Registered Nurse (RN)Reports To: Day Program Manager
Department: Mosaic Medical Model Adult Day Programs
Position SummaryThe Registered Nurse Clinical Program Administrator provides clinical leadership and clinical administrative oversight of health care systems across WTC's Mosaic medical model adult day programs. The position is accountable for safe nursing practice, clinical compliance, supervision of Licensed Vocational Nurse staff, review of medical admissions, health related staff training, and the integration of each client's health needs into person centered services.
The RN works in partnership with the Day Program Manager and Program Coordinators. Program Coordinators retain responsibility for daily client programming, client conferences, DSP supervision, activities, and the overall client experience. The RN has clinical authority when a matter involves nursing practice, physician orders, medications, restricted health conditions, infection control, emergency response, or medical safety.
Role Boundaries and Working RelationshipsClear division of responsibility is essential to the two-program model. The RN leads clinical systems across both locations while each Program Coordinator leads service delivery within the assigned program.
- Directly supervises LVN staff and evaluates their nursing performance.
- Provides clinical direction to DSPs and DSP Leads but does not serve as their administrative supervisor.
- Consults on activities and client goals when health needs affect participation; the Program Coordinator remains the lead for programming and client conferences.
- Leads communication about medical matters and keeps the Program Coordinator informed when health information affects attendance, activities, staffing, or service delivery.
- Escalates unresolved operational, staffing, or compliance concerns to the Director of Client Services and other designated leadership.
Essential Duties and ResponsibilitiesClinical Leadership and Nursing Practice- Assess and monitor client health needs and changes in condition and provide nursing intervention, referral, and follow up within the RN scope of practice.
- Review and implement physician orders, medication orders, individualized health care plans, restricted health condition plans, emergency protocols, and related nursing documentation.
- Provide, delegate when legally permitted, or oversee nursing services that may include medication administration, enteral nutrition and hydration, diabetes care, skin and wound care, positioning, catheter and ostomy care, inhalation assistance, and tracheostomy related supports.
- Establish clinical expectations and provide timely direction when a health or safety issue requires immediate action.
- Communicate with physicians, pharmacies, families, care providers, Regional Center personnel, and other health professionals about medical matters within applicable privacy and consent requirements.
- Other Duties as assigned
Cross Program Administration and Compliance- Maintain clinical oversight across both Mosaic programs and support consistent nursing systems, documentation standards, and health and safety practices at each location.
- Monitor compliance with Community Care Licensing requirements, Title 22, applicable nursing laws and standards, WTC policies, program designs, physician orders, and client specific health plans.
- Provide required RN oversight for programs using LVN services, including at least eight hours per month at the existing Mosaic program or a greater amount when required by law, regulation, program design, client need, or agency direction.
- Prepare for and participate in licensing reviews, surveys, audits, investigations, corrective action plans, quality assurance activities, and policy updates involving health services.
- Monitor clinical incidents, medication variances, changes in condition, infections, skin concerns, hospitalizations, and other trends; ensure appropriate assessment, notification, documentation, and follow up.
- Evaluate clinical staffing, supplies, adaptive equipment, emergency equipment, and facility conditions and recommend corrective action when needed.
Supervision Training and Competency- Recruit, orient, supervise, coach, and evaluate LVN staff in coordination with Human Resources and program leadership.
- Develop, provide, or approve health related training for LVNs, DSPs, and DSP Leads, including medication practices, infection prevention, hydration, positioning, skin integrity, emergency response, and client specific protocols.
- Validate and document staff competency for health-related procedures as required and suspend a task assignment when competency or safety cannot be assured.
- Collaborate with Program Coordinators on DSP performance concerns involving medical care, documentation, health protocols, or safety expectations.
- Participate in staff meetings and promote respectful teamwork between nursing and direct support staff.
Admissions Service Planning and Client Conferences- Supports the medical review of prospective admissions and confirm that required orders, medications, health plans, equipment, staffing supports, and emergency information are available before services begin.
- Advise program leadership whether identified health needs can be safely supported within the applicable program design, staffing model, license, and scope of practice.
- Provide clinical information and recommendations for person-centered planning without unnecessarily limiting client choice, participation, or independence.
- Participate in client conferences when medical issues, changes in condition, or health related decisions need to be addressed; present and own the medical portion of the discussion.
- Complete assigned follow-up and provide the Program Coordinator with relevant clinical information needed for goals, activities, schedules, and support planning.
Documentation and Communication- Maintain accurate, timely, and confidential nursing records, medication records, assessments, physician orders, health care plans, training records, and required reports.
- Ensure that medication changes, new orders, hospital discharge instructions, and significant health information are communicated to the appropriate staff and incorporated into current plans.
- Keep the Director of Client Services, Day Program Manager, and Program Coordinators informed of significant health, safety, staffing, licensing, or compliance concerns.
- Use WTC computer and mobile systems to communicate, review information, and complete documentation.
Decision Authority- May issue clinical direction to Mosaic staff when necessary to protect client health or comply with orders, plans, law, regulation, or nursing standards.
- May stop or modify a health-related procedure, outing, or service activity when an immediate clinical risk exists and promptly communicates the reason and next steps to program leadership.
- Recommends admission conditions, staffing supports, clinical equipment, and corrective action; final organizational decisions remain with authorized WTC leadership except where nursing law requires independent professional judgment.
Core Competencies- Clinical judgment and accountability
- Regulatory compliance and documentation
- Staff supervision training and competency development
- Interdisciplinary communication and collaboration
- Person centered problem solving and respect for client choice
Minimum Qualifications- Current active California license as a Registered Nurse in good standing.
- Current First Aid and CPR certification, or ability to obtain and maintain certifications within the timeframe established by WTC and applicable requirements.
- Demonstrated ability to provide clinical oversight, supervise licensed nursing staff, organize work across more than one program location, and communicate clearly with nonclinical staff and support teams.
- Ability to use WTC computer and mobile applications for communication, documentation, scheduling, and record review.
- Ability to maintain confidentiality and professional boundaries and to represent WTC appropriately with clients, families, care providers, agencies, and community partners.
- Ability and willingness to work overtime as required.
Preferred Qualifications- Experience supporting adults with developmental disabilities or complex medical needs in an adult day, community based, school, residential, or long-term care setting.
- Experience supervising LVNs and providing clinical training or competency validation to direct support staff.
- Knowledge of person-centered practices, positive behavior supports, Community Care Licensing requirements, medical model adult day services, and restricted health condition requirements.
- Experience with licensing surveys, quality assurance, incident review, and corrective action planning.
Physical and Working ConditionsThe employee regularly stands, walks, bends, reaches, uses hands, communicates verbally, and may sit for extended periods. Adherence to established dress standards. The position may require assisting with transfers and positioning, operating mechanical lifts, responding to health emergencies, and providing physical assistance to persons receiving services. Vision requirements may include close, distance, color, peripheral, and depth perception and the ability to adjust focus. Local travel between program locations is required. Reasonable accommodation will be provided as required by law.
Pre Employment and Ongoing Requirements- Must be at least 18 years of age.
- Valid California driver license and driving record acceptable to WTC when driving is an assigned function.
- Required Department of Justice and or FBI fingerprint clearance.
- Ability to satisfy required drug screening, medical examination, tuberculosis screening, and ongoing health requirements.
- Maintenance of required professional license, certifications, training, and adherence to WTC dress and safety standards.
Full-Time: Monday-Friday
30+ hours a week
