Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
Dawan Antonio Anderson
Created: 02/07/2020
Other names under which employment may be verified:  
Updated: February 7, 2020

Home Address
Street Address
3518Ashland Ave
Unit/Suite Number
City ST/Zip
Steger, IL 60475
Home Phone
7088294978
Mobile Phone
7088294978
Alternate Phone

Have you ever worked for us before?   No
If no, how did you hear about us?
Rate of pay desired.   17.00
Do you have a valid driver’s license?   Yes
Do you have access to a car? No

I am able to work client who has or lives with:
Family
Yes
Hospice
Yes
Cats
Yes
Dogs
Yes
Smoker
Yes
What languages do you speak?   english
Do you have any caregiver training from other home services agencies?  Yes
If yes, explain.  Excelsior Healthcare Academy, Chicago Heights, IL

How many years have you worked as a professional caregiver?  8
What percent of your previous case work has been for an agency?  0
Please explain how you will contribute to strengthen the Water Tower Nursing team.

I am very interested in working in the medical field building on my work ethics.

My relevant qualifications include my CPR Certification. Equipping ability to handle unexpected situation, especial dealing with people of all ages and walks of life. My most recent position was as a Nursing Assistant for Franciscan Hospital in the ICU. In this role, I was responsible for Assist residents with all daily living activities, measuring and record vital signs per policy and upon direction of nurse, monitoring resident environment to ensure all safety standards are met or exceeded. Staying respectful, productive, and attentive. Delivering great customer service.

With my skill set and proven track record, I can be a valuable addition to your team. I can be reached for an interview at your convenience.

Sincerely,

Dawan A. Anderson

Please share one or more personal or professional experiences you have had as a caregiver.

Availability

Days   Yes
Nights   Yes
Weekdays   Yes
Weekends   Yes
Live-in   Yes
Can you travel outside the city of Chicago to work?   No

Education

High School   Bloom Trail
Location:   Chicago Heights, IL
Did you graduate?   Yes
Subjects Studied   General Education/ AP Communications

College   
Location:   
Did you graduate?   
Degree:   

Other:   
Location:   
Did you graduate?   
Degree:   

Special awards you earned or courses you have taken.

Military Service

U.S. Military or Naval Service   No
Military branch and rank at discharge:   

Licenses and Certifications

EMPLOYMENT HISTORY

Company Name
Glenwood Health Care & Rehab
Phone
(708) 758-6200
Address

19330 S Cottage Grove Ave, Glenwood, IL 60425

Supervisor
Brian
Job Title
Certified Nursing Assistant
Salary or Rate of Pay
0.00
Responsibilities
Provide high-quality patient care as an in-demand per-diem CNA within surgical, acute-care, rehabilitation, home-healthcare and nursing-home settings. ▪ Preserve patient dignity and minimize discomfort while carrying out duties such as bedpan changes, diapering, emptying drainage bags and bathing. ▪ Commended for chart accuracy, effective team collaboration, patient relations and consistent delivery of empathetic care.
From
04/01/2013
To
05/06/2013
Reason for Leaving
Clinical
May we contact this employer?  Yes

Company Name
St. James Manor & Villas
Phone
(708) 672-6700
Address

1251 E Richton Rd, Crete, IL 60417

Supervisor
Angela
Job Title
Certified Nursing Assistant
Salary or Rate of Pay
15.00
Responsibilities
Provide high-quality patient care as an in-demand per-diem CNA within surgical, acute-care, rehabilitation, home-healthcare and nursing-home settings. ▪ Preserve patient dignity and minimize discomfort while carrying out duties such as bedpan changes, diapering, emptying drainage bags and bathing. ▪ Commended for chart accuracy, effective team collaboration, patient relations and consistent delivery of empathetic care.
From
01/01/2014
To
01/01/2015
Reason for Leaving
School/Hours
May we contact this employer?  Yes

Company Name
Franciscan Health
Phone
(708) 646-7436
Address

20201 Crawford Ave, Olympia Fields, IL 60461

Supervisor
Vallyn
Job Title
Certified Nursing Assistant
Salary or Rate of Pay
16.00
Responsibilities
Provide high-quality patient care as an in-demand per-diem CNA within surgical, acute-care, rehabilitation, home-healthcare and nursing-home settings. ▪ Preserve patient dignity and minimize discomfort while carrying out duties such as bedpan changes, diapering, emptying drainage bags and bathing. ▪ Commended for chart accuracy, effective team collaboration, patient relations and consistent delivery of empathetic care.
From
01/04/2016
To
01/02/2017
Reason for Leaving
Relocated
May we contact this employer?  Yes

Company Name
St. Pauls House
Phone
7088294978
Address

3800 N California Ave, Chicago, IL 60618

Supervisor
Kim
Job Title
Certified Nursing Assistant
Salary or Rate of Pay
16.75
Responsibilities
▪ Provide high-quality patient care as an in-demand per-diem CNA within surgical, acute-care, rehabilitation, home-healthcare and nursing-home settings. ▪ Preserve patient dignity and minimize discomfort while carrying out duties such as bedpan changes, diapering, emptying drainage bags and bathing. ▪ Commended for chart accuracy, effective team collaboration, patient relations and consistent delivery of empathetic care.
From
01/02/2017
To
01/01/2019
Reason for Leaving
Unhealthy Work Conditions
May we contact this employer?  Yes

 

REFERENCES & ACCEPTANCE

Thank you for entering your employment history in Part Two. Before proceeding, could you please explain any gaps in your work history.
No gaps or no explanation provided.
Character References
Please provide the names and contact information for three persons, not related to you, whom you have known for at least one year.
Name
Angela Turner
Phone
7088433835
Address
Chicago, IL
Relationship
Registered Nurse (Former Co-worker)

Name
John Doyle
Phone
(815) 545-6225
Address
New Lenox, IL
Relationship

Name
Vallyn Guliano
Phone
7086467436
Address
Willow-brook,IL
Relationship
Registered Nurse (Former Co-worker)
Additional Information
Feel free to add any notes or additional information to your application in the space provided below.
No additional notes provided.
Thank you for entering your employment history. If gaps exist in your employment history, please explain the gaps here.
No gaps or no explanation provided.
Additional Certifications
No additional certifications or licenses provided.

Have any of your certifications or licenses been suspended or revoked?  
If yes, explain.  
Resume Upload (optional)
If hired, would you be able to provide a copy of your Social Security Card?* (IDPH requirement)
Yes

I certify that the information contained in this application is true and correct to the best of my knowledge and I understand that falsification of this information is grounds for refusal to hire, or if hired, termination of my employment.

I agree that my employment is at-will and may be terminated or an offer of employment may be withdrawn by Water Tower Nursing and Home Care, Inc. (WTN) at any time, with or without notice, and for any lawful reason.

I understand that as a condition of employment and for continued employment, WTN may require periodic drug testing. I understand WTN will use the information gathered on this employment application to conduct background checking and will contact my references and agree to such references giving WTN any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I hereby release WTN, its shareholders, officers, directors, employees and agents from any an all liability for any damage that may result from the collection or utilization of such information in connection with evaluating my potential employment.

I understand if hired, I will be required to produce documentary evidence proving that I am currently authorized to work in the United States. I understand my continued employment is contingent upon providing proof of continuing work authorization upon expiration of any documents provided at time of hire. I understand I will have to provide a copy of my Social Security card upon hire as required by the Illinois Department of Public Health (IDPH).

I understand and agree that no representative of WTN has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to foregoing, unless it is in writing and signed by WTN’s President.

Accepted by
Dawan Anderson

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
February 7, 2020
This application has been submitted and can no longer be edited.