ptanner@abc-seniors.com

How Can We Help You  (412) 835-2087

 APPLICANT INFORMATION

 

Employment Opportunities

 

Always Best Care Seniors Services is looking for care providers who enjoy working with seniors.  ABC offers flexible schedules, full-time and part-time positions.

 

Apply Today

Please fill out this online application.  Once received, one of our recruiting professionals will contact you.

 

 

 

Personal Information

First Name

 

Last Name

Address 1

Address 2

City

State

Zip Code

Email Address 

Home Phone

Work Phone

Mobile Phone

Driver's License #

 

Section 1 - Personal Information

Number

Question

1

How long have you lived at your current address? (required)

 

Section 2 - General Information

Number

Question

1

Position Applying For? (required)

2

Who referred you to us?

3

Are you 18 years or older? (required)
 Yes    No

4

Have you ever applied to Always Best Care before?
 Yes    No

5

We do not permit smoking while on duty.  Are you willing to comply? (required)
 Yes    No

6

Up to 50 lbs of lifting several times a day is an essential function of care giving.  Are you willing and able to comply with this requirement? (required)
 Yes    No

7

Always Best Care does not tolerate drug use by employees before or during work.  Are you willing to comply? (required)
 Yes    No

8

Would you consent to a pre-employment background check and verification of your work history? (required)
 Yes    No

9

Do you have reliable transportation to and from work during all shift hours? (required)
 Yes    No

10

Do you have two or more moving violations in the last 3 years? (required)
 Yes    No

11

Have you ever worked under another name? (required)
 Yes    No

12

Please list other name(s):

13

How many years of experience do you have working in "Home Care"? (required)

14

Do you have experience working with clients that have Dementia or Alzheimer's? (required)
 Yes    No

15

How many years of experience?

16

Are you capable of reading, writing, and understanding English as a part of your job performance? (required)
 Yes   No

17

If you speak any other languages other than English, please list:

 

18

What is the minimum amount you need to earn hourly? (required)

19

If offered a position with Always Best Care, how long would you plan to remain employed with us? (required)

 

20

Why are you applying for a position with us? (required)

21

Have you ever been convicted of, or plead guilty or no contest to, a misdemeanor or felony in this state or any other that has not been annulled, expunged, or sealed by the court? (required)
 Yes   No

22

If yes, please explain.

23 

Can you provide documentation of a driver's license and auto insurance? (required)
 Yes   No

24

Driver's License Expiration Date: (required)

25

Auto Insurance Expiration Date: (required)

26

Do you have any driving violations on your record? (required)
 Yes   No

27

If so, please list:

28

We have specific requirements for personal appearance:  clean solid color pants, and tops with a collar and sleeves or scrubs without a logo, no excessive jewelry or makeup, and good general hygiene.  Are you willing to comply with these requirements?  (required)
 Yes    No
Section 3 - Employment Verification

Number

Question

  1

Are you a U.S. citizen? (required)
 Yes    No

  2

If you are not a U.S. citizen, please indicate VISA type and number.

  3

Are you authorized to work in the U.S.? (required)
I am authorized to work in the U.S. for any employer.
I am authorized to work in the U.S. only for my current employer.
I require sponsorship to work in the U.S.
I do not know my work status.
Section 4 - Characteristics

Number

Question

  1

How many jobs have you had in the last year? (required)

  2

How many jobs have you had in the last 2 years? (required)

  3

Have you ever quit a job without giving two-weeks notice? (required)
 Yes    No

  4

Have you ever been fired or asked to resign from a position? (required)
 Yes   No

  5

Have you ever ignored company policy because most other employees ignored it, too? (required)
 Yes    No

  6

Have you every taken cash or items from an employer or client because you did not think you had been paid enough? (required)
 Yes    No

  7

Is it okay to borrow something from work/client without permission as long as you return it? (required)
 Yes    No

  8

Do you believe you are positive? (required)
All of the time.
Most of the time.
Some of the time.
Not so much of the time.

 9

Have you been recently blamed at work for something that was not your fault? (required)
Yes   No

10

Have you ever had a problem with a co-worker at a previous job? (required)
Yes   No

11

Have you been in an argument with a client or a client's family in the past? (required)
Yes   No

12

Do you believe an employee should be warned 3 times about missing work before action is taken? (required)
Yes   No

13

How often do you lose temper? (required)
Never
Rarely
Sometimes
Frequently

14

On average, how often are you late for work? (required)
Less than one a month
Once a month
Once a week
More than once a week

15

How many days were you absent from work during the last year because you did not like your job? (required)
None
1-2
3-4
5 or more

16

Do  you consider yourself as having strong people skills? (required)
Yes   No

17

Would clients say you go out of your way to help them? (required)
Yes   No

18

Do you think most accidents and injuries can be avoided? (required)
Yes   No

19

Do you enjoy interacting with others during the day? (required)
Yes   No
Section 5 - AVAILABILITY

Number

Question

  1

When would you be available to start? (required)

  2

Are you giving your current employer two weeks notice? (required)
Yes   No

  3

Do you have any schedule obligations (e.g., annual trips, vacations, weddings, reserve duty, or holidays) coming up that we need to know about? (required)
Yes   No

 4

If Yes, Explain:

 5

What commitments do you have or anticipate having that may affect your schedule? (required)

 6

Are you willing to work holidays? (required)
Yes   No

 7

Would you be willing to work flexible hours (Including weekends)? (required)
Yes   No

 8

Are you willing and able to work 12 hour shifts? (required)
Yes   No

 9

Are you willing and able to work double shifts? (required)
Yes   No

10

Are you willing to work day shifts? (required)
Yes   No

11

If yes, which days? (required)

12

Are you available to work evening shifts? (required)
Yes   No

13

If so, which evenings?

14

Are you willing to work overnight shifts? (required)
Yes   No

15

If yes, which overnights?

 

16

Are you available to work Live-in shifts? (required)
Yes   No

17

If yes, what days?

18

What days and times of the day are you NOT available to work? (required)
Section 6 - EDUCATION

Number

Question

 1

Name of High School: (required)

 2

Location of High School: (required)

 3

Did you graduate? (required)
Yes   No

 4

Years Attended (From/To): (required)

 5

Additional Education (vocational, undergraduate, etc.) (required)

 6

If yes, please list the name of the school and years attended (From/To)
Section 7 - CERTIFICATIONS/LICENSES/CREDENTIALS

Number

Questions

1

Do you have a current License in good standing from the state to which you are applying? (required)
Yes   No

2

List current licenses:

3

Do you have a current Certificate in good standing from the state to which you are applying? (required)
Yes   No

4

List current Certificates:

5

Has your License/Certificate ever been revoked or suspended? (required)
Yes   No

6

Please list the last date you had a TB Skin Test or Chest X-ray? (required)

7

Have you ever been fingerprinted for a Care giving job? (required)
Yes   No
Section 8 - CURRENT EMPLOYER/MOST RECENT EMPLOYER

Number

Question

 1

Current Employer: (required)

 2

Address: (required)

 3

City: (required)

 4

State: (required)

 5

Zip Code: (required)

 6

Start Date: (required)

 7

End Date: (required)

 8

Hours Worked: (required)      
Full Time
Part Time
Temporary
Live -In
Salary

 9

Position/Title: (required)

10

Starting Wage: (required)

11

Describe Your Responsibilities: (required)

12

Supervisor's Name/Title (required)

13

Supervisor's Phone: (required)

14

Reason for Leaving: (required)

15

May we contact? (required)
Yes   No

16

Amount of time lost in the past year (in days) for any reason: (required)
Section 9 - SECOND MOST RECENT EMPLOYER

Number

Question

 1

Employer: (required)

 2

Address: (required)

 3

City: (required)

 4

State: (required)

 5

Zip Code: (required)

 6

Start Date: (required)

 7

End Date: (required)

 8

Hours Worked: (required)
Full Time
Part Time
Temporary
Live-In
Salary

 9

Position/Title: (required)

10

Starting Wage: (required)

11

Describe Your Responsibilities: (required)

12

Supervisor's Name: (required)

13

Supervisor's Phone: (required)

14

Reason for Leaving: (required)

15

May we contact? (required)
Yes   No

16

Amount of time lost in the past year (in days) for any reason: (required)
Section 10 - THIRDMOST RECENT EMPLOYER

Number

Question

 1

Employer: (required)

 2

Address: (required)

 3

City: (required)

 4

State: (required)

 5

Zip Code: (required)

 6

Start Date: (required)

 7

End Date: (required)

 8

Starting Wage: (required)

 9

Hours Worked: (required)
Full Time
Part Time
Temporary
Live-In
Salary

10

Position/Title: (required)

11

Supervisor's Name/Title: (required)

12

Supervisor's  Phone: (required)

13

Amount of time lost in the past year in days for any reason: (required)

14

Describe your Responsibilities: (required)

15

Reason for leaving: (required)

16

May we contact? (required)
Yes   No
Section 11 - PROFESSIONAL REFERENCE - 1 (No Friends/Relatives)

Number

Questions

 1

Name: (required)

 2

Company: (required)

 3

Phone: (required)

 4

Position: (required)
Section 12 - PROFESSIONAL REFERENCE - 2 (No Friends/Relatives)

Number

Question

 1

Name: (required)

 2

Company: (required)

 3

Phone: (required)

 4

Position: (required)
Section 13 - PROFESSIONAL REFERENCE - 3 (No Friends/Relatives)

Number

Question

 1

Name: (required)

 2

Company: (required)

 3

Phone: (required)

 4

Position: (required)
Section 14 - Emergency Contact Information

Number

Question

 1

First Name (required)

 2

Last Name: (required)

 3

Address: (required)

 4

City: (required)

 5

State: (required)

 6

Zip Code: (required)

 7

Phone 1: (required)

 8

Phone 2: (required)

 9

Relationship: (required)
Section 15 - CAREGIVER TEST

Number

Question

 1

Betty Smith is a client who has been discharged from the hospital with a diagnosis of CHF and Diabetes.  Which 2 types of food do you need to avoid when cooking her meals?
Sweet
Sour
Salty
None of these

 2

Carl has had right hip replacement surgery and is now at home.  What precautions are needed when transferring him to and from a wheelchair and a walker?
 Make sure brakes are locked on wheelchair
 Avoid twisting of the hips and torso
 Make sure the walker is locked and placed directly in front of the client
 All of the above

 3

Sarah was discharged home from the hospital with left sided CVA.  She is to have her foods prepared for her that are pureed and her liquids are to be thickened.  While supervising her meals, what are 2 important observations to make?
 She is enjoying her meal
 Her swallowing
 Her plants need watering
 Pocketing of food on her affected side

 4

Sarah is also under aspiration precautions, what does this mean?
 She sweats a lot
 She stops breathing
 She may inhale her food into her lungs

 5

Charles came home from the hospital 2 days ago, this is your second day of caring for him.  You are in the laundry room, when suddenly you hear a thud.  You run toward the bathroom only to see that he has fallen in the hallway.  You would:
 Grab him underneath the arms and assist him to standing position
 Grab him underneath the arms and assist him to a sitting position on the floor
 Ask him if he is able to get up by himself and if he cannot, you do not move him.  You call 911 then call the office.

 6

Which of the following foods are high in sodium?
 Corn Chips
 Soda
 Oranges
 Celery
 Milk
 Chicken noodle soup

 7

You are caring for Gertrude who has Dementia.  She insists there is an intruder stealing jewelry from her bedroom.  What do you do to calm her?
 Tell her that her mind is playing tricks on her
 Tell her you are going to go into the bedroom apprehend the intruder and get rid of him
 Change the subject

 8

Harold came home from the hospital with a Foley catheter.  You are asked to empty it every 8 hours or when 2/3 full.  What observations will you be making of his urine to ensure safety?
 Color
 Presence or absence of blood
 Clarity
 Amount
 All of the above

 9

Sylvia has been your client for a week now, she is always complaining of constipation.  You know that she has had a bowel movement everyday you have been there.  She suddenly complains of severe, acute abdominal pain and doubles over.  You:
 You make her some warm prune juice
 Tell her she should probably take a pain medication
 Call 911, and then call the office

10

You are caring for a 45 year old woman who is an alcoholic.  She especially drinks excessively on the anniversary of her son's death.  You are caring for her on that very day.  What do you do to help her cope?
 Lock all the liquor in the cabinet
 Dump it all down the drain
 Encourage her to talk about her grief, remain with her at all times even though she is drinking, and call the office
 Start mixing up drinks for both of you since this case if very depressing

11

You are caring for a man who is confused (usually very pleasant), he suddenly becomes very belligerent and is verbally abusive.  When serving his dinner he strikes you on the arm accusing you of poisoning his food.  What do you do?
 Ignore him
 Calmly reassure him and call the office
 Strike him on his arm

12

Your client is an 85 year old elderly woman.  She has a 90 year old husband who can no longer care for her.  He request that you fix meals for both of them.  You would:
 Say, "Of course I will"
 Tell them this will be an extra charge
 Tell him you are only there to prepare meals for his wife

13

Sally has been home from the SMF for 2 weeks now.  She really feels the need to get out.  She asks if you will drive her to her favorite restaurant for lunch.  She wants you to drive her car.  You:
 Say, "Of course I will"
 Call the office to get approval and have this added to her care plan, explaining to the client that additional paperwork may need to be done regarding insurance and transportation.
 Say, "No I cannot do that for you"

14

Betty is a client you are caring for.  Her daughter Kelly is visiting after work one day and asks you if you could stay 2 extra hours.  what do you do?
 Say, "Yes"
 Call the office with the request and have Kelly talk to the manager or staff to authorize this.
 Tell her you will if she pays you cash

15

You are working as a live-in caregiver.  You have been caring for Gertrude a 91 year old woman.  Lately she's been staying up until 3 a.m. and she used to go to sleep at 10 p.m.  She wanders around the house and jabbers constantly.  You are now getting four hours of sleep per night if you are lucky.  You are the best of friends but you are very weary and feel yourself becoming sick.  She has been telling you she has a very limited income.  What should you do?
 Keep going to the assignment hoping her sleep schedule will return to normal
 Call her family to see if they can help
 Call the office

16

You are caring for Zelda.  You have noticed that she has become increasingly more agitated each day and today she is very agitated and nervous.  She has a prescription for both Xanax and Valium available.  Zelda agrees she needs help calming herself and asks you to giver her whichever medication you think will work the best.  What do you do?
 Give her one of the meds
 Explain to her you are not allowed to administer meds and call the office
 Give her both of the meds to be on the safe side

17

You have cared for Bob for 6 months now.  You are very close with the whole family.  It's the holidays and as you leave your shift they hand you a card.  You open it, not only have they given you a Christmas card but have also included $200 cash.  You:
  Graciously accept the Christmas card, you have earned it!
  Call your manager, you cannot accept gifts
  Tell the family thank you, but do not tell my manager

18

While giving Jane her shower you notice that her perineal area is very red, inflamed and sore.  What should you do?
 Call the office
 Call the family and notify them of the condition
 Look for the proper ointment to apply

19

You have just started with a new client.  While preparing him for bed you notice there is bruising on his arms and legs.  What do you do?
 Ask the client what happened
 Ignore the bruising
 Call the office and let them know APS needs to be notified

20

When cleaning the perineal area you should always clean:
 Back to front
 Does not matter
 Front to back
Section 16 - SIGNATURE

Number

Question

 1

By entering my name and today's date and submitting this form, I am indicating that I am electronically signing this form and have read and understand the content, intent and terms of this application. (required)