1200 E. California Blvd.

Division or Department Name Pasadena, CA 91125

Date:
TO: Name of Employee

FROM: Name of Manager

SUBJECT: Telecommuting Guidelines

Telecommuting Guidelines

For the purpose of this work arrangement, Telecommuting shall be defined as a

temporary work arrangement that allows the staff member to fulfill a portion of
his/her primary job responsibility at a location other than his/her Caltech work
site, such as home.

The needs of the department and the Institute shall be taken into account when
this work arrangement is approved. The supervisor, the department head and
the Director of Employee and Organizational Development or their designee for
Human Resources must approve this option.

Staff members suited for telecommuting are self-disciplined, self-motivated and

comfortable working alone. Job characteristics of a position suited for
telecommuting typically require minimum supervision and minimum face-to-face
contact. Telecommuting should include work activities with clearly defined and
measurable deliverables.

Telecommuters who work from home are responsible for having a designated
work area. Telecommuters who require home adjustments are responsible for
any costs related to remodeling and the initial setup of designated workspace.
Tax implications related to the off-site work area are the responsibility of the staff
member, who is advised to consult a tax professional.

Telecommuters who are in an overtime eligible position are responsible to report

their actual time worked, in and out times for meal periods, and/or absences
accurately and completely for each day.

Any work-related accident, injury, or illness which occurs while telecommuting

should be reported immediately to the staff member’s supervisor and to the
Leave and Disability Unit at (626) 395-3092 or [email protected].

Equipment needs for telecommuting are determined on a case-by-case basis

between the supervisor and staff member. Caltech will not provide
telecommuting equipment unless it is justified based on the needs of the
department and the nature of the work assignment. The decisions as to type,

Updated 7.2018
nature, function and/or quality of electronic hardware, modems, systems access,
data and phone lines rests entirely with the supervisor in coordination with the
appropriate computing support department. If equipment is provided by Caltech,
the telecommuter agrees that the use of the equipment, software, data and
supplies provided by their department is limited to authorized persons and for
Caltech related purposes only. Staff members using their personal equipment
are responsible for any loss, damage or wear to their personal equipment. Staff
members agree to abide by software licensing agreements.

Telecommuting Location

The location of the telecommuting assignment may have an effect on payroll

taxes and the health and welfare benefit options available to the telecommuter.
Please indicate the city and state where the employee will work when
telecommuting.
City
City: ___________________ State
State: ____________________

It is important that out-of-state telecommuting arrangements be discussed with

Employee and Organizational Development as soon as possible, and prior to
finalizing a start date for the arrangement. Please note that in some cases it may
take up to several months to set up payroll for an out-of-state telecommuting
arrangement.

Assignments

It is anticipated that you will telecommute no more than ___hours per week of
your regular ___ hour per week schedule.

The following is an abridged list of assignments and does not include continued
responsibilities regarding issues and questions of the division’s/department’s
function which you are expected to maintain, or other items that may be added
during weekly meetings.

1. ____________________________________________________________
List assignments here
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________

Additional Job Assignments/Duties

Updated 8.2018
Technical Support

If necessary, I will notify IMSS of technical support needs once this

arrangement is approved by Human Resources.

Effective Dates

The effective dates of this alternative work arrangement are MM/DD/YY - MM/DD/YY ;
however; the telecommuting schedule may be modified or cancelled at any time
at the department’s discretion. Should additional time be required, an extension
of this arrangement may be approved at the discretion of the department and
Employee and Organizational Development. Telecommuting agreements
should, at a minimum, be reviewed on an annual basis to ensure that the
arrangement continues to meet the needs of the department and Institute.

I have read and understand this agreement:

Employee Signature Date

********************************************************************************************

Approvals

By signature below, the staff member’s supervisor and department head have
approved this telecommuting arrangement for the dates specified.

__________________________________
_____________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________ _______________________________________________________
________________
Supervisor Date

___________________________________ _________________
Division Administrator or Department Manager Date

___________________________________ _________________
Employee and Organizational Development Date

Updated 8.2018