In the State of California, the opportunity for employees to adopt an alternate work week schedule is facilitated through a comprehensive agreement outlined by the California Department of Human Resources. This agreement, designed to introduce flexibility in the work environment, allows employees to deviate from the traditional 5/8/40 work week to options such as the 9/8/80 or 4/10/40 schedules, providing a structured framework for those seeking to adjust their working hours while ensuring compliance with the Fair Labor Standards Act (FLSA). Key components of the form include the recording of employee information, the selection of a preferred alternate work week schedule, and an understanding of how overtime will be computed based on the newly adopted timetable. Importantly, the agreement emphasizes the permanence of the chosen schedule barring specific exceptions like jury duty or military leave, and outlines conditions under which the agreement might be terminated. Furthermore, it highlights the importance of adhering to policies regarding leave credits and the handling of hours worked beyond the standard schedule. By signing the document, all parties involved – the employee, division chief, supervisor, and personnel officer – acknowledge their understanding and acceptance of the terms, ensuring that the alternate work week schedule is documented and officially recognized in the employee's personnel file. This system not only offers an adaptable work-life balance for employees but also maintains the integrity of work hours compensation under federal law.
| Question | Answer |
|---|---|
| Form Name | California Work Week Agreement Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | alternative agreement workweek california form, alternative work schedule agreement form california, calhr183, california alternate week agreement |
Alternate Work Week Agreement
California Department of Human Resources
State of California
1. Employee Information
Employee Name
Division
2. Alternate Work Week Schedule
Position # |
Today's Date |
Effective Date
Please indicate which Alternate Work Week Schedule you are requesting (check one).
9/8/80 Work Schedule: • Regular Day Off (RDO): (Monday - Friday)
•Date of first RDO:
•Work schedule for
•Work schedule for
4/10/40 Work Schedule: • Regular Day Off (RDO): (Monday - Friday)
•Work schedule for
Other: Specify schedule and work hours:
If you are on a 9/8/80 Alternate Work Week Schedule, your work week for overtime purposes will start
In signing this agreement, and in accordance with the provisions of the FLSA, you agree to permanently maintain your agreed upon alternate work week schedule. Periodic changes will not be permitted unless you are placed on jury duty, military leave, or
This agreement may be cancelled at any time by either you or the Department. Failure to comply with the procedures as outlined in the CalHR Alternate Work Week Policy, including maintaining a minimum of 40 hours of leave credits or other paid leave (other than sick leave), will cause you to be removed from your alternate work schedule and return you to a normal Monday - Friday, 5/8/40 work week.
3. Approval
I have read and understand the above terms and conditions of the alternate work week schedule and understand that this agreement is made in accordance with the provisions of the FLSA. I also acknowledge receipt of CalHR's policy on Alternate Work Week Schedules and understand a copy of this agreement will be placed in my official personnel file for audit purposes. I further understand that any excess hours accrued as a result of this schedule will be compensated as straight time when paid by lump sum, and any deficit hours will be charged to vacation, holiday credit, excess hours, personal leave, annual leave, CTO or approved dock.
Employee Signature
Division Chief Signature
Supervisor Signature
Personnel Officer Signature
CalHR 183 |
Page 1 of 1 |
(rev 04/2016) |