PLEASE FILL OUT ALL REQUIRED FIELDS OR THE APPLICATION WON'T SUMMIT PROPERLY.
Position Applying For? Child Care Day ShiftChild Care Night ShiftAdministrativeOther
Date Available to Start
How did you hear about Father's Heart Ranch? NewspaperEmployeeRadioOther
Your Full Name
Your Full Address
Your Telephone Number
Your Email
Are You 21 Years of Age or Older? YesNo
Driver's Licence Number (DMV reports are required for applicants being considered for positions which will normally require them to drive for company business)
Date of Last T.B. Test
Date of Last Physical
A. After employment, can you submit verification of your legal right to work in the United States? YesNo
B. Have you worked at FHR previously? YesNo
C. Any days/hours not available to work?
D. Did you serve in the military? YesNo
E. With or without accommodation, can you perform the duties of this job? YesNo
F. Have you ever been convicted of an offense other than the following?
1. Minor traffic violations for which the fine was $50 or less before April 5, 1984 or $100 or less on or after April 4, 1984 or
2. Any offense which was finally settled in a juvenile court or under a welfare youth offender law. (Offenses which fall under numbers 1 and 2 above need not be reported)
Employment is contingent upon clearance of your criminal record by Community Care Licensing.
YesNo
G.Has your driver's license ever been suspended or revoked? YesNo
H.If you answered "YES" to either F or G above, please provide the following information for each event: The Date, Location, Nature and Disposition of the circumstance.
Highest Year Completed in School 6789101112
Did your receive a High-School Diploma? YesNo
Are you currently enrolled in high-School Completion Courses? YesNo
Please provide the following: Name of University, Major, Years Completed Units Completed, Degree, and Date Completed.
Please provide the following: Course Title, Name of School or Organization & Location, Units and Date Completed.
Describe any specialized training, apprenticeships, skills ans extra-curricular activities:
List any licenses or certificates that you hold:
List any honors you have received:
List professional, trade business, or civic associations of which you are a member (You may exclude groups which indicate race, color, religion, sex, age or other protected status):
What foreign languages do you speak, read, or write?
State any additional information you feel may be helpful to us in considering your application:
Company Name:
Telephone Number:
Address:
Dates of Employment:
Name of Supervisor:
Job Title:
Hours Worked Per Week:
Describe Responsibilities/Duties:
Reason for leaving:
Company Name (previous employer):
Name:
Relationship:
I certify that the answers given herein are true and complete to the best of my knowledge. If I am employed, I understand that false or misleading information given on this application or during interview(s) may result in discharge at any time.
I authorize investigation of all statements contained in this application. I authorize Father's Heart Ranch to contact any of my references, employers and/or schools to furnish any information concerning my employment, education, and/or background, character, abilities, etc. I release Father's Heart Ranch and all persons and organizations from all claims and liabilities of any nature arising from such inquiries and investigations.
I understand that employment depends upon the screening of my criminal history, TB clearance, physical examination and child abuse check.
I understand that employment at Father's Heart Ranch is "at will". If I am employed, I at my own discretion, or Father's Heart Ranch, at its own discretion, may terminate my employment at any time with or without cause and with or without notice.
By checking "Agree" below, I electronically certify and agree to all of the above statements. AgreeDisagree
The following questions are related to the child care worker position for which you are applying. Please write a short paragraph in response to each of these questions.
1. After having enjoyed a weekend off, you arrive to work at the group home on Monday morning. One of the clients with whom you have developed a good rapport approaches you and says, "I have a secret to share with you but you can't tell anyone else." She proceeds to tell you that during a recent home visit, she was molested by a family member. How would you handle this situation?
2. A child who was recently placed at Father's Heart Ranch challenges your level of concern for his well-being. After a small verbal battle he states, "You don't care about me and neither does anyone else at this place-you all get paid to be here!" How would you respond to this?
3. If you could establish your own discipline policy for a group home, what would it be?
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