First Call Removal of Remains 18. Supervised Pallbearers or Instructed Pallbearers

5.* Prepared/Filed Required Forms – i.e. Obituary,

Clergy Data, Report of Death

19. Arranged/Supervised Cortege

6.* Arranged for Shipment/Transfer of human

remains

20. Notwithstanding

7.* Dressing, Casketing

8.* Cosmeticize Remains

9.* Check For/Removal of Pacemaker or Other

Implants

10.* Prepared/Assisted Cemetery Arrangements

11.* Assisted at Graveside Service/Alternative

Disposition

12.* Assisted at Funeral/Memorial Service/Viewing

13.* Take First Call Information

14.* Transfer Cremains into Display Urn(s) or

Alternative Container

IV. Cases:

Name Of Deceased

Date Activities Performed Printed Name & License

Number Of Supervisor

Supervisor’s

Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

*Must perform six (6) functions (burial or cremation) with an asterisk to receive credit for

a case.

I affirm that I performed all tasks listed in this report:

____________________________ _______________ ____________ Signature of Student Provisional License Number Date

I certify that the student named above assisted in all listed tasks under the direct and personal supervision of a

licensed funeral director.

EVALUATION OF

Funeral Director TRAINING

EXCELLENT

GOOD

UNSATISFACTORY

Willingness to Perform Tasks

Exhibits Professional Attitude

Quality of Work

Use of Judgment

COMMENTS:

___________________________________________ _______________________ __________________

Signature of Supervisor License Number Date

TFSC F#00-01 (EM)

San Antonio College

STUDENT

EMBALMER TRAINING REPORT I. Instructions: Please fill out completely. Any incomplete reports will be invalid and will not count towards


____________________________________________ ________________________________

Printed Name Semester/ Year

____________________________________________ ________________________________


_________________________________________________________________________________________


_________________________________________________________________________________________

II. Report for cases during the month of: _______________________20________


1.* Make Incision d. Brachial Artery 14. Enclose In Plastic Garment/Pouch

2.* Set Features e. Iliac Artery 15. Topical Disinfection/Preservation

3.* Hypodermic

Treatment/Disinfection

f. Radial Artery 16. Clean Up Area and Proper Disposal of

Waste

4.* Aspirate Cavity/Re-aspirate

Cavity

g. Femoral Artery 17. Restoration

5.* Inject Cavity/Re-inject Cavity h. Ulnar Artery 18. Autopsy

6.* Insert arterial tube i. Jugular Vein 19. Notwithstanding

7.* Mixed Embalming Solution j. Axillary Vein

8.* Suture incision

k. Femoral Vein

9.* Raise Vessels

10. First Call Removal of Remains

a. Carotid Artery 11. Wear Protective Clothing

b. Subclavian Artery 12. Bathe/Disinfect Remains

c. Axillary Artery 13. Disinfect/Pack Orifices

TFSC F#00-01 (EM)

IV. Cases:

Name Of Deceased


Number of Supervisor

Supervisor’s

Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

*Must perform six (6) of the above nine (9)* functions to receive credit for a case.

EVALUATION OF TRAINING

EXCELLENT

GOOD

UNSATISFACTORY Willingness to Perform Tasks


Quality of Work

Use of Sanitary & Safety Devices

COMMENTS:


________________________________ _______________ ____________ Signature of Student Provisional License Number Date

I certify that the student named above assisted in all listed tasks under direct and personal supervision of a licensed

embalmer and that the authorization to embalm was granted.

________________________________________________ ______________________ __________________


Date _______-_______-_______ Total Time Spent: ___________________

Permission To Embalm: Yes No Treatment to proceed on basis of: ____ signed authorization ____ oral authorization ____ statutory 3-hr attempt to secure Name & location where embalming procedure was performed:_____________________________ ____ orders from _________________________ _______________________________________________________________________________ Deceased ___________________________________________________Mortuary ___________________________________________________

Age c.__________ yrs. Race _________________Sex: male female Weight c.____________lbs. Height c.___________ft.___________in.

Date of death ______________________________Time _____:_____ am pm Time of removal _____:_____ am pm Date:____-____-____

PRE-EMBALMING OBSERVATIONS

Operation before death? No Yes Type/Area _______________________________ _______________________________________ Autopsy performed? No Yes Complete Torso/Trunk Cranial Before embalming After embalming

Viscera: Retained Received Time between death and treatment: c. hrs. Time between receipt of remains and treatment: c. ___________hrs. Body: Warm Cold Refrigerated: Duration c. hrs. Thawed//Out of Refrigeration c._______hrs. Rigor mortis: Yes__________No___________ Abdominal distension: No Yes Slight Moderate Intense Liquid Gas Purge before embalming: No Yes Type: Edema: Abdomen Thorax R. Leg L. Leg R. Arm L. Arm Face Degree__________________________ Discolorations: Lividity Stain _____in; _________________________________________________________________________________ Lesions:_________________________________________________________________________________________________________________ Comments: ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

EMBALMING PROCEDURE

Arteries Injected: Veins Drained: Disinfection: (Check Appropriate Areas) Cm. Carotid R-L ___ Iliac R-L ___ Internal Jugular R-L Eyes __________ Other body orifices ___________ Subclavian R-L Femoral R-L Axillary R-L Mouth _________ Nose _______ Axillary R-L Radial R-L _____Iliac R-L Body orifices packed _____________ Brachial R-L Dorsalis pedis R-L Femoral R-L Remains bathed with antiseptic soap _________ Others ________________________________ Others_____________________________ Condition of: Arteries: ___________________________________________ Veins: ___________________________________________________ Injection: pre-injection (co-injection) 1st _____gal. 2nd _____gal. 3rd _____gal. arterial concentrate ____________(%) or( Index) 1st _____oz 2nd _____oz. 3rd _____oz. arterial concentrate ____________(%) or (Index) 1st _____oz. 2nd _____oz. 3rd _____oz. fluid modifier ________________ 1st _____oz. 2nd _____oz. 3rd _____oz. humectant ___________________ 1st _____oz 2nd _____oz. 3rd _____oz. other _______________________ 1st _____oz. 2nd _____oz. 3rd _____oz. Injection Method: Continuous Alternate Drainage: Intermittent Continuous Quality of Drainage _______________________________________ Quality: Heavy clots Medium Light None Cavity Treatment: Cavity fluid ____________(%) Quantity used ________oz. Method: Gravity Motorized Delayed Immediate Autopsied cases: Viscera immersed Preservative powder used Additional treatment: ____________________________________

Other: Direct Topical Hypodermic Treatment(Check Appropriate Areas): Arms Torso Face Legs Neck Distribution Exceptions ____________________________________________________________________________________________________ Additional Treatment ______________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

Condition of Body at Completion (include comments on conditions noted above) ______________________________________________________ _______________________________________________________________________________________________________________________

Posing Features Mouth Closure : Suture Needle Injection Natural Dentures Cotton Other ____________________

Eye Closure Cotton Eye Caps Natural Other

IDENTIFICATION AND TREATMENT REFERENCE Indicate on chart all identifying scars, incisions, lesions and special body characteristics.

Description of items marked on chart: 1. ______________________________________________ 2. ______________________________________________

3. ______________________________________________

4. ______________________________________________

5. ______________________________________________

6. ______________________________________________

7. ______________________________________________

8. ______________________________________________

Date and Time Case Report Completed:_____________________________________________________________________

____________________________________________________ License No. ________________________________________

Embalmer

____________________________________________________ Provisional License No. ______________________________

Student or Provisional Licensee

E. g. “housekeeping” post-embalming checklist (re-aspirated, dressed, etc.)

S A M P L E San Antonio College

MORTUARY SCIENCE DEPARTMENT MRTS 1286 Internship I - Funeral Director

Employer Satisfaction Survey

Student: ___________________________________ Please indicate the degree to which you agree with the following statements by circling a number. Ten (10) is the highest value: six (6) is the lowest. If any rating is less than seven (7), please provide a reason in the comments section, referring to that rating by the number corresponding to the statement. (Comments on ratings higher than seven (7) are optional). Criteria: Rating: _____________________________________________________________________________________ My Student: 1. Dressed appropriately according to our firm’s

dress code. 6 7 8 9 10 2. Followed instructions for assigned tasks. 6 7 8 9 10 3. Exhibited professionalism among staff

and client-families. 6 7 8 9 10 4. Showed enthusiasm for learning from me. 6 7 8 9 10 5. Will be an asset to funeral service. 6 7 8 9 10 _____________________________________________________________________________________ Total: __________________________________ Comments: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Evaluator Signature and License Number : __________________________________ Date: ____________________________________

February 1, 2017

Funeral Home ___________, Manager

San Antonio, Texas 78230

Dear ___________,

This letter is to notify you of the student who has selected to serve her Funeral Service Internship at your establishment. Internship will begin the week of Monday, February 6, 2017 and end the week of Monday, April 3, 2017 (eight weeks total). Included are the days of the week and the shifts that the student has selected to work.

______Thursday & Friday 8:30am -4:30pm (30 min lunch break)

If you have any questions or concerns, please do not hesitate to contact me. Thank you for your continued support.

Respectfully,

Mary Mena, Internship Coordinator Mortuary Sci ence Department Office: 486-1136 Home: 674-8301

1819 N. Main Avenue I San Antonio, TX 78212-4299 11210) 486-0000 I alamo,edu/sac

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SECTION 4 MRTS 2286

Funeral Service and Mortuary Science Internship II


MRTS 2286 Funeral Service and Mortuary Science

(Internship II)

A student enrolled in MRTS 2286 is required to complete 10 embalming cases under the direction of a licensee. Some of the tasks that Internship Funeral Services students are expected to participate in include:

Setting Features Mixing Embalming Solution Raising Vessels Making Incisions Aspirating Cavity/Re-aspirating

***See Student Embalming Training Report for a more detailed listing.


FUNERAL SERVICE AND MORTUARY SCIENCE

INTERNSHIP II MRTS-2286

______________________________________________________________________





Course Description:

A work-based learning experience that enables the student to apply specialized occupational theory, skills and concepts. A learning plan (Student Training Report) is developed by the college and the employer. This is a captstone course for the Associate of Applied Science Degree in Mortuary Science. A student is required to complete 10 embalming cases under direct supervision of a licensed embalmer. Course Outcomes: 1. As outlined in the learning plan (Student Training Report), apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupation and the business/industry.

2. Demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry.

Learning Outcomes

1. Observe receipt of the notification of death 2. Assist with removal of remains 3. Observe arrangements for disposal of remains 4. Dress/Casket remains 5. Prepare/File required forms and documents 6. Handle floral tributes 7. Usher attendees at services 8. Supervise pallbearers 9. Assist with cortege formation 10. Assist with graveside/committal services 11. Set up facilities for viewing 12. Assist in the selection room 13. Become familiar with selection room pricing and merchandising 14. Relate the implications of the types of death to embalming 15. Employ the necessary terminology to facilitate communication with members of

allied professions and the public 16. Employ adequate methods of self-protection from communicable and infectious

diseases and hazardous chemicals 17. Observe those conditions whereby notification of death to public officials is required 18. Discuss how handling, treatment and disposition of the dead human body meet the

sociological, psychological, theological, physical and legal requirements of family and community.

Evaluation: Letter grades are based on percentage values as follow:

A= 93-100% B = 89-92% C = 84-88% D = 78-83% F = 00-77%


SAMPLE


STUDENT DATA SHEET


SEXUAL HARASSMENT



SAMPLE

Site Preference Form MRTS 1286/MRTS 2286

To: Funeral Service Internship I MRTS 1286 Funeral Service Internship II MRTS 2286 From: Mary Mena, Professor Date: Semester______________ Year:______________ Subj: Student preference of internship site Please complete the form below and return it NOW. Name: ______________________________ My choices of internship sites are in the order I prefer: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ On what days for a total of 16 hours per week will you be able to devote 8 hours a day (excluding a meal time) to your college internship career? Internship students will be extended the flexibility of a 24 hour clock, 7 days a week. Day 1: ______________________________ Time: _________________________ Day 2: ______________________________ Time: _________________________ Please be advised that you are limited to one absence. The student understands that failure to show up to the assigned funeral home on the above days and times may result in being dropped from this course. Please initial here __________ that you understand the attendance policy and demands of this course and the consequences of not following the attendance policy.


MRTS ____________

______________ 20_________

Semester

Weekly Time Log

Student: _______________________________________ Banner ID:________________________________

Internship Site: ___________________________________ From: ________________ To:_____________

Day Date In Out to lunch In from lunch Out Total Hours Initials

Total I hereby affirm that the entrees made in the foregoing Internship Programs' Time Log are true and accurate. Furthermore, I understand and acknowledge by virtue of my signature that any willful misinformation made constitutes fraud the consequence of which will be the maximum penalty allowed by established Alamo Colleges policy.

Student Signature:___________________________________________________________________________ Attest: _______________________________________________ Date:_______________________________

TFSC F#00-01 (EM)

San Antonio College

STUDENT

EMBALMER TRAINING REPORT I. Instructions: Please fill out completely. Any incomplete reports will be invalid and will not count towards


____________________________________________ ________________________________

Printed Name Semester/ Year

____________________________________________ ________________________________


_________________________________________________________________________________________


_________________________________________________________________________________________

II. Report for cases during the month of: _______________________20________


1.* Make Incision d. Brachial Artery 14. Enclose In Plastic Garment/Pouch

2.* Set Features e. Iliac Artery 15. Topical Disinfection/Preservation

3.* Hypodermic

Treatment/Disinfection

f. Radial Artery 16. Clean Up Area and Proper Disposal of

Waste

4.* Aspirate Cavity/Re-aspirate

Cavity

g. Femoral Artery 17. Restoration

5.* Inject Cavity/Re-inject Cavity h. Ulnar Artery 18. Autopsy

6.* Insert arterial tube i. Jugular Vein 19. Notwithstanding

7.* Mixed Embalming Solution j. Axillary Vein

8.* Suture incision

k. Femoral Vein

9.* Raise Vessels

10. First Call Removal of Remains

a. Carotid Artery 11. Wear Protective Clothing

b. Subclavian Artery 12. Bathe/Disinfect Remains

c. Axillary Artery 13. Disinfect/Pack Orifices

TFSC F#00-01 (EM)

IV. Cases:

Name Of Deceased


Number of Supervisor

Supervisor’s

Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

*Must perform six (6) of the above nine (9)* functions to receive credit for a case.

EVALUATION OF TRAINING

EXCELLENT

GOOD

UNSATISFACTORY Willingness to Perform Tasks


Quality of Work

Use of Sanitary & Safety Devices

COMMENTS:


________________________________ _______________ ____________ Signature of Student Provisional License Number Date

I certify that the student named above assisted in all listed tasks under direct and personal supervision of a licensed

embalmer and that the authorization to embalm was granted.

________________________________________________ ______________________ __________________


Date _______-_______-_______ Total Time Spent: ___________________

Permission To Embalm: Yes No Treatment to proceed on basis of: ____ signed authorization ____ oral authorization ____ statutory 3-hr attempt to secure Name & location where embalming procedure was performed:_____________________________ ____ orders from _________________________ _______________________________________________________________________________ Deceased ___________________________________________________Mortuary ___________________________________________________

Age c.__________ yrs. Race _________________Sex: male female Weight c.____________lbs. Height c.___________ft.___________in.

Date of death ______________________________Time _____:_____ am pm Time of removal _____:_____ am pm Date:____-____-____

PRE-EMBALMING OBSERVATIONS

Operation before death? No Yes Type/Area _______________________________ _______________________________________ Autopsy performed? No Yes Complete Torso/Trunk Cranial Before embalming After embalming

Viscera: Retained Received Time between death and treatment: c. hrs. Time between receipt of remains and treatment: c. ___________hrs. Body: Warm Cold Refrigerated: Duration c. hrs. Thawed//Out of Refrigeration c._______hrs. Rigor mortis: Yes__________No___________ Abdominal distension: No Yes Slight Moderate Intense Liquid Gas Purge before embalming: No Yes Type: Edema: Abdomen Thorax R. Leg L. Leg R. Arm L. Arm Face Degree__________________________ Discolorations: Lividity Stain _____in; _________________________________________________________________________________ Lesions:_________________________________________________________________________________________________________________ Comments: ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

EMBALMING PROCEDURE

Arteries Injected: Veins Drained: Disinfection: (Check Appropriate Areas) Cm. Carotid R-L ___ Iliac R-L ___ Internal Jugular R-L Eyes __________ Other body orifices ___________ Subclavian R-L Femoral R-L Axillary R-L Mouth _________ Nose _______ Axillary R-L Radial R-L _____Iliac R-L Body orifices packed _____________ Brachial R-L Dorsalis pedis R-L Femoral R-L Remains bathed with antiseptic soap _________ Others ________________________________ Others_____________________________ Condition of: Arteries: ___________________________________________ Veins: ___________________________________________________ Injection: pre-injection (co-injection) 1st _____gal. 2nd _____gal. 3rd _____gal. arterial concentrate ____________(%) or( Index) 1st _____oz 2nd _____oz. 3rd _____oz. arterial concentrate ____________(%) or (Index) 1st _____oz. 2nd _____oz. 3rd _____oz. fluid modifier ________________ 1st _____oz. 2nd _____oz. 3rd _____oz. humectant ___________________ 1st _____oz 2nd _____oz. 3rd _____oz. other _______________________ 1st _____oz. 2nd _____oz. 3rd _____oz. Injection Method: Continuous Alternate Drainage: Intermittent Continuous Quality of Drainage _______________________________________ Quality: Heavy clots Medium Light None Cavity Treatment: Cavity fluid ____________(%) Quantity used ________oz. Method: Gravity Motorized Delayed Immediate Autopsied cases: Viscera immersed Preservative powder used Additional treatment: ____________________________________

Other: Direct Topical Hypodermic Treatment(Check Appropriate Areas): Arms Torso Face Legs Neck Distribution Exceptions ____________________________________________________________________________________________________ Additional Treatment ______________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

Condition of Body at Completion (include comments on conditions noted above) ______________________________________________________ _______________________________________________________________________________________________________________________

Posing Features Mouth Closure : Suture Needle Injection Natural Dentures Cotton Other ____________________

Eye Closure Cotton Eye Caps Natural Other

IDENTIFICATION AND TREATMENT REFERENCE Indicate on chart all identifying scars, incisions, lesions and special body characteristics.

Description of items marked on chart: 1. ______________________________________________ 2. ______________________________________________

3. ______________________________________________

4. ______________________________________________

5. ______________________________________________

6. ______________________________________________

7. ______________________________________________

8. ______________________________________________

Date and Time Case Report Completed:_____________________________________________________________________

____________________________________________________ License No. ________________________________________

Embalmer

____________________________________________________ Provisional License No. ______________________________

Student or Provisional Licensee

E. g. “housekeeping” post-embalming checklist (re-aspirated, dressed, etc.)

San Antonio College

STUDENT

FUNERAL DIRECTOR TRAINING REPORT I. Instructions: Please fill out completely. Any incomplete reports will be invalid and will not count towards


____________________________________________ ________________________________

Printed Name Semester/Year

____________________________________________ ________________________________


_______________________________________________________________________________________________________________________


__________________________________________________________________________________________ II. Report for CASES DURING the MONTH of: _______________________ in the year 20________


1.* Arrangement Conference with Authorizing

Agent

15. Set Up Equipment

2.* Present “Facts About Funerals” Publication

Information

16. Arranged Flowers

3.* Presented Funeral Merchandise 17. Arranged for Clergy/Fraternal Organization

4.* First Call Removal of Remains 18. Supervised Pallbearers or Instructed Pallbearers

5.* Prepared/Filed Required Forms – i.e. Obituary,

Clergy Data, Report of Death

19. Arranged/Supervised Cortege

6.* Arranged for Shipment/Transfer of human

remains

20. Notwithstanding

7.* Dressing, Casketing

8.* Cosmeticize Remains

9.* Check For/Removal of Pacemaker or Other

Implants

10.* Prepared/Assisted Cemetery Arrangements

11.* Assisted at Graveside Service/Alternative

Disposition

12.* Assisted at Funeral/Memorial Service/Viewing

13.* Take First Call Information

14.* Transfer Cremains into Display Urn(s) or

Alternative Container

IV. Cases:

Name Of Deceased


Number Of Supervisor

Supervisor’s

Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

*Must perform six (6) functions (burial or cremation) with an asterisk to receive credit for

a case.


____________________________ _______________ ____________ Signature of Student Provisional License Number Date

I certify that the student named above assisted in all listed tasks under the direct and personal supervision of a

licensed funeral director.

EVALUATION OF

Funeral Director TRAINING

EXCELLENT

GOOD

UNSATISFACTORY

Willingness to Perform Tasks


Quality of Work

Use of Judgment

COMMENTS:

___________________________________________ _______________________ __________________


San Antonio College S A M P L E

MORTUARY SCIENCE DEPARTMENT

MRTS 2286 Internship II Funeral Director/Embalming

Employer Satisfaction Survey

Student Name: ___________________________________

Please indicate the degree to which you agree with the following statements by circling a number. Ten (10)

is the highest value: six (6) is the lowest. If any rating is less than seven (7), please provide a reason in the

comments section, referring to that rating by the number corresponding to the statement. (Comments on

ratings higher than seven (7) are optional.)

Criteria: Rating:

_____________________________________________________________________________________

The Student:

1. Dressed appropriately according to our firm’s

dress code. 6 7 8 9 10

2. Followed instructions for assigned tasks. 6 7 8 9 10

3. Exhibited professionalism among staff

and client-families. 6 7 8 9 10

4. Showed enthusiasm for learning from me. 6 7 8 9 10

5. Will be an asset to funeral service. 6 7 8 9 10

6. Employed safe work practices. 6 7 8 9 10

7. Followed Instructions. 6 7 8 9 10

8. Exhibited reverence and respect for the dead 6 7 8 9 10

9. Will be an asset in the preparation room. 6 7 8 9 10

10. Demonstrated a desire to learn. 6 7 8 9 10

_____________________________________________________________________________________

Total: __________________________________

Comments:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Evaluator Signature and License Number: __________________________________

Date: ____________________________________

February 1, 2017

Funeral Home ___________, Manager

San Antonio, Texas 78230

Dear ___________,

This letter is to notify you of the student who has selected to serve her Embalming Internship at your establishment. Internship will begin the week of Monday, February 6, 2017 and end the week of Monday, April 3, 2017 (eight weeks total). Included are the days of the week and the shifts that the student has selected to work.

______Thursday & Friday 8:30am -4:30pm (30 min lunch break)

If you have any questions or concerns, please do not hesitate to contact me. Thank you for your continued support.

Respectfully,

Mary Mena, Internship Coordinator Mortuary Sci ence Department Office: 486-1136 Home: 674-8301

1819 N. Main Avenue I San Antonio, TX 78212-4299 11210) 486-0000 I alamo,edu/sac


SECTION 5 Acknowledgement Forms


FUNERAL HOME COPY

Signature of Acknowledgement

I acknowledge that I have received and read a copy of the San Antonio College Mortuary Science Training Manual which describes important information about students enrolled in the Mortuary Science Program that may be sent on-site to observe and/or participate in the daily operations of the funeral home, cemetery, crematory. I understand that I should consult the Mortuary Science Program should I have any questions.

Mortuary Science Program Nail Technical Center, Room #238

Direct Number: 210-486-1137 Internship Coordinator: Mary Mena, Professor

Nail Technical Center, Room # 237 Direct Office Number: 210-486-1136

___________________________________ ______________________________ Funeral Home Name Funeral Home Address

___________________________________ _________________ Funeral Home Representative Date ___________________________________ _____________________________ Title License Number

___________________________________ _________________ Mortuary Science Program Representative Date


DEPARTMENT COPY

Signature of Acknowledgement

I acknowledge that I have received and read a copy of the San Antonio College Mortuary Science Training Manual which describes important information about students enrolled in the Mortuary Science Program that may be sent on-site to observe and/or participate in the daily operations of the funeral home, cemetery, crematory. I understand that I should consult the Mortuary Science Program should I have any questions.

Mortuary Science Program Nail Technical Center, Room #238

Direct Number: 210-486-1137 Internship Coordinator: Mary Mena, Professor

Nail Technical Center, Room # 237 Direct Office Number: 210-486-1136

___________________________________ ______________________________ Funeral Home Name Funeral Home Address

___________________________________ _________________ Funeral Home Representative Date ___________________________________ _____________________________ Title License Number

___________________________________ _________________ Mortuary Science Program Representative Date


SECTION 6 Resources


RESOURCES

American Board of Funeral Service Education 992 Mantua Pike, Suite 108 Woodbury Heights, NJ 08097 www.abfse.org 816-233-3747 Mortuary Science Program 1819 N. Main San Antonio Texas 78212 www.alamo.edu/sac/mortuary 210- 486-1137 Texas Funeral Service Commission 333 Guadalupe Street Austin, Texas 78701 www.tsfc.state.tx.us 888-667-4881 512-936-2474

mortuary science program 1819 n. main ave. nail technical ......forth by the alamo colleges, the...

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