Employment Opportunities

To apply for employment please fill out the forms below in full.

    Application For Employment

    * is a required field Are you either a U.S. Citizen or an alien who has the right to remain and work in U.S.? YesNo

    Have you ever been convicted of a crime? YesNo Are there any criminal charges against you?* YesNo Have you ever had a non-criminal ongoing investigation of abuse, neglect or Misappropriation of resident property that involves you?* YesNo

    HEALTH

    Do you have any allergies to food, pets, and etc?* YesNo

    WORK HISTORY

    (LIST LAST JOB FIRST)

    Employment History

    EMPLOYMENT AVAILABILITY

    Monday Available from AM to PM Tuesday Available from AM to PM Wednesday Available from AM to PM Thursday Available from AM to PM Friday Available from AM to PM Saturday Available from AM to PM Sunday Available from AM to PM Please select below if available for live-in:

    REFERENCES

    Two persons not related to you

    Employee Skills Checklist

    Directions: Please carefully assess your strengths and select the appropriate experience level for each skill. Please put appropriate skill level next to all skills mentioned below. 1 = Expert 2 = Experienced 3 = Familiar 4 = No Experience

    Personal Care ADL

    Bed Bath Sponge Bath Tub Bath Shower Nail & Skin Care Hair Care Oral Hygiene Brush Denture Care Shave/Razor Assist w/ dressing

    Meal Preparation

    Assist w/ Feeding Diabetic Diet Low Sodium Diet Special Diet Instructions

    Client Transportation

    Assist in/out of wheelchair Use of manual wheelchair Use of electric wheelchair

    Transfers

    Assisting from chair to stand Stand to a chair Assisting in/out shower Hoyer Lift

    Elimination

    Use of bed pan Use of bedside commode

    Housekeeping Duties

    Washing clothes Folding clothes Dishes Mop Floors Vacuum Grocery Shopping/Errands Dusting

    Education