Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
Joyce Valencia Sexton
Created: 10/29/2020
Other names under which employment may be verified:  
Updated: November 10, 2020

Home Address
Street Address
2453 west Lexington
Unit/Suite Number
Apt 1
City ST/Zip
Chicago, IL 60612
Home Phone
7736333952
Mobile Phone
7736204746
Alternate Phone

Have you ever worked for us before?   No
If no, how did you hear about us? Online
Rate of pay desired.   15 hrly
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
Do you have any caregiver training from other home services agencies?  Yes
If yes, explain.  Taking Care of Our Seniors, Gardea Homecare

How many years have you worked as a professional caregiver?  16
What percent of your previous case work has been for an agency?  50
Please explain how you will contribute to strengthen the Water Tower Nursing team.

I will be able to strengthen this team through my hard work and determination. I'm always willing to go above and beyond.

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

One of my favorite accomplishments was recieving a thoughtful and touching letter from one of my caregivers spouses. In this letter she mentioned how I was instrumental in boosting the clients health. She went on to say how she was finally able to rest after 4 months because she finally had the help she needed. This showed me even during the rough days I was making a difference not only in my clients life but the people around him as well.

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   Crane High School
Location:   Chicago, IL
Did you graduate?   Yes
Subjects Studied   High School Diploma

College   Devry University
Location:   
Did you graduate?   No
Degree:   Business Adminstration

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
Phone
In rehab
Address

6808 north wayne

Supervisor
Donald Levin
Job Title
Caregiver
Salary or Rate of Pay
300 wkly
Responsibilities
Laundry, meal prep, bathing, medication reminders
From
01/08/2015
To
11/03/2020
Reason for Leaving
Still working
May we contact this employer?  Yes

Company Name
Private Caregiver
Phone
Unknown
Address

Northside Chicago

Supervisor
Layne Miller
Job Title
Caregiver
Salary or Rate of Pay
24p wkly
Responsibilities
Housekeeping, shopping, laundry
From
11/01/2016
To
11/30/2018
Reason for Leaving
Client became ill
May we contact this employer?  Yes

Company Name
Private Caregiver
Phone
N\\A
Address

Downtown Chicago

Supervisor
Shannon Giblin
Job Title
Healthcare aid
Salary or Rate of Pay
300 wkly
Responsibilities
Shopping, bathing, laundry
From
09/01/2015
To
11/24/2015
Reason for Leaving
Better opportunity
May we contact this employer?  Yes

Company Name
Gareda Home Care
Phone
7739784889
Address

8551 South Stony Island

Supervisor
Sherman Hensley
Job Title
Caregiver
Salary or Rate of Pay
375 hrly
Responsibilities
Meal prep, laundry, bathing, errands, medication reminders, diaper changing
From
03/03/1982
To
11/30/1983
Reason for Leaving
Better Opportunity
May we contact this employer?  Yes

Company Name
Taking Care of Our Seniors
Phone
8159773025
Address

119 Wyman St. Rockford Il

Supervisor
Beverly Davis
Job Title
Caregiver
Salary or Rate of Pay
800 wkly
Responsibilities
Meal prep, laundry, bathing, errands, medication reminders, diaper changing
From
10/01/2015
To
08/31/2016
Reason for Leaving
Closed Down
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
Donald Levin
Phone
Unknown but I can get .
Address
6808 north wayne
Relationship
Client

Name
Ozean Edwards
Phone
7735101042
Address
Unknown
Relationship
Friend

Name
Michael Moore
Phone
7734252141
Address
Relationship
Previous Landlord
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?  No
If yes, explain.  
Resume Upload (optional)
No Resume Uploaded
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
Joyce Sexton

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
November 4, 2020
This application has been submitted and can no longer be edited.