Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
Aileen Prudente Benedicto
Created: 04/03/2020
Other names under which employment may be verified:  
Updated: April 3, 2020

Home Address
Street Address
7501 160th place
Unit/Suite Number
City ST/Zip
tinley park, IL 60477
Home Phone
Mobile Phone
7088130625
Alternate Phone

Have you ever worked for us before?   No
If no, how did you hear about us?
Rate of pay desired.   $25
Do you have a valid driver’s license?   Yes
Do you have access to a car? Yes

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, tagalog
Do you have any caregiver training from other home services agencies?  Yes
If yes, explain.  Bethshan Association

How many years have you worked as a professional caregiver?  9
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 compassionate, dependable and capable of multi tasking in a fast paced environment. Stay focused with positive attitude and team work in the healthcare team.

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

Supervise and assists individual with disabilities to lead a self-directed life and self-reliant life to be able to contribute and become a productive member of the community.

* Encourages individuals with disabilities through positive motivation in performing meaningful tasks/activities of daily living as required by instilling to these individuals the right attitude and good behavior that will enhance inclusion.

* Provide adequate support to these individuals with disabilities at home, work, school, church and other community places.

* Act as an effective and compassionate advocate for persons with disabilities and special needs in communicating their specific needs, appropriate self expressions and realistic goals.

Availability

Days   Yes
Nights   Yes
Weekdays   Yes
Weekends   Yes
Live-in   Yes
Can you travel outside the city of Chicago to work?   Yes

Education

High School   
Location:   philippines
Did you graduate?   Yes
Subjects Studied   

College   
Location:   philippines
Did you graduate?   Yes
Degree:   

Other:   
Location:   
Did you graduate?   
Degree:   

Special awards you earned or courses you have taken.
BS Psychology and BS Nursing

Military Service

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

Licenses and Certifications

EMPLOYMENT HISTORY

Company Name
Bethshan Association
Phone
7083712911
Address

12927 S. Monitor, Palos Heights IL 60463

Supervisor
Beth Toeset Boss
Job Title
Administrator
Salary or Rate of Pay
$16.80 per hour
Responsibilities
I am essentially responsible for their activities of daily living, making sure therapies and programs performed and making sure they are taking care off in every aspects of their lives
From
11/16/2011
To
04/03/2020
Reason for Leaving
i want new challenges for better career growth, opportunities and learnings
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.
i was in the army, armed forces of the philippines for 10 years before i worked at Bethshan
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
Kathleen Zulvic
Phone
+1 (773) 814-8136
Address
12927 S Monitor Ave Palos Heights
Relationship
Case Manager

Name
Michele Hines
Phone
(708) 308-6504
Address
12927 S Monitor Ave Palos Heights
Relationship
Case Manager

Name
Lilibeth Rupisan
Phone
(708) 407-3667
Address
12927 S Monitor Ave Palos Heights
Relationship
Supervisor
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.
i was in the army, armed forces of the philippines for 10 years before i worked at Bethshan
Additional Certifications
No additional certifications or licenses provided.

Have any of your certifications or licenses been suspended or revoked?  No
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
aileen p benedicto

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
April 3, 2020
This application has been submitted and can no longer be edited.