WE are licensed, insured and bonded because we value your confidence in our company.

 

CAREGIVERS' PAGE

Do you want to be a part of our family?

Simply fill out the application form below and submit a copy of your valid CA Driver Licence, TB test, CPR and First Aid cards by email or fax.  Thank you!

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Support Human Rights

Are you currently employed?

May we contact your present employer?

Are you physically able to perform the duties of the job which your are applying for?

Have you ever been convicted of any felony?

If you answered yes, please explain in writing by email.

Do you drive?

Please check the duties that you are able to perform:

Bath: bed/tube/shower/sponge

Dressing/grooming     

Transfers (from wheelchair to bed and bed to wheelchair)  

Lifting with Hoyer Lift   

G-tube feeding

Cooking

Light Housekeeping/Laundry, etc.  

Blood pressure monitoring

Blood sugar monitoring

Grocery shopping

Escort to appointments

Please check the conditions that you have handled or are able to handle:

Alzheimer's Disease/Dementia 

Parkinson's Disease

Hip replacement surgery

Cancer

Patient with a colostomy bag

Patient with a catheter

I certify that the answers given herein are true and complete and to the best of my knowledge.  I authorize investigation of all information contained in this application which may be necessary for the employer to arrive at an employment decision.  I understand that any false answers or statements I may make in this application shall be considered sufficient cause to deny employment.

By clicking this button, you authorize Chateau Domestics to verify your identity, work authorization and eligibility. 

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Last Name:            First Name: Middle Name: DOB: *Height: *Weight: SS No.: Home No. Mobile No. Email address: Position applying for: How did you learn about us? On what date would be available for work? How long have you been a caregiver? Please tell us something about yourself: * We need these information to match you properly with a client

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