Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
Allan P Bacho
Created: 05/28/2020
Other names under which employment may be verified:  
Updated: May 28, 2020

Home Address
Street Address
4113 West Barry Ave.
Unit/Suite Number
City ST/Zip
Chicago, IL 60641
Home Phone
7732262324
Mobile Phone
7732262324
Alternate Phone
Email Address

Have you ever worked for us before?   No
If no, how did you hear about us? From a caregiver friend
Rate of pay desired.   $15/hour
Do you have a valid driver’s license?   No
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, tagalog
Do you have any caregiver training from other home services agencies?  Yes
If yes, explain.  In house training from ARC Homecare and Nursing Professionals and InHome Personal Services, Inc

How many years have you worked as a professional caregiver?  0.8
What percent of your previous case work has been for an agency?  0.8
Please explain how you will contribute to strengthen the Water Tower Nursing team.

My contribution to the WTN strength is my attitude towards caring for the elderly. I am compassionate and take care all of clients with outmost care of their wellbeing. In addition, I pick-up excellent skills in ambulation strategies and use of some ambulatory tools. I developed skills in understanding their behavior pattern to that I can assist them to live a meaningful life.

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

My greatest professional experience is from my current client who has developed an advance stage of dementia and moderate alzheimer. More so, he cannot speak and I have to understand him from his behavior pattern. Understanding his behavior pattern, I think I am efficient in providing him his personal care from eating to personal hygiene and effective to a point only when his dementia have not taken over his behavior. He is sun-downer and exhibits strong aggressive behavior. In good mood, even when he cannot communicate verbally,we smiled on common things we observed.

Availability

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

Education

High School   MOGCHS
Location:   Cagayan de Oro, Philippines
Did you graduate?   Yes
Subjects Studied   Basic

College   Xavier University-Ateneo de Cagayan
Location:   Cagayan de Oro, Philippines
Did you graduate?   Yes
Degree:   Chemistry

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
ARC Homecare and Nursing Professionals, Inc
Phone
847-509-5988
Address

5 Revere Drive, Northbrook, Illinois, 60062

Supervisor
Alejandra Paiz
Job Title
Manager
Salary or Rate of Pay
$12/hr
Responsibilities
Providing care to ARC client
From
09/11/2019
To
Reason for Leaving
For better pay
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 am shifting career for better pay
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
Alejandra Paiz
Phone
224 8148032
Address
ARC Homecare and Nursing Professionals
Relationship
Manager

Name
Luz Habon
Phone
708-315-4294
Address
ARC Homecare and Nursing Professionals
Relationship
Supervisor

Name
Rochelle Mejorada
Phone
224-388-2008
Address
Private Caregiver
Relationship
Her constant work reliever
Additional Information
Feel free to add any notes or additional information to your application in the space provided below.

For your kind consideration.

I guarantee that I am an asset to WTN team

Thank you for entering your employment history. If gaps exist in your employment history, please explain the gaps here.
I am shifting career for better pay
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
Allan P Bacho

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
May 28, 2020
This application has been submitted and can no longer be edited.