Application for Employment

EMPLOYMENT DESIRED

QUALIFICATIONS

Some positions with the Company may require employees to transport individuals in a vehicle. Therefore, a valid driver’s license may be required. Prior to hire, your driver’s license may be processed to ensure you are a valid and insurable driver.

EDUCATION

SPECIALIZED TRAINING, CERTIFICATION OF EXPERIENCE

REFERENCES

The company requires that all applicants submit four references, which may include: current or former employers, supervisors, teachers or other qualified to objectively evaluate your ability to work in the position for which you have applied. Please list reference information identified below. The Company will be contacting each reference listed.

PERSONAL REFERENCES:

We prefer to not use relatives as references.

WORK HISTORY PLEASE COMPLETE WORK HISTORY FOR AT LEAST THE LAST 5 YEARS

Begin with current or most recent employer or position with employer:

We are pleased you are interested in becoming a member of our Company. We are proud of our excellent reputation and the services we provide. We value diversity and want our work experience to be enjoyable. To help ensure a safe work environment and excellent services we carefully screen the background of all applicants. This screening may include an oral interview, as well as an investigation of your work history, driving record, application information, and reference check. Some service areas may also require an investigation of your background for any criminal conduct and an illegal drug screening.

APPLICANT DECLARATION OF UNDERSTANDINGPLEASE READ CAREFULLY AND SIGN BELOW

• I understand that the Company may conduct an investigation of the information I have provided on the application and, as part of that investigation, may contact prior and/or current employers and references, among others, including but not limited to the following:
• I authorize the Company to conduct this inve stigation and I release from all liability to hold harmless any person giving or receiving information about me relative to this investigation.
• I understand that any falsification, misrepresentation or omission of information discovered as a result of this investigation may prevent my being hired or if hired, may subject me to the immediate termination of my employment with the Company.
• I understand that this application process does not create an employment contract
• I declare that I have never committed nor been charged or convicted of any act of abuse, neglect, exploitation or fraud in relationship to dependent/vulnerable child or adult, within the past 10 years.
• I declare that I have never knowingly violated any applicable rules or laws in any previous employment in a residential, healthcare or similarly related employment.
• The Company is an equal opportunity employer and encourages diversity in employment. The Company makes all hiring decisions without regard to an applicant’s race, religion, sex, age, national origin, sexual orientation, disability or other protected classification under federal, state or local equal opportunity laws.
• The use of illegal drugs is absolutely prohibited under Company policy. Where allowed by applicable law, the Company may require employees to submit to drug testing as a condition of continued employment.