Caregiver Job Application


APPLICANT INFORMATION

Application Status
Submitted
Name (First, Middle, Last)
Morgan Taylor Zivin
Created: 10/01/2019
Other names under which employment may be verified:  
Updated: October 4, 2019

Home Address
Street Address
1040 W Adams St.
Unit/Suite Number
unit 375
City ST/Zip
Chicago, IL 60607
Home Phone
Mobile Phone
847-208-0025
Alternate Phone

Have you ever worked for us before?   No
If no, how did you hear about us? Emily Cohen
Rate of pay desired.   $30,000 / Yr
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?  No
If yes, explain.  

How many years have you worked as a professional caregiver?  0
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 enjoy working and I enjoy taking care of people. I will work hard everyday and make sure that my patients are happy and comfortable. I am someone who is always smiling even when I am in a stressful situation. I worked as a high school teacher for two years, which helped me with my patience and listening skills. I care about the work that I do. I don't just do it because it is my job, but because these people deserve to live the rest of their lives happy and pain-free. I will put in 120% everyday. I am an honest, empathetic, and understanding professional and I am ready to work as a professional caregiver.

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

I haven't had a full time job as a caregiver, but I did complete my training hours at Wesley Place Rehab. Here I had the opportunity to practice giving bed baths, showers, shaving, feeding, and building positive relationships with residents. I know that the residents are not always in the best mood and that they are in a very difficult time in their life, but I did everything I could to get them to smile. I played sudoku with one of the residents and listened to a story about another residents past while I gave him a bed bath. I have changed plenty of adult incontinence pads and I have made open and closed beds, as well as an occupied bed. Each of these skills were pretty difficult in the beginning, but after a good amount of practice I feel I have gotten a lot better.

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   Glenbrook North High School
Location:   Northbrook, IL
Did you graduate?   Yes
Subjects Studied   

College   Indiana University
Location:   Bloomington, IN
Did you graduate?   Yes
Degree:   Kinesiology

Other:   
Location:   
Did you graduate?   
Degree:   

Special awards you earned or courses you have taken.
Anatomy, Chemistry, Biology, CNA Certification Course

Military Service

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

Licenses and Certifications

EMPLOYMENT HISTORY

Company Name
GoNanny
Phone
872-220-9798
Address

No address

Supervisor
Patrice Darby
Job Title
Nanny
Salary or Rate of Pay
$20/hr
Responsibilities
I provide rides for families that have children that need to get to school or be picked up from school and brought to an after school activity. I also provide in home care more multiple families, which includes cooking, cleaning, helping with homework, or entertaining the children. I make sure the children are safe when dropping them off, picking them up, or at their home.
From
09/01/2019
To
10/01/2019
Reason for Leaving
Still working for them
May we contact this employer?  Yes

Company Name
Glenbrook North High School
Phone
847-272-6400
Address

2300 Shermer Rd
Northbrook, IL 60062

Supervisor
Bob Pieper
Job Title
Instructional Assistant in P.E. department
Salary or Rate of Pay
~$18.75 / Hr
Responsibilities
Assist the P.E. teachers with their classes, help with equipment and oversee the class. Be a positive role model for the students and build positive relationships with students and teachers in order to understand and to gain trust and respect.
From
08/15/2018
To
05/20/2019
Reason for Leaving
Started my CNA course
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
Max Motew
Phone
847-533-8762
Address
1040 W Adams St. Chicago, IL 60607
Relationship
significant other

Name
Emily Cohen
Phone
224-234-5699
Address
1 W Superior Place Chicago, IL
Relationship
friend

Name
Danielle Smith
Phone
847-812-8381
Address
Relationship
co-worker at Glenbrook North
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
Morgan Taylor Zivin

PART FIVE – APPLICATION SUBMISSION

Application Status
Submitted
Date Submitted
October 1, 2019
This application has been submitted and can no longer be edited.