Apply for Full-Time Caregiver needed with flexible schedule

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Full-Time Caregiver needed with flexible schedule
ID:	1040
Location:	Fairfax VA,
Department:	Home Care
Salary Range:	$22-$25

Resume
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Opt-In Confirmation
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Attachments
Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Caregiver Screening

* Do you have a valid Driver License?:

	Yes
	No

* Do you have an insured vehicle to use during your shifts?:

	Yes
	No

* Are you at least 21 years of age?:

	Yes
	No

* Are you willing to drive 20 miles if needed to a shift?:

	Yes
	No

Do you hold a heath care certificate from the state of Virginia?:

	CNA
	PCA
	HHA

Do you have a current CPR & 1st Aid card?:

	Yes
	No

* Can you lift up to 50lbs?:

	Yes
	No

* Can you speak, read and write in English?:

	Yes
	No

* Do you own and can you use a smart phone?

	Yes
	No

* How much experience do you have providing homecare?

	<1 year
	1-3 years
	4-9 years
	>10 years

* I am available for the following time slots:
Mark all that apply. These are not shifts.

* I am seeking:

* Will you be able to provide personal care/hygienic care for clients, such as showering, toileting assistance, and other hands-on care after proper training?

	Yes
	No

Background Disclosure

Sworn Disclosure Statement Please answer truthfully. A full background check will be performed upon hiring. Applicant Criminal Record Information

* Full Legal Name:
First, Middle, Last:

* Social Security Number:

* Date of Birth:

* To the Applicant:

Section 32.1-162.9 of the Code of Virginia requires that any person desiring to work at a licensed home care organization shall provide the hiring facility with a sworn statement or affirmation disclosing any criminal convictions or any pending criminal charges, whether within or outside the Commonwealth of Virginia.

The law prohibits license home care organizations from hiring any individuals convicted of a barrier crime (specified at the back page). However, applicants convicted of one misdemeanor barrier crime not involving abuse or neglect may be hired if five years has lapsed since the conviction.

Any person making a false statement on this form regarding any criminal offense shall be guilty of a Class 1 misdemeanor.

Further dissemination of the information provided on this form is prohibited other than to the Commissioner’s representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.

I agree that the information given below in this document is true and current to the best of my ability. I understand IncrediCare will require a criminal background check as part of being considered for a position within the company. I understand IncrediCare will deduct $25.00 from my second paycheck to cover this cost.

I have been charged, convicted of, or have pending charges that:

	Will disqualify me from working in a home care organization under Section 32.1-162.9 of the Code of Virginia
	Will Not disqualify me from working in a home care organization under Section 32.1-162.9 of the Code of Virginia
	Not Applicable to me I have never been convicted or charged with a crime.

* By signing you are giving IncrediCare permission to run a complete background check on or before your hiring date. (please sign "type" full name)

Knowledge and Skills Test

Please answer each question.

* Which of the following would be an example of abuse?

	The caregiver locks the clients in their room.
	The caregiver asks for permission before assisting the client to the bathroom.
	The caregiver cleans the client’s glasses.
	The caregiver prepares lunch for the client.

* When you return to Mrs. Smith’s after the weekend off, you notice multiple bruises on her upper arm while assisting with her morning bath. She is quiet and withdrawn and unable to explain how she got the bruises. Explain how you would handle this situation.

* You are assisting Mrs. Smith today. Her care plan states she has MRSA in a wound on her lower leg. What would be an appropriate choice while providing care?

	Ask Mrs. Smith to remove the bandage so you can clean the area well.
	Avoid disturbing the dressing, wear gloves, and wash hands well before and after providing care.
	Remove the bandage and clean the area well with warm soap and water.

* What is the best way to avoid the spread of germs and infection?

	Frequent hand washing
	Wear gloves when providing care
	Apply antiseptic hand sanitizer before and after providing care
	All of the above

* Which of the following would be a key part of care when assisting with a shower?

	Use cool water to promote better circulation.
	Allow client to participate in care to promote independence.
	Clean the perineal area first, then assist with washing the face.
	Provide all care to avoid the client becoming fatigued.

* Which of the following guidelines regarding clients who are hard of hearing would be considered correct?

	Speak in a high-pitched voice to enhance understanding.
	Write down all communication to save time.
	Speak clearly and slowly as you speak face-to-face with the client.
	Provide care to the client and avoid speaking.

* CPR should be performed when

	A client has no pulse and is not breathing
	A client has a pulse but is not breathing
	A client is choking
	A client is unconscious

* A client is on a clear liquid diet. Which of the following is NOT allowed on this diet?

	Coffee with creamer
	Water
	Tea
	Ginger Ale

* A normal blood pressure is 120/80. However, your client’s blood pressure today is 113/76. Should you alert the on-call Nurse?

	Yes
	No

* You are providing morning care to Mr. Roberts when he requests you to increase his oxygen to 4L/min because he is experiencing shortness of breath. You know that Mr. Roberts should be on oxygen for his COPD continually at 2L/min. What should you do?

	Turn the oxygen up to 4L/min as requested for 10 mins, then back to 2L/min.
	Turn the oxygen up to 3L/min then call the on-call Nurse.
	Call the on-call Nurse to get further instructions.
	Tell Mr. Roberts that you turned it up but don’t and tell him he will feel better after his shower.

* You are assisting Mrs. Allen with her morning care. Mrs. Allen states it is time for her to take her morning medications. Normally her daughter sets up her pill box each Sunday night after church. However, the daughter is out of town and forgot to set up the pill box. Mrs. Allen asked that you open the pill bottles of the medications that she takes and put them in her pill cup for her to take. Please explain the steps you would take for this task.

* You are assisting Mrs. Sally with her morning shower when you hear the smoke alarm sounding in the kitchen. You ensure Mrs. Sally is safe and go to the kitchen to investigate. There are flames and smoke coming from the oven. What should you do first?

	Call the fire department since the phone number is listed on the refrigerator.
	Get the fire extinguisher from under the kitchen sink and attempt to put out the fire.
	Return to the bathroom and assist Mrs. Sally down the hallway to the back door and escort her outside to safety.
	Run to the neighbors’ house next door for help since you know he is a fire fighter.

* You are leaving to run errands for Mr. Paul when he stops you and asks you to pick up some vodka from the liquor store across from the Walmart. He says he will give you an extra $20.00 if you do not mention this to his daughter. Choose the best action to take:

	Mr. Paul is a very sweet man and you would do anything to keep him happy so, you pick it up.
	Tell Mr. Paul that you are not allowed to purchase alcohol for clients per company policy.
	Tell Mr. Paul he should not drink because he has liver disease and you are going to report this to his daughter.

* You are working with a client who is diabetic. They would like you to prepare them a well-balanced lunch that will adhere to their diet. Please choose the best meal below:

	Leftover pizza in the fridge with chocolate pie for dessert and Pepsi.
	McDonald’s hamburger, fries, and a milkshake.
	Baked Tuna, a green salad with a side of fruit with unsweet tea.
	Baked Lasagna, creamed corn, mashed potatoes with gravy, carrot cake for dessert with a vodka tonic.

* You are going to take vital signs on your client. You realize they have just had a cold beverage. How long should you wait before taking the client’s temperature?

	20-30 mins.
	10-20 mins.
	30 mins

* You are providing incontinence care to Mr. Dooly when you notice a small amount of blood in his brief. What should you do next?

	Ask Mr. Dooly if he has any burning when he urinates?
	Change his brief and apply some barrier cream.
	Provide incontinence care then alert your on-call Nurse
	Call the daughter and tell her to make an appointment with the primary doctor

* You are providing perineal care to your client, what are you doing?

	Assisting with ambulation
	Cleaning the genital area
	Assisting the client to the bathroom
	Assisting with passive range of motion

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

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