PAID SICK LEAVE REQUEST FORM

An employee qualifies for paid sick leave by working for an employer on or after January 1, 2015, for at least 30 days within a year in California and by satisfying a 90 day employment period (which works like a probationary period) before an employee can actually take any sick leave. You begin to accrue paid sick leave on July 1, 2015, or your first day of employment if you are hired after July 1, 2015. If you have worked less than 90 days for Santa Cruz Staffing, you are not entitled to take paid sick leave.

Starting July 1, 2015, employees will earn at least one hour of paid leave for every 30 hours worked. You are allowed to take up to 24 hours (three days) in one year. If your job ends and you get rehired with Santa Cruz Staffing within 12 months, you can reclaim your hours. Hours are not “paid out” at any time. An employee is entitled to use (take) paid sick leave only after meeting the qualifications for paid sick leave and accruing enough paid sick leave time to use for one of the stated purposes of the law. You can take paid leave for you or a family member for preventive care or care of an existing health condition or for specified purposes if you are a victim of domestic violence, sexual assault or stalking. Family members include the employee’s parent, child, spouse, registered domestic partner, grandparent, grandchild, and sibling. Preventive care would include annual physicals or flu shots. For partial days, you must take at least two hours of leave.

To request Paid Sick Leave please fill out this form. Your check stub will provide you with the number of hours that you have accrued. The form must be filled out and sent to Santa Cruz Staffing with your timecard.

*PLEASE NOTE THAT ANY REQUEST SUBMITTED AFTER NOON ON MONDAY WILL BE PROCESSED THE FOLLOWING WEEK. REQUESTS MUST BE SUBMITTED WITHIN A WEEK OF THE DAY REQUESTED FOR PAID SICK LEAVE*

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