We are hiring experienced/certified caregivers & New "ADDITIONAL SERVICE TECHS" now!
Select Your Experience Level Here
No experience, training needed
Caregiver for family
2 Yrs Exp Caregiver
1 year Experienced Caregiver
Patient Care TECH
Certified Nursing Assistant
Certified Medical Assitant
List your job knowledge or skills in non-medical direct care
(example: bed baths,tranfers, ROM, bowel/bladder care)
List conditions you are familiar with
(ex: Alzheimer's Disease, Parkinson's, Spinal Cord Injury)
Employment information: List your last three Employer's Names
(Example: "Happy Homecare")
Business References: List three of your past/present supervisors and contact information
Schooling / Education: List all
Are you taking any medications that would inhibit your ability to care for others?
Tell us more about yourself:
Do you have any physical restrictions that limit your ability to lift 50 lbs, bend, walk, or clean a home?
Are you interested in being a part of our "Extra Services Team?" These jobs help us reach more people in the community.
In which if any of the following "extra services" do you have experience? (select all that apply)
Pet Care (dogs, cats, fish)
1. This position may require driving on the job. Do you have a valid driver's license, current insurance and working car today?
2. If your transportation fails, how do you plan to get to work?
Friend or Family will drive me
I would have to call off work
What other sources of transportation might you use in an emergency?
3. Which of these best describes your thoughts about honesty?
(select all that apply)
People are usually honest unless they're in trouble.
You can't trust anyone really.
I know a lot of people who would never lie.
I would not even lie for my employer or my friend.
There are levels of honesty: unharmful white lies, hurtful lies, stealing little things, and criminal dishonesty
I swear to tell the truth, the whole truth and nothing but the truth. No white lies, grey or inbetween.
4. Which of these is true in your opinion? (select all that apply)
Everyone uses drugs at some point in his/her life
Some people can keep a drug habit secretly for years.
Most people get high on the weekends.
People who avoid drugs are the most responsible
5. Which of these is true for you? (select all that apply)
I am trying to repair my credit history.
I enjoy reconciling my checkbook.
I have pretty good credit.
I have excellent credit.
I do not discuss my credit history. It's personal.
6. Why do you think people steal?
Hard life, no money; they have no choice.
They are addicted to it, like a drug habit.
Most people try stealing at some point in their lives.
Some people have no conscience, (they don't care that it's wrong)
Some people just make mistakes
7. Why do you think MOST PEOPLE go to prison?
Wrong place at the wrong time.
They are guilty of crimes.
Down on their luck in life.
8. Which of these statements BEST describe your views on theft?
Unfortunately, some people have to steal to survive.
Everyone steals at some time.
Shoplifting is very common amongst my peers .
I do not know anyone who steals.
If I saw someone stealing, I'd report it.
Some people don't know any better.
9. This job may require decisions with money. How are you with money? (select all that apply)
I'm not good with budgeting or math.
I prefer not to handle my finances. Someone helps me.
I'm good at budgeting, a careful spender.
I have my own checking account, debit card, savings and I know how to use them.
I have worked with money as a cashier, teller or other trustworthy positions.
I just use cash, nothing complicated.
10. Which of these statements describe you? (select all that apply)
If everything goes well I'm on time.
It is always my intention to be on time but emergencies do happen once in a while.
I am rarely late for work, even in bad weather.
I'm usually early for work, school and appointments. I hate being late.
I usually run in the door to arrive barely on time or a minute late.
I prefer flex time. If I arrive late, I'll stay late.
11. Some CLIENTS may have challenging personalities. Which types of people would you find too difficult to work for? (select all that apply)
People who talk down to me.
People who have a speech impediment.
People who try to control me.
People who do not speak English very well.
People who think they are better than others.
People who smoke.
People who don't try to help themselves even though they can.
People who are moody.
People who have no sense of humor.
People who gripe and complain.
Difficult people don't bother me.
Other PERSONALITY types you cannot work for:
12. Finish this sentence: Elderly or disabled people...
...make me uncomfortable.
...are all mentally slow, depressed and helpless.
...have no purpose left in life, they just exist.
...are very interesting to talk to and listen to.
...should be as active as possible, having fun.
...may be grumpy sometimes but it doesn't bother me.
13. Finish this sentence: If anyone is rude to me...
...I snap back to put him in his place.
...I leave the scene, avoiding confrontation.
...I use a gentle answer.
...I go silent and ignore him.
...I shove him to let him know not to mess with me.
14. Ways that I try to save money include...
I use coupons.
I don't claim all that I earn on my tax return.
I sneak my friends, kids, myself into movie theatres.
I watch the papers for sales.
I make copies of rental movies instead of buying them.
I get discounts by shopping where my friends work.
15. In spending time with clients on the job, you may have conversations about things you enjoy. Using your discretion, which of the following past times are appropriate discussion subjects or activities? (select all that apply)
TV shows I like:
Books I like:
Oija Boards and Seances
Surfing for pornography
Gossip and life's problems
Sewing or knitting
Getting drunk with friends
16. Reasons why I have called off work with less than 24 hours notice: (check all that apply)
I was ill.
Not enough money to buy gas.
Family member is sick.
Appointment I forgot about.
Emergency in the family.
My babysitter was unable to help me.
My pet was sick, ran away, etc.
No busses running that day.
Lost car keys.
17. Reasons why you have been late for work: (check all that apply)
Office communication error.
18. Until what date (approx) were you last employed?
I'm presently employed.
19. What was your last job and how did it end?
20. What did you like most about your last past job?
21. What did you like least about your last employer?
22. Finish this sentence:
When a co-worker or client tells me the latest complaint about another co-worker or office employee,... I listen politely .
I add my opinion.
I ask questions to validate the complaint.
I pass on the complaints to others to warn them.
I change the subject quickly so as not to gossip .
I suggest that they speak to a manager .