Staffing

OGHC (Oceangates Healthcare LLC) provides equal employment opportunity to all qualified persons, and does not unlawfully discriminate against any person on the basis of race, color, creed, religion, sex, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.
Please:
• Complete all items on the application, even if the information is included on your resume or other document submitted by you.
• Sign and date your application.
• Specify the exact title of the position in which you are interested.
• Type or print all requested information.
• Provide three professional references.
• Attach resume (optional).

POSITION APPLYING FOR

Personal Information

First Name

Middle Name

Last Name

SOCIAL SECURITY NUMBER *

DRIVER'S LICENSE (STATE/NUMBER)

TELEPHONE NUMBER *

ALTERNATE NUMBER

STREET ADDRESS *

CITY *

STATE *—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCASGUMPPRUMVI

ZIP CODE *

EMAIL ADDRESS *

ATTACH RESUME

General Information

ARE YOU LEGALLY ELIGIBLE FOR WORK IN THE UNITED STATES? * YESNO
If yes, verification will be required.

HAVE YOU EVER APPLIED TO OR WORKED FOR THIS OGHC (Oceangates Healthcare LLC) BEFORE? * YESNO

ARE ANY OF YOUR RELATIVES CURRENTLY WORKING FOR OGHC (Oceangates Healthcare LLC)? * YesNo

HAVE YOU EVER BEEN CONVICTED OF A FELONY? * YesNo

Employment Request

MINIMUM SALARY REQUESTED (USD) *

IF APPLICABLE, ARE YOU AVAILABLE FOR OVERTIME? * YesNo

WHAT IS THE EARLIEST DATE YOU CAN BEGIN WORK? *

HOW DID YOU HEAR ABOUT THIS POSITION? *
—Please choose an option—Recruited InternetJob PostingNewspaper Classified Company WebsiteOther

Employment History

Please begin with most recent employment.

Employer 1

EMPLOYER *

MAY WE CONTACT YOUR CURRENT EMPLOYER? * —Please choose an option—YesNoNot Applicable

ADDRESS *

SUPERVISOR *

TELEPHONE NUMBER *

DATES OF EMPLOYMENT: FROM * TO *

POSITION *

PAY OR SALARY – Start * USD

PAY OR SALARY – Final * USD

DUTIES *

REASON FOR LEAVING *

Employer 2

EMPLOYER *

MAY WE CONTACT YOUR CURRENT EMPLOYER? * —Please choose an option—YesNoNot Applicable

ADDRESS *

SUPERVISOR *

TELEPHONE NUMBER *

DATES OF EMPLOYMENT: FROM * TO *

POSITION *

PAY OR SALARY – Start * USD

PAY OR SALARY – Final * USD

DUTIES *

REASON FOR LEAVING *

Employer 3

EMPLOYER *

MAY WE CONTACT YOUR CURRENT EMPLOYER? * —Please choose an option—YesNoNot Applicable

ADDRESS *

SUPERVISOR *

TELEPHONE NUMBER *

DATES OF EMPLOYMENT: FROM * TO *

POSITION *

PAY OR SALARY – Start * USD

PAY OR SALARY – Final * USD

DUTIES *

REASON FOR LEAVING *

Employer 4

EMPLOYER *

MAY WE CONTACT YOUR CURRENT EMPLOYER? * —Please choose an option—YesNoNot Applicable

ADDRESS *

SUPERVISOR *

TELEPHONE NUMBER *

DATES OF EMPLOYMENT: FROM * TO *

POSITION *

PAY OR SALARY – Start * USD

PAY OR SALARY – Final * USD

DUTIES *

REASON FOR LEAVING *

Education

HIGH SCHOOL/GED *

LOCATION *

COURSE OF STUDY *

DEGREE OBTAINED *

COLLEGE/UNIVERSITY *

LOCATION *

COURSE OF STUDY *

DEGREE OBTAINED *

GRADUATE SCHOOL *

LOCATION *

COURSE OF STUDY *

DEGREE OBTAINED *

VOCATIONAL/SPECIALIZED *

LOCATION *

COURSE OF STUDY *

DEGREE OBTAINED *

Military

MILITARY SERVICE* YesNo

BRANCH *

SPECIALIZED TRAINING *

References

NAME *

COMPANY *

TITLE *

CONTACT INFORMATION *

NAME *

COMPANY *

TITLE *

CONTACT INFORMATION *

NAME *

COMPANY *

TITLE *

CONTACT INFORMATION *

Signature / Certification

I, certify that the facts set forth in this application are true, complete, and correct to the best of my knowledge. I understand that any misrepresentations, falsifications, or omissions on this applciation can be ground for rejection of my application or, if this company employs me, for my immediate termination from employment. I authorize OGHC (Oceangates Healthcare LLC) to make any necessary inquires and investigations into my education, military, or employment hisroty. I further authorize, unless otherwise indicate on this application, the release of my information to OGHC (Oceangates Healthcare LLC) by any of the schools, services, or employers listed on this application.

NAME OF APPLICANT *

DATE *

Please click to view and download the forms:

• Form I-9
• Form W-4
• Health Care Worker Background Check Form

Pre-Employment Background Check Authorization

I understand that as part of the employment process, needs to complete a background check of me regarding:
1. Criminal Record
2. Sex and Violent Offernders Record;
3. Employment Verification
4. Education Verification
5. License Verification
6. Motor Vehicle Records
7. Personal/Professional Reference Verification
8. Medical Suitability
9. Drugs/Alcohol

I authorize all federal and state agencies, persons and organizations that may have information relevant to this research to disclose such information to OGHC (Oceangates Healthcare LLC) or its authorized agent(s).
I understand that this authorization is to be part of the written and signed employment application.
I also understand that I do not have to give authorization for a background check but if I don’t give permission, my employment application will not be processed further.
I understand that I have specific rights under the faderal Fair Credit Reporting Act (FCRA) and may have additional rights under relevant State law.
I further authorize that a photocopy of this authorization may be considered as valid as the original.
I hereby certify that all statements on this form are true and correct to the best of my knowledge and belief. I understand that employment with OGHC (Oceangates Healthcare LLC) is contingent upon the successful completion of a background check.

FULL NAME *

DATE *

TELEPHONE NUMBER *

FORMER NAME(S) AND DATE(S) USED *

CURRENT ADDRESS *

DATE OF BIRTH *

SOCIAL SECURITY NUMBER *

CURRENT DRIVER'S LICENSE *

STATE *—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCASGUMPPRUMVI

List any other cities, states and dates of residency during last 10 years.

CITY *

STATE *—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCASGUMPPRUMVI

FROM * TO *

CITY *

STATE *—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCASGUMPPRUMVI

FROM * TO *

CITY *

STATE *—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDCASGUMPPRUMVI

FROM * TO *

Home Care Companion Job Description

Description:

• Home Care Companions provide service to individuals in their own homes and communities who need assistance caring for themselves as a result of old age, sickness, disability, and/or other inflictions.
• Home care may include light housecleaning, laundry, meal preparation, transportation, companionship, respite, and advice on such things as nutrition, cleanliness, and household activities.
• Home Care Companions are responsible for ensuring that service is delivered in a caring and respectful manner, in accordance with relevant Agency policies and industry standards.
Reporting Relationship:
• Reports to Supervisor

Responsibilities/Activities:

• Provide companionship, friendship, and emotional support.
• Talk, listen, share experiences, play games/cards, read to clients, etc.
• Help keep clients in contact with family, friends, and the outside world.
• Provide transportation to medical appointments, grocery stores, and errands.
• Accompany clients to recreational and/or social events.
• Assist with plans for visits and outings.
• Write or type letters/correspondence.
• Organize and read mail.
• Plan trips and outings and possibly travel with clients.
• Teach/perform meal planning and preparation.
• Perform light housekeeping.
• Participate in the Care Team by providing input and making suggestions.
• Ensure service is delivered in accordance with Agency policies, procedures, and industry standards.
• Monitor supplies and resources.
• Evaluate the program and make recommendations, as indicated. Follow the written care plan.
• Assist in basic client transfers providing the client has been assessed as being capable of ambulating without assistance; and/or, providing another trained caregiver (including family) is involved in the transfer.
• Carry out duties as assigned by the Supervisor.
• Observe the client’s functioning and report to Supervisor.
• Complete and maintain records of daily activities, observations, and direct hours of service.
• Develop and maintain constructive and cooperative working relationships with others.
• Make decisions and solve problems.
• Assist with pet care.
• Communicate with Supervisor and co-workers.
• Attend orientation, in-service training sessions, and staff meetings.

Required Knowledge:

• Knowledge of home management skills.
• Knowledge of principles and processes for providing client services, including needs determinants, meeting quality standards, and evaluation of client satisfaction.
• Knowledge of the English language.
• Knowledge of information and techniques needed to diagnose and treat injuries including emergency first aid and CPR.
• Knowledge of clerical procedures such as maintaining records and completing forms.

Required Skills/Abilities:

• The ability to be aware of other people’s reactions and understand why they react as they do.
• The ability to establish and maintain relationships.
• The ability to teach others.
• The ability to identify problems and determine effective solutions.
• The ability to apply reason and logic to identify strengths and weaknesses of possible solutions.
• The ability to understand written and oral instructions.
• The ability to communicate information orally and in writing. The ability to listen and understand the spoken word.
• The ability to work independently and in cooperation with others.
• The ability to determine or recognize when something is likely to go wrong.
• The ability to suggest a number of ideas on a subject.
• The ability to provide advice and consultation to others.
• The ability to observe and recognize changes in clients.
• The ability to establish and maintain harmonious relations with clients/families/co-workers.
• Physical and Mental Demands:
• Good physical and mental health.
• Physical ability to stand, walk, use hands and fingers, reach, stoop, kneel, crouch, talk, hear and see.
• Mental fortitude and stability to handle stress.
• Physical and mental ability to drive a vehicle.
• Qualifications/Education:
• High school diploma
• Current driver’s license.
• Proper Vehicle Insurance Coverage.
• Training/Experience:
• May require related experience.
• May require similar social and cultural backgrounds with some clients.

I have read and understand the job descrition and agree to fulfill the position’s responsibilities.

EMPLOYEE NAME *

DATE *

SUPERVISOR NAME

DATE *

Additional Documents

TB Test *

Covid Card *

Social Security Card *

CPR *

Physical *

Identity Card (ID) *