EMPLOYMENT OPPORTUNITIES

Horizon Support Services, Inc is currently seeking caring, compassionate, dependable caregivers
to provide non-medical assistance to the elderly and disabled adults.

Employment is contingent upon meeting all job requirements listed and submitting all necessary documents.

Are you a compassionate caring and patient individual who is looking for a rewarding position as a care giver? If so, we encourage you to apply

We can work around your schedule.
Flexible Schedules – we offer days, evenings, nights, weekends, hourly and live-in positions.
We offer competitive pay and several incentive programs.
Providing care in a relaxed home environment allows you and your client to bond and build a lasting relationship.
We offer continuous in-service training and regular evaluations.

JOB REQUIREMENTS

►Have a minimum of 2 years experience providing care for the elderly or the disabled
►Read, write and speak fluent English (Bi-lingual is a plus)
►Complete an application with verifiable references
►Complete a competency test
►Have a current valid CALIFORNIA Drivers License
►Have a DMV & Background clearance with no infractions
►Own or posses a vehicle for work purposes
►Have current CALIFORNIA vehicle registration
►Have automobile insurance
►Have a valid Social Security Card with eligibility to work in the U.S.
►Current negative T.B. Test

If you meet these requirements, then you would be a good candidate to join our team.

Please read every section carefully and answer each question as required.

First Name *

Last Name *

Address *

City *

State

Zip Code *

Phone *

Alternate Phone *

Email Address *

Which position are you applying for? *

Companion/Homemaker

Care giver/Personal Care Assistant (PCA)

Certified Nursing Aid (CNA)

Certified Home Health Aid (CHHA)

Medical Assistant

Licensed Vocational Nurse (LVN)

Which certifications or licenses do you currently have?

Personal Care Assistant (PCA)

Certified Nursing Aid (CNA)

Certified Home Health Aid (CHHA)

Medical Assistant

Licensed Vocational Nurse (LVN)

How many years experience do you have caring for seniors or the disabled? *

1 Year

2+ Years

5+ Years

10+

Did you graduate High School or obtain your GED? *

Yes

Are you currently attending school? If yes, where at?

Did you graduate from college or trade school? *

Yes

If yes, please list name of School, City and certification or graduate

Can you work a live-in position? *

Yes

Please indicate the minimum Live- In pay you will accept per day

Please indicate the minimum hourly pay you will accept *

What schedule are you available to work? Check all that apply. *

Week Days - Day Shift

Week Days - Evening Shift

Week Days Night Shift

Weekends - Day Shift

Weekends - Evening Shift

Weekends - Night Shift

How far are you willing to travel? *

1-20

21-30

31+

Do you have a vehicle to drive to work? *

Yes

Do you have a valid CALIFORNIA driver's license *

Yes

Have you ever had a driver's license suspended or revoked? *

Yes

If yes, please give the dates and details

Have you ever been convicted of a misdemeanor or felony, including sex-related or child abuse offences? *

Yes

If yes, please give the dates and details:

Please list all moving traffic violations in the last five (5) years

Note: Answering “yes” to these questions does not constitute an automatic bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account.

#1 Company Name *

List company name of previous employer starting with the most recent first

#1 Supervisor *

Phone number *

Address *

City *

State *

Zip

Job Title and Duties *

#1 List dates of employment *

Example: From January 2011 To Present

Reason for leaving? *

May we contact this Employer?

Yes

#2 Company Name *

#2 Supervisor *

Phone number *

Address *

City *

State *

Zip

Job Title and Duties *

#2 List dates of employment *

Example: From January 2011 To Present

Reason for leaving? *

May we contact this Employer? *

Yes

Tell us a little about your self and why you feel that you would be a good candidate for a position with our company. *

Employment Agreement

I authorize the above work experience and references to be contacted. I also understand that misrepresentation or omission of the facts on this application will result in my failure to receive an offer of employment or for dismissal in the ivent that I am employed. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the company or any of its agents, employees or representatives.

I understand that all offers of employment are conditioned on the provisions of satisfactory proof of an applicant’s identity and legal authority to work in the U.S., passing clearance of criminal background, DMV/Driving report free of any violation points.  Offers of employment are also conditioned on the company’s receipt of satisfactory responses to reference requests and the satisfactory completion of a post-offer medical examination as applicable to the position, verification of professional licensure and skills competency acceptability as applicable for the position.

Please indicate if you agree or do not agree to the terms of this employment application. *

I Agree

I do not agree

Employment

EMPLOYMENT OPPORTUNITIES

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