First Name

Last Name

Email Address

Phone Number

Address

City

State

Zip Code

Supported formats: Word, PDF, RTF, Text and HTML (5mb file size limit)

Additional Questions

Are you willing to go through the LiveScan background check process for the California Home Care Aide Registry?

Are you 18 years of age or older?

Do you possess a valid California Driver’s License?

Can you provide proof of vehicle insurance?

Can you provide proof of High School graduation or GED?

Are you authorized to work in the United States?

Are you currently listed on the California Home Care Aide Registry?

Do you understand that this position is not full time but based on open shifts and client needs?

What is your job history? (if not listed on resume)

What is your prior experience (if any) as a caregiver, CNA, or HHA?

What is your ideal work schedule/hours per week?

Are you available to work evenings and weekends?

Are you fluent in the English Language?

Are you fluent in any foreign languages?

What is your interview preference?