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Please access the official job application at: https://hh58896.clearcareonline.com/quick-apply/ and submit for consideration (Thank you!)
First Name
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Last Name
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Preferred Name
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Email Address
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Date that you can begin working shifts:
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Below are tasks you may be asked to do for our clients / items relevant to our clients' environments. Your answers will guide us in placing you with compatible clients.
I will commute to the worksite location using my own car (or a car you can use regularly)?
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Yes (must provide Drivers License and Proof of Insurance)
No (I will be regularly chauffeured)
No (I will pay for commuting/transportation)
Comfortable in homes with pets?
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Yes, I don't object to any type of pet
No, I object to every type of pet
I object to these specific types of pets
I object to these specific types of pets
Comfortable in homes with a smoker?
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Yes, I don't object (I will not smoke, regardless)
No, I object
No, I object
Do you own scrubs?
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Yes
No
No
Top Size
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Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Fill In
Pant Size
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Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Fill In
Please check all that apply:
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I own a smartphone
I own a computer, printer
I own a computer, no printer
I can access a computer, printer at home
I can access a computer, but no printer at home
No computer access
Homemaking/Housekeeping
Vacuum / Sweep Floors
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Dust Furniture
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Polish Furniture
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean Mirrors
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Wet Mop Floors
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean Kitchen Surfaces
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean Inside Windows
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean Stove / Oven
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Change Bed / Linen
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Prepare Meal(s)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Receive and prepare or store delivered meals
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Hand wash laundry, hang clothes to dry
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Clean, organize refrigerator (inside)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Defrost freezer
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean microwave oven
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean bathroom sink
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean bathtub/shower
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean toilet
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Make bed(s)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Prepare meals in advance for storage
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Laundry (washer/dryer)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Laundry (laundromat)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Other unspecified homemaking or housekeeping tasks requested
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Companion/Sitter
Companionship/supervision & overseeing of client's activities
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Transportation & Escort
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Taking client for walks
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Medication reminding
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
(Taking) shopping
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Incidental household tasks (for client & others)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Socialization activities
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Meal service, including preparation & clean-up (assistance)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Assisting with correspondence (handwriting or typing3
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with personal business (bill paying, appointment setting, calendar)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with electronic devices (computer, television, cellphone)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Other
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Personal Care
Assisting with bathing/showering (bathroom)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Sponge bathing
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Bed bathing
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Wash hair
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Stand by to ensure bathroom safety
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Shaving (face and body)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Brush teeth
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean dentures
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Clean hearing aid(s)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Routine skin care
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Nail care (hands and feet)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Wash hands and face
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Dressing and undressing
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assist with exercising
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Toileting (toilet, commode, bedpan)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with eating, drinking, utensils, adaptive devices
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with feminine hygiene
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with toilet hygiene
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Changing protective undergarments (diapers)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Transferring
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Positioning (chair, bed, couch, recliner)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Assisting with ambulation (walking, walker, rollator, wheelchair, cane)
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Supervision / encouragement of independent personal care activities
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Supervision / assistance, encouragement of therapeutic activities
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
Other unspecified personal care activities
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Yes, I can and will
Yes, I would but I need instruction
No, I am unwilling
No, I am unwilling
Availability
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Mon
Tues
Wed
Thur
Fri
From (time)
Mon
Tues
Wed
Thur
Fri
To (time)
Mon
Tues
Wed
Thur
Fri
*
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Sat
Sun
From (time)
Sat
Sun
To (time)
Sat
Sun
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