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In-Home Caregiver (HCA) | Bilingual Spanish/English Preferred | Lancaster, CA
A Better Solution In Home Care
Basic Information
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Personal Information
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Position Applying For
What do you like most about working with the elderly, disabled, or convalescing client?
What do you find most challenging in this type of work?
Emergency Contact
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Transportation
Do you have a car?
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If you don't have a car how would you get to work?
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Availability
How many hours can you work weekly?
Are you available to work nights?
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Are you legally authorized to work in this country?
Yes
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Would you consider live-in?
Yes
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Employment Desired
Full Time
Part Time
Full or Part Time
Are you available to work weekends?
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Available to Start Date
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Education
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Certifications and Professional Licenses
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Expiration Date
License
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Expiration Date
Attributes - Please indicate whether you have assisted or performed the following tasks
Companionship
Yes
No
Dressing / Grooming
Yes
No
Meal Preparation
Yes
No
Transferring
Yes
No
Light Housekeeping
Yes
No
Incontinence Care
Yes
No
Bathing / Showering
Yes
No
Dementia / Alzheimers
Yes
No
Additional Skills
Employment History (list most recent first)
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Application Questions
Do you have a valid Home Care Aide Certification?
Yes
No
Do you have experience in Working with individuals with neurological conditions?
Yes
No
Do you have a TB test within the last 90 days?
Yes
No
Are you comfortable passing a background check process?
Yes
No
Do you speak Spanish?
Yes, fluently
Yes, conversationally
No
Additional Information
Cover letter (optional)
Portfolio (optional)
Required Documents
1. Home Care Aide (HCA) Registration ID – a copy of your current HCA registration
2. TB Test Results – must be dated within the last 90 days