Employment Eligibility Verification

Employment Eligibility Verification
Name*

First NameLast Name
E-mail*
Do you have at least 2 years of caregiver experience?*

YesNo
Are you registered with the State of California as a Home Care Aide?*

YesNo
Are you at least 21 years or older?*

YesNo
Do you have personal care experience?*

YesNo
Do you have a positive work attitude?*

YesNo
Do you have a strong work ethic?*

YesNo
Are you fluent in English? (spoken and written)*

YesNo
Do you currently have a valid driver's license that is in good standing?*

YesNo
Do you have daily access to a reliable vehicle with current registration and valid proof of insurance?*

YesNo
Have you had LiveScan Fingerprinting in the past?*

YesNo
Do you love helping others?*

YesNo
Are you CPR certified?*

YesNo
Have you had a negative TB test or chest X-ray within the last two years or able to complete one within 7 days of hire?*

YesNo
Are you eligible to work in the United States?*

YesNo
Do you understand that drug testing can be done at random?*

YesNo
I hereby certify that the information I have provided or indicated above is true to the best of my knowledge. I understand that providing false information may result in disqualification for employment eligibility and consideration.*

I agree
Upon selecting the "Submit" button below, your answers will be assessed. Those who are eligible to submit job applications based on the answers provided will receive an e-mail momentarily containing a link to complete your employment application.
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