SA Remote/Hybrid/Flex Work Proposal

The purpose of this assessment is to allow you to consider your ability and preferences surrounding remote work. If you have been working remotely, please reflect upon your experiences to better examine your 'remote/hybrid/flex-ability'. This form and process are intended for semi-permanent work arrangements. This form and process are not required for incidental or "one-off" requests, which can be approved by supervisors as needed.

Your Name

Your UCSB Email Address

Department

Working Title

HR Title

If your title does not appear in the list, please select "OTHER" and contact the VCSA Office to request that your title be added.

What is your appointment percentage?

Is your position exempt or non-exempt?

Non-exempt (hourly)

Exempt

Your Direct Supervisor's Email Address

Department Head

In some cases, this person might also be your supervisor. If you are the department head, select your control point.

Section A – Personal Traits/Preferences

Indicate an approximate fraction/percentage for each statement. Bear in mind that there are not "correct" responses to these statements; the purpose is to reflect mindfully on your capacities and preferences as they relate to remote, hybrid, and/or flexible work arrangements.

I enjoy working independently.

I manage my tasks and schedule effectively.

I have the motivation/discipline to finish tasks.

I am comfortable not having daily in-person interactions with people.

I have skills to focus on project work when necessary and understand the importance of communicating my workflows with others.

I have tools/methods to avoid overwork and working when "off the clock."

I have an internal motivation to accomplish tasks and contribute to my role in meeting the mission of my unit and UC Santa Barbara.

Section B – Home Office Space/Environment

Complete each statement below. Use red for "disagree," yellow for "somewhat agree," and green for "agree." Again, there are no "correct" responses. The purpose of the assessment is to identify aspects of your environment that are well-suited to remote, hybrid, and/or flexible work arrangements as well as aspects that need to be addressed to better support these work modalities. I have space in my offsite work environment that...

Has an adequate amount of work space for my needs.

Has adequate ergonomic equipment (e.g. chair, lighting, technology).

Has minimal distractions which allow for concentration.

Provides appropriate separation of work and home to protect my wellbeing and encourage work productivity.

Is covered by homeowner's or renter's insurance to protect business equipment.

Section C – Job Appropriateness

Complete each statement below. Use red for "disagree," yellow for "somewhat agree," and green for "agree." My job...

Requires minimal in-person interaction.

Involves spending a small percentage of time answering a campus-based phone number.

Involves a majority of tasks and responsibilities that can be accomplished virtually.

Has tasks and responsibilities that can be measured and monitored.

Affords me the flexibility to manage my work as I see most appropriate, as long as I meet expectations and deadlines.

Does not require a high degree of co-located (same place), synchronous (same time) work with other members of my team.

Offers me the ability to meet in-person with other team members, when necessary to complete work.

Are you a supervisor?

Yes (students or staff)

Section D – Proposal and Resources

Given the above self-assessment of your personal traits/preferences, offsite office space/environment, and your current position, indicate your proposed work arrangement.

Note: For non-exempt employees, "days" are defined as 8 hours worked in a single day, pro-rated based on your position's FTE. E.g., if you work 50%, a day is defined as 4 hours worked in single day.

Are you proposing a flexible schedule with this proposal?

Yes - schedule proposed below

No - regular department hours

Optional: Describe your proposed work arrangement (days, hours, etc.)

Add any detail not fully captured in the above questions.

Proposed Work Agreement Start Date

mm/dd/yyyy

Proposal Rationale

Please address the following topics in a thorough manner. Include any relevant data to support your case. • Your individual business case for entering into a Hybrid/Remote/Flexible Work Agreement. • How you will accomplish your job functions under this proposal. • Potential impacts of the work arrangement proposed here and a plan to address them.

Agreement

I understand that departments have the authority to establish, approve, or deny remote/hybrid/flexible work proposals for individual positions, and that the decisions regarding the appropriateness of such arrangements are made on a case-by-case basis based on the department's operational and business needs.

Report Abuse