Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
DESIREE DANETTE HALL
Created: 10/23/2020
Other names under which employment may be verified:  NONE
Updated: November 2, 2020

Home Address
Street Address
8643 SOUTH KOMENSKY AVE
Unit/Suite Number
8643 SOUTH KOMENSKY AVE
City ST/Zip
CHICAGO, IL 60652
Home Phone
773-424-0927
Mobile Phone
708-305-2788
Alternate Phone
773-853-9535

Have you ever worked for us before?   No
If no, how did you hear about us? INDEED
Rate of pay desired.   14.50 AN 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
No
Cats
No
Dogs
No
Smoker
No
What languages do you speak?   english
Do you have any caregiver training from other home services agencies?  Yes
If yes, explain.  ABCOR

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.

WORKED AS A PATIENT CARE TECH FOR 25 YEARS IN DIALYSIS AND THREE YEARS IN NURSING HOME AS A CNA AND 8 MONTHS AS A HOME CARE AIDE FOR MOTHER. RIGHT NOW NO LIVE-IN ASSIGNMENT TAKING CARE OF MOTHER MAYBE A YEAR FROM NOW, ONLY FEMALE CLIENT RIGHT NOW

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

AS A CARE GIVER YOU LEARN A LOT ABOUT A CLIENT WHETHER ITS FAMILY OR NOT DO AND DONTS BUT SOMETIMES IT VERY REWARDING YOU BECOME GOOD FRIENDS WITH THE FAMILY AND THEY TRUST YOU. SO IT MAKES YOU WANT TO DO YOUR BEST .

Availability

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

Education

High School   PAUL ROBERSON
Location:   CHICAGO, ILL
Did you graduate?   Yes
Subjects Studied   GENERAL

College   KENNEDY-KING COLLEGE
Location:   CHICAGO. ILL
Did you graduate?   Yes
Degree:   ASSOCIATE DEGREE IN LIBERAL ARTS

Other:   DAWSON TECHINICAL INSTIUTE
Location:   CHICAGO. ILL
Did you graduate?    Yes
Degree:   CERTIFICATE AS A CNA

Special awards you earned or courses you have taken.
NONE

Military Service

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

Licenses and Certifications

EMPLOYMENT HISTORY

Company Name
ABCOR HOME HEALTH
Phone
312-724-6655
Address

868 NORTH MILWALKEE AVE CHICAGO, ILL 60642

Supervisor
MRS SHABAZZ
Job Title
HOME HEALTH AIDE
Salary or Rate of Pay
13 AN HOUR
Responsibilities
BATH, FEEDING, WASHING CLOTHES, GOING TO DOCTOR APPOINTMENT MEAL PREPARTATION
From
12/27/2019
To
11/02/2020
Reason for Leaving
CURENTLY EMPLOYED
May we contact this employer?  Yes

Company Name
LITTLE COMPANY OF MARY HOSPITAL-OSF
Phone
708-422-6200
Address

2800 WEST 95 STREET EVERGREEN PARK . ILL 60805

Supervisor
RESHAWN BRUCE
Job Title
EVS TECH SUPPORT
Salary or Rate of Pay
12 AN HOUR
Responsibilities
DISCHARGE ROOMS/CLEAN FOR THE PATIENT WORKED ALSO IN THE E.R
From
05/04/2020
To
11/01/2020
Reason for Leaving
MORE MONEY AND POSSIBLE A UNION
May we contact this employer?  Yes

Company Name
DAVITA
Phone
773-445-0558
Address

3401 WEST 111 STREET CHICAGO, ILL 60655

Supervisor
SONAL PATEL
Job Title
PATIENT CARE TECH
Salary or Rate of Pay
19.25
Responsibilities
PATIENT CARE TECH TAKING CARE OF PATIENT ON DIALYSIS
From
08/09/2004
To
06/30/2017
Reason for Leaving
TAKING CARE OF MOTHER FOR THREE YEARS
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.
HAVE NOT FOUND WORK YET
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
LAVONDA MCKISSACK
Phone
773-767-4352
Address
79 CALIFORNIA
Relationship
FRIEND

Name
MARK WESTON
Phone
708-422-5111
Address
9230 SOUTH PULASKI ROAD
Relationship
PASTOR

Name
TAMMY POMA
Phone
773-834-4173
Address
8725 SOUTH STONEY ISLAND
Relationship
CO-WORKER
Additional Information
Feel free to add any notes or additional information to your application in the space provided below.

HI MY NAME IS DESIREE DANETTE HALL- PATIENT CARE TECH-HOME HEALTH AID, STOP WORKING AS A PATIENT CARE TECH TO TAKE CARE OF MY MOTHER WHO WAS ILL FOR THE PAST THREE YEARS, THEN START WORKING PART-TIME AS HER CARE-GIVER THROUGH ABCOR HOME HEALTH INTHE MORNINGS, AND ITS BEEN A BLESSING, MY REASON FOR DOING THIS IS TO GO BACK TO SCHOOL AND TO STAY CLOSE TO HER ALSO LEAVING MY JOB A LIITLE COMPANY OF MARY HOSPITAL TO HAVE THE FREEDOM TO HAVE A FLEXIBLE SCHEDULE TO STAY AND WORK. THANK YOU FOR EVERYTHING.

Thank you for entering your employment history. If gaps exist in your employment history, please explain the gaps here.
HAVE NOT FOUND WORK YET
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
DESIREE DANETTE HALL

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
November 2, 2020
This application has been submitted and can no longer be edited.