Helping Hands Childcare and Preschool Employment App Logo
  • Employment Application

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  • Education

  • Personal References* (required for first time staff only) No former employers or relatives.

  • Criminal Background

    A conviction will not necessarily disqualify you
  • Supplemental Criminal History Information Child Care Development Fund

    Employee or Volunteer
  • I have been informed that participation in CCDF Program requires the following individuals to consent to a statewide criminal history check:
    a. The applicant (defined as person signing the application)
    b. Any employee or volunteer serving as a caregiver at the facility where the provider provides childcare.
    I have also been informed that in addition to the requirement to consent to a state wide criminal history check I shall report it to the Childcare facility and the Bureau of Child Care all information regarding:

    1. Police Investigations
    2. Arrest; and
    3. Criminal Convictions

    Not listed on the state wide criminal history record or that occurs after the initial statewide criminal history check was conducted.
    I understand by my signature that I shall report this information to the childcare provider requesting my criminal history immediately and that my failure to report this information may result in the providers and ability to participate in the Child Care Development Fund Voucher program.

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  • Unlicensed Registered Child Care Ministry Substance Abuse Screening Test Consent Form

    Ministry Name: Helping Hands Childcare & Preschool | Ministry ID# RM-10057-A
  • Indiana Code 12-17.2-5-3.5 requires that each childcare Ministry shall maintain and make available drug test results which do not show a presence of the legal control substance(s) for themselves, all individuals' employee or volunteer caring for children prior to application employment or volunteering. This shall include Amphetamines, Cocaine, Opiates, PCP, and THC.

    I understand I have been informed that drug test results must be maintained to the unlicensed registered childcare ministry and available to the division of family resources. Confidentiality of these drug testers results will be maintained by the ministry and will not be disclosed to any other parties.

    The results of this drug test will be used to determine compliance with IC12-17.2-5-3.5 If drug testing results of any individual, required supplying such a test, indicate the presence of any illegal controlled substance, the registered Ministry shall immediately suspend or terminate the individuals from particpation in the Child Care Development Fund (CCDF) voucher program. I further understand that this test will not be considered a drug test for purposes of determining compliance with IC12-17.2-5-3.5

    I understand that if I refuse to consent to take the test and maintain the results for inspection by the DFR that I will not be in compliance with IC12-17.2-5-3.5

    I have read and understand the drug testing guidelines and consent form that have been provided to me

     

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  • Drug Testing Policy

    Employee and Volunteer
  • I agree to and understand the following policy.

    • All employees and volunteer applicants shall have a drug test prior to providing child care at the facility.
    • All employees are subject to random drug testing at any time. Refusal to submit to a random drug test will be classified as a positive drug test result.
    • Any employee or volunteer suspectd of being under the influence of drugs or alcohol will be immediately required to submit a drug test and will be placed on a suspended status until the results of the drug test are obtained. 
    • Any applicant with a positve drug test result will be ineligible for hire, continued employement/service.
    • Any employee eith a positive drug test will be immediately terminated from their child care duties with the facility. 

     

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  • I have been informed that my participation in the Child Care Development Fund Voucher Program requires me to provide assurance that I will not allow anyone to participate in the following acts during the hours in which I provide care.

    • I will not use tobacco anywhere in the child care facility (including outdoor play areas) during child care hours.
    • I will not allow any staff member or guest use tobacco anywhere in the child care facility (including outdoor play areas) during child care hours.
    • I will not use alcohol anywhere in the child care facility (including outdoor play areas) during child care hours.
    • I will not use any substance labeled harmful or fatal if swallowed or inhaled in a manner other than areas during child care hours.
    • I will not allow guest to use any substance labeled harmful or fatal if swallowed or inhaled in a manner other than areas during child care hours.
    • I will not use or have possession of any illegal substance on the premises of the child care facility.
    • I will not allow guest to have possession of any illegal substance on the premises of the child care facility.

    I understand by my signature below that my failure to comply with the above statements may result in the Ministry's inability to participate in the Child Care Development Fund Voucher Program.

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  • Workplace Violence Policy

  • Helping Hands Childcare & Preschool is committed to preventing workplace violence into maintaining a safe work environment. Given the increasing violence of society in general, Helping Hands Childcare & Preschool has adopted the following guidelines to deal with intimidation, harassment, or other threats of (or actual) violence that may occur during business hours or on its premises.

    All employees, including supervisors and temporary employees, should be treated with courtesy and respect at all times. Employees are expected to refrain from fighting, horseplaying, or other conduct that may be dangerous to others. Firearms, weapons, and or other dangerous or hazardous devices, substances or creatures are prohibited from the premises of Helping Hands Childcare & Preschool without proper authorization. 

    Conduct that threatens, intimidates, or coerces another employee, a customer, or a member of the public at any time, including business functions and off-duty periods, will but not be tolerated. This prohibition includes all acts of harrasement, including harassment that is based on an individual six, race, age, or any characteristic protected by federal, state, or local law.

    All threats or actual violence those direct and indirect, should be reported as soon as possible to your immediate supervisor. This includes threats made by employees, as well as threats by customers, vendors, solicitors, or members of the public. When reporting a threat of violence, you should be a specific and detailed as possible.

    All suspicious individuals or activities should be also reported as soon as possible to a supervisor. Do not place yourself in peril. If you see or hear commotion or disturbance near your workstation, do not try to intercede or see what is happening.

    Helping Hands Childcare & Preschool will promptly and thoroughly investigate all reports or threats or actual violence and of suspicious individuals or activities. The identity of the individual making a report will be protected as much as practical. In order to maintain workplace safety and the integrity of its investigation, Helping Hands Childcare & Preschool may suspend employees, without pay, pending investigation. Anyone determined to be responsible for threats of (or actual) violence or other conduct that is in violation of these guidelines may be subject to prompt disciplinary action up to and including termination of employment. 


    Helping Hands Childcare & Preschool encourages employees to bring their disputes or differences with other employees to the attention of their supervisor before the situation escalates into potential violence. Helping Hands Childcare & Preschool is eager to assist in the resolution of employee disputes and will not discipline employees for raising such concerns.

     

  • I, have received a copy of the Helping Hands Childcare & Preschool (hereinafter referred to as Company) workplace violence policy. The company workplace violence policy contains policies, practices, and regulations, which are relevant to my employment with the company.
    I have read and understood these policies, practices, and regulations. I additionally agree to comply with these policies, practices, and regulations during my employment with the Said company.
    I further understand that I will be responsible for complying with future changes in any such policies, practices, and regulations. Whether or not I have signed or acknowledged such changes, it will be my responsibility to adhere with all such changes communicated to employees.

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  • APPLICANT ACKNOWLEDGEMENT AND AUTHORIZATION

    *PLEASE READ CAREFULLY BEFORE SIGNING*
  • I hereby certify that all of the information provided by me in this application (or any other accompanying required documents) is correct, acurate and complete to the best of my knowledge. I understand that falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employement or immediate termination of employement regardless of the timing or circumstances of discovery. I understand that submition of an application does not guarantee employement. I further understand that, should an offer of employement be extended by Helping Hands Childcare and Preschool (hereinafter referred to as "HELPING HANDS CHILDCARE & PRESCHOOL") that such employement with HELPING HANDS CHILDCARE & PRESCHOOL is at will, for no specific duration and may be terminated by either HELPING HANDS CHILDCARE & PRESCHOOL or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of HELPING HANDS CHILDCARE & PRESCHOOL or its representatives used during the employemeny process is deemed a contract of employement real or implied. I understand that no respresentative of HELPING HANDS CHILDCARE & PRESCHOOL except the Executive Director has the authority to enter into any agreement guaranteeing any conditions of employement or any agreement  contrary to the foregoing statements that any such agreements must be made in writing and signed by the Executive Director of HELPING HANDS CHILDCARE & PRESCHOOL in consideration for employement with HELPING HANDS CHILDCARE & PRESCHOOL, if employed, I agree to conform to the rules, regulations, policies and procedures of HELPING HANDS CHILDCARE & PRESCHOOL at all times and understand that such obedience is a condition of employement. I understand that due to the nature of HELPING HANDS CHILDCARE & PRESCHOOL business, attendance and punctuality are considered essential requirments of every job at HELPING HANDS CHILDCARE & PRESCHOOL and that poor attendance or tardiness will result in disciplinary action. I understand that if offered a position with HELPING HANDS CHILDCARE & PRESCHOOL, I may be required to submit a pre-employement medical examination, drug screening and background check as a condition of employement. I understand that unsatisfactory result from, refusal to cooperate with, or any attempt to affect the results of these pre-employment test and checks will result in withdrawal of any employment offer or termination of employement if already employed. I hereby authorize any and all schools, former employers, references, courts and any representatives, agents, or vendors and I release all parties involved from any and all liability for any and all damage that may resut from providing such infomation. I understand that this application is considered current for three months. If I wish to be considered for employement after this period I must fill out and submit a new application.

    BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.

    HELPING HANDS CHILDCARE & PRESCHOOL IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECIEVE CONSIDERATION WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, AGE, DISABILITY, VETERAN STATUS, OR ANY OTHER STATUS PROTECTED BY LAW. 

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  • Drug Free Workplace Policy

  • Purpose: 

    The company is committed to providing a safe work enviroment and likewise expects its staff to report to their job physically and mentally ready for work. Furthermore, the company is commited to assuring its continued representation as a quality business enterprise. To achieve these goals, the company must take a firm and positive stand against drug free work enviroment for the benefit of stff and customers of the company.

    With respect to existing staff, the policy's objective is to emliminate substance abuse, not the substance abuser. To this end; the company is prepared to help and support all staff requesting assistance in dealing with drug ir alcohol problems. No one will be disciplined for requesting assistance. Indeed, the company has established an Employee Assistance Porgram that provides confidential services to staff who seek helping with dealing with drug or alcohol problems. The program may include to referral to outside treatment or rehabilitation facilities The costs of treatment may include to referral to outside treatment or rehabilitation facilities. The costs of treatment may be covered with in accordance with applicable benefit plans. 

    Policy Requirements: 

    1. The use, possession, sale or transfer of an illegal drug by any associate on company premises, in the performance of company business, or at company-sponsored events, is strictly prohibited. 
    2. The use of any legaly obtained drug by an associate while performing company business, or while on company premises is prohibited to the extent that such use may adversly affect the safety of the associates or others, the associates job performance or the company's regard or repuation in the community. Staff who have been informed or have discovered that the use of a legal drug may adversly affect job performance or behavior are to report such drug use and possible side effects to management. 
    3. The unauthorized use, possesion, sale, or transfers, of alcohol on company business, attending company-sponsored business or social functions, otherwise representing the company outside of company premises is permitted only to the extent that it is not unlawful and does not adverly affect the safety of the associates or others, the assicates job perfomance or the company's regard or reputation in the community. 
    4. The presence is specified amounts of illegal drug or alcohol in an associates system while on company premises or while otherwise performing company business is prhibited. This includes (but not limited to) the use of hemp products which may cause a positive test result for cannabis, regardless of the source; for this reason, the company does not approve of or otherwise condone the use of any hemp products, nor will it allow such use to excuse any positive test result for cannabis.

     

  • Testing and Treatment:

    1. All prospective new staff will be tested for the use of illegal drugs and controlled substances. All offers of employement made to the applicant are contingent upon successful completion of a pre-employement drug test. Applicants who refuse to complete the necessary paperwork and test, or who test positive on the drug screen, will not be offered employment Any contingent offers of employment will be revoked under these circumstances.
    2. Any staff involved in an on-the-job accident or any other incedent in which the associate or others could have been injured will be required to take a breath test, urinalysis or other drug/alcohol test before returning to or resuming work for the company. An associate must complete the necessary drug information and consent forms prior to the testing.
    3. Whenever anyone in the company suspects that an associate's work performance or on-the-job behavior may be affected in any way by alcohol or drugs, or that an associate has otherwise violated this policy, he/she shall immediately report the suspicion to the direct supervisor or to the Human Resources Department. The company may then require a breath test, urinalysis, or other drug/alcohol test. An associate must complete the necessary drug information and consent forms prior to testing. 
    4. Througout their employment with the company, all staff will be required to consent in writing to the undergo periodic testing for the presence of any illegal drug or alcohol in an associate's system while on company premises or while otherwise performing company business.
    5. Any associate who has completed the company's Employee Assistance Program for possible drug/alcohol use will be required to consent in writing to undergo periodic testing for a period of one year after release from the treatment program.
    6. An associate who test positive for alcohol or drugs during the associates introductory period will be discharged immediately for violation of this policy. After the associates introductory period, an associate whose alcohol or drug use test is positive will be subject to discipline (as set out in the following section) and may be also provided the following rehabilitation procedure:
    1. First Positive : If the company determines that it wishes to provide rehabilitative assistance to the associate, the associate will be placed on an immediate leave of absence and referred to the Employee Assistance Program for mandatory participation. The associate cannot return to work until a company approved counselor or physician releases the associate to return to regular and complete job duties and responsibilities.

     

  • Disciplinary Action:

    1. Any violation of these policy requirments will result in discipline up to and including discharge, even for a first offense. (As provided above, the first offense for an associate within his/her introductory period is immediate discharge).
    2. The failure or refusal to complete the necessary paperwork to submit to a drug test or to undergo treatment pursuant to the requirements of this policy will be grounds for immediate termination of employment.
    3. All performance shortcormings prohibited conduct, and attendance problems will result in discipline pursuant to the company's normal policies independently of any drug or alcohol implications or causes.
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  • Thank you for your interest in being a part of the Helping Hands Childcare and Preschool Family!

    By submitting this form you give us permission to contact your references and begin the screening process.
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