Comfort Keepers Employment Application

Carefully and accurately fill out all fields. When ready, click "Submit" below.
1. How did you hear about this position?
2. How many hours per week are you looking to work?
3. Do you have professional caregiving experience?
Yes No
4. Do you have family experience caregiving?
Yes No
5. Please explain your caregiving experience:
6. Do you have experience and/or training in Personal Care? (ex: transferring, bathing assistance, incontience care, etc.)
Yes No
7. Have you ever worked for Comfort Keepers?
Yes No
8. Where and when?
9. Do you have a valid CA drivers license?
Yes No
10. Do you have a reliable car that you can provide incidental transportation for clients in?
Yes No
11. Do you have current auto insurance in your name?
Yes No
12. What days and hours are you available to work for Comfort Keepers? (Availability must be honored for at least 3 months)
13. Are you willing to work in Contra Costa county? (Walnut Creek, Danville, Lafayette, Moraga, Orinda, Pleasant Hill, Concord)
Yes No
14. Are you willing to work in the Tri-Valley area? (Dublin, Pleasanton, San Ramon)
Yes No
15. Are you wiling to work in Alameda county? (Fremont, Union City, Newark, Milpitas, Hayward, Castro Valley)
Yes No
16. Are you able to pass a criminal background and DMV check? (including DUI's)
Yes No
17. Are you able to pass a health screening and drug testing?
Yes No
18. Do you speak any other languages?
Yes No
19. Please list any certifications. (ex: CNA, CPR, LifeScan, First Aid, etc.)
20. Are you comfortable working with pets in the clients home?
Yes No