Full Name

Phone number

E-Mail

Do you have a CNA, MA or CBRF certification? (required)

Do you travel by car or by bus? (required)

Are you currently employed? If yes, how many hours per week? What shift, morning, afternoon, or night?

What do you feel your responsibilities are as a caregiver? Name at least four things. (required)

Please tell us what ADLs are.

As part of our ADLs you will be going to Dr. appointments. Have you ever done that before? If so, when and where?

What is Charting? What is a M.A.R.?

Have you provided care to people with special needs such as : Dementia, Alzheimer's, Wound Care, Wheelchair, Total Care, & feeding tube?

What are your expectations of clients?(required)

How do you handle someone with behavior issues?

How do you respond to someone who gets an attitude with you?

How do you deal with a very aggressive client?

Have you ever had conflict in the workplace? Please describe. (required)

Have you ever had conflict in life? Please describe.

How do you resolve conflict?

We hire for split shifts- morning then back in the afternoon/evening. Knowing this, do you still want to work with us?

What does the word authority mean to you?

When do you think someone in authority has gone too far?

Give an example of constructive criticism.

What would it take for your Boss to get on your nerves?

Have you had a TB skin test within the last 90 days? If not, you will need to before you begin working.

Why should we hire you?

Do you have a cell phone?

Employees are monitored by GPS during their shift using the signal from their cell phone. Are you okay with being tracked by GPS during your shift? (required)

Who is your cell phone provider?

What type of work experience do you have?

Why did you leave your last job? How long were you there for?

What do you enjoy about being a caregiver? Why are you in this field?

What do you hate about being a caregiver?

What are your strengths and weakness?

What qualities do you feel a successful Caregiver should have?

How many people during a shift have you provided care for at one time?

Have you ever passed medications? When? How?

What is M.A.R? How do you use it?

What do you do when a client refuses medication? How do you fill out the M.A.R. once they refuse meds?

Do you prefer working as a team or independently?

Can you cook? Can you clean? Please describe what it means to cook and clean well.

Explain what the word Supervision mean to you.

Have you ever had a conflict with a Supervisor? How was it resolved?

When you walk into a client's house what is the first thing you say?

What makes you lose your temper?

Have you ever been written up at work? If yes, what happened?

How do you handle a situation that could cause you to be tardy or absent from work?

Why do you want this job?

Why should we hire you?>

Is there anything in your background that we need to be aware of?

Do you have another job?

Are you unable to work weekends?

Any additional information you would like to share?

Please be aware that:
Starting pay is $9.00/hour based on qualifications
Please note that you will be expected to work a full 90 days before taking time off unless there a verifiable emergency.
Please note that you will be expected to work alternating weekends as a condition of employment.