Available Positions

To view detailed information about a job, click on the title.
Before submitting your online application, please check the box next to each position you are interested in applying for.

  Position/Facility/Department Requistion Number
1. Homemaker/Companion
Homemaker/Companion
A Caring Hand LLC, Vernon, CT
03032017-1
2. Personal Care Assistant
Personal Care Assistant
A Caring Hand LLC, Vernon, CT
03032017-2
3. Live-in Personal Care Assistant
Live-in Personal Care Assistant
A Caring Hand LLC, Vernon, CT
03032017-3

Online Application

IMPORTANT: Please read these instructions before you begin your application, failure to do so may result in having to complete another application:

  1. Complete all areas of the application (even if attaching /uploading a resume). Review of your application, by the recruiter, will include a full review of your work history including dates of employment, etc. and it is most important that you provide all pertinent information into those fields.
  2. Use both upper and lower case letters, do not use ALL CAPS.
  3. Fields marked with are required information.

CAREFULLY READ THIS SECTION PRIOR TO PROVIDING SIGNATURE BELOW

I consent to any medical examination required by A Caring Hand LLC at any time to determine my ability to perform the duties of my job with ACH. I understand that I will be required to satisfactorily complete an alcohol/drug screening as a condition of employment. I further understand that a positive and properly confirmed drug test for controlled substances or refusal to submit to a drug test is grounds for denial or termination of employment.

I understand that my employment can be terminated at any time and for any reason, at the option of either the employer or myself. I understand that no one has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except for a written employment agreement signed by an authorized representative of ACH.

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration for employment and may result in discharge even if discovered at a later date.

I hereby authorize persons, schools, my current employer (if applicable) and previous employers and organizations named in this application (and accompanying resume, if any) to provide ACH with any relevant information regarding an employment decision, and I release all such persons from any liability regarding the provision or use of such information. I understand that ACH may use the services of an outside agency to conduct reference checks. I hereby authorize any such agency to provide relevant information to ACH and I release all such agencies, their directors, officers, agents and employees from any liability regarding the provision of such information.

My typed name below shall have the same force and effect as my written signature.

Signature
Date

PERSONAL INFORMATION

First Name (As it appears on your Social Security card)
Middle Name (As it appears on your Social Security card)
Last Name (As it appears on your Social Security card)
Last 4 Digits of SSN
Email Address
Daytime Phone 000-000-0000
Evening Phone 000-000-0000

Present Address

Street Address
City
State
Country
Zip 00000

Previous Address

Street Address
City
State
Country
Zip 00000

WORK STATUS INFORMATION

Other names you have worked under
Yes No Are you a U.S. citizen or authroized to work in the U.S. on an unrestricted basis?
Yes No Can you, at the time of orientation, submit proof of your legal right to work in the U.S.?
Yes No Can you, at the time of orientation, submit a birth certificate or other proof of age?

POSITION INFORMATION

Salary Requirement
Days Available Times Available
Monday Mornings
Tuesday Afternoons
Wednesday Evenings
Thursday Weekends
Friday Overnights
Saturday Anytime
Sunday
Yes No Were you previously employed by VNHSC, A Caring Hand, ECHN or their affiliates?
If yes, when/where?
Names of relatives employed by VNSHC, A Caring Hand, ECHN or their affiliates?
If an offer is extended, when would you be available for work? mm-dd-yyyy
How did you become aware of the position for which you are applying? Please give name of individual or source if not Web Site
Yes No Do you have your own reliable vehicle?

EDUCATION LEVEL

High School/GED
Some College
College Graduate

LICENSE INFORMATION

Driver's license
number
Driver's license
state
Driver's license expiration date mm-dd-yyyy
Do you have any valid professional licenses or certification related to the position for which you are applying?
Certified Nurse Assistant
Home Health Aide
Other
License No.
State Issued
Expiration Date mm-dd-yyyy

EMPLOYMENT INFORMATION

This section must be completed in full

Yes No Are you presently employed?
Yes No May we contact your present employer?

Starting with your most recent position, state your last three employment experiences, please complete even if application is accompanied by a resume.

Most Recent Employment

Start Date MM/YYYY
End Date MM/YYYY
Name of Employer
City
State
Zip 00000
Supervisor
Phone 000-000-0000
Job Title & Duties
Starting Salary
Ending Salary
Reason for Leaving

Second Most Recent

Start Date MM/YYYY
End Date MM/YYYY
Name of Employer
City
State
Zip 00000
Supervisor
Phone 000-000-0000
Job Title & Duties
Starting Salary
Ending Salary
Reason for Leaving

Third Most Recent

Start Date MM/YYYY
End Date MM/YYYY
Name of Employer
City
State
Zip 00000
Supervisor
Phone 000-000-0000
Job Title & Duties
Starting Salary
Ending Salary
Reason for Leaving

ADDITIONAL INFORMATION

Yes No Do you speak, read or write in any language other than English?

Please use this space to list and/or describe any additional skills you possess (i.e. computer hardware/software, typing (wpm), etc.

Yes No Can you perform the essential functions of the job you are applying for with or without reasonable accommodations.

If no is checked, please list below special accommodations that would be necessary:

BACKGROUND CONSENT

FCRA DISCLOSURE AND ACKNOWLEDGMENT

IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING AUTHORIZATION


DISCLOSURE REGARDING BACKGROUND INVESTIGATION

Eastern Connecticut Health Network (�the Company�) may obtain information about you from a consumer reporting agency for employment purposes from a third party consumer reporting agency. Thus, you may be the subject of a �consumer report� and/or an �investigative consumer report� which may contain information regarding your criminal history, social security verification, motor vehicle records (�driving records�), verification of your education or employment history, or other background checks. An investigative consumer report may also include information about your character, general reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends, or associates. Please be advised that the nature and scope of the most common form of investigative consumer report obtained is an investigation into your education and/or employment history. You have the right, upon written request made within a reasonable time, to request disclosure of the nature and scope of any investigative consumer report.

The report will be generated by Universal Background Screening (7720 North 16th Street, Suite 200, Phoenix, AZ 85020, 1-877-263-8033, www.universalbackground.com) or another outside organization. The scope of this notice and authorization is all-encompassing, however, allowing the Company to obtain from any outside organization all manner of consumer reports and investigative consumer reports now and, if you are hired, throughout your employment to the extent permitted by law now and throughout the course of your affiliation with the Company, to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report.

New York and Maine applicants or employees only: You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. You may also contact the Company to request the name, address and telephone number of the nearest unit of the consumer reporting agency designated to handle inquiries, which the Company shall provide within 5 days.

New York applicants or employees only: Upon request, you will be informed whether or not a consumer report was requested by the Company, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. By signing below, you also acknowledge receipt of Article 23-A of the New York Correction Law.

Oregon applicants or employees only: Information describing your rights under federal and Oregon law regarding consumer identity theft protection, the storage and disposal of your credit information, and remedies available should you suspect or find that the Company has not maintained secured records is available to you upon request.

Washington State applicants or employees only: You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.

ACKNOWLEDGMENT AND AUTHORIZATION

I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION (above) and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT (separate document) and certify that I have read and understand both of those documents. I hereby authorize the obtaining of �consumer reports� and/or �investigative consumer reports� by the Company at any time after receipt of this authorization and, if I am hired, throughout my employment and throughout my affiliation with the Company, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Universal Background Screening, another outside organization acting on behalf of the Company, and/or the Company itself. I agree that a facsimile (�fax�) or photographic copy of this Authorization shall be as valid as the original.

New York applicants or employees only: By signing below, you also acknowledge receipt of Article 23-A of the New York Correction Law.

Minnesota and Oklahoma applicants or employees only: Please check this box if you would like to receive a copy of a consumer report if one is obtained by the Company.

California applicants or employees only: By signing below, By signing below, By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW. Please check this box if you would like to receive a copy of an investigative consumer report or consumer credit report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law.

Full Name
Driver License State / Number
Social Security Number 000-00-0000
Date mm-dd-yyyy
Date of Birth mm-dd-yyyy

This information will be used for background screening purposes only and will not be used as hiring criteria.

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