NEW Sheraton Caregiver Employment Application

Sheraton Caregiver Employment Application

Step 1
Personal Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Residential Address

Street Address

CityState

Zip Code
Mobile Phone
Please enter a valid phone number.Format: (000)000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Vaccinated Against COVID-19?
Are you at least 18 years old?
Position Applied for?
Please indicate the days & times you are available to work?
How many hours can you work weekly?
Are you able to work weekends?
Are you able to work nights?
Would you consider live-in?
In accordance with IRCA 1986 are you able legally authorize to work in the US?
When are you available to work?
Have you worked under a different name?
Driver's License
Driver License Received
Driver License Number
State
Do you have access to an automobile for your shift?
Have you had your license revoked in the past 3 years?
Reference Information

Please list two references OTHER THAN relatives or previous employers. (i.e. people you've helped in the past, friends.co-workers, etc.)
References #1
Full Name*
Company*
Relation*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Reference #1
Full Name*
Company*
Relation*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
More About You

An application form sometimes makes it difficult to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications to be a caregiver. Please note any experience with caregiving professionally, for your parents, spouse, children or friends. Use additional sheets, if necessary.
Why do you enjoy caregiving?*
What do you like most about Elderly?*
What are some of your hobbies and interest?*
How did you hear about the position? Who referred you?*
Education
High School
Address
Number of Years Attended
Did you graduate?
College or Tarde School
Address
Major & Degree
Number of Years Attended
Did you graduate?
Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give company name. Attach additional sheets if necessary.
Company*
Address*
Name of Supervisor*
Phone Number*
Are you currently employed? If yes please add dates*
Employment Date
Company*
Address*
Name of Supervisor*
Phone Number*
Are you currently employed? If yes please add dates*
Employment Date
Company
Address
Name of Supervisor
Phone Number
Are you currently employed? If yes please add dates
Employment Date
Emergency Contact #1

Personal Information
Personal Information*
Contact Information*
Address

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact #2
Personal Information*
Contact Information*
Address

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact #3
Personal Information
Contact Information
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Disclosure and Authorization for Consumer and/or Investigate Consumer Report

Company Name: SHERATON CAREGIVERS, LLC
In connection with your application and/or employment with above listed Company (here in after "Company ") this notice is provided to inform you that a "consumer report" and/or "investigative consumer report", as defined by the Fair Credit Reporting Act (15 U.S.C. § 1681), may be obtained from a consumer reporting agency or state judicial website for employment purposes. These reports may include information about your character, general reputation, personal characteristics and mode of living, whichever are applicable. The report may also contain information about you relating to criminal history , credit history , motor vehicle records such as driving records, social security verification , workers ' compensation claims (post job offer or conditional job offer), verification of education or employment history or other background checks. They may involve personal interviews with sources such as your neighbors, friends or associates. You have the right, upon written request ·made within a reasonable time after receipt of this notice, to request a copy of the report from the Human Resource Dept. of Sheraton Homecare Services. The scope of this notice and authorization is not limited to the present and, if you are hired, will continue and allow Company to conduct future background screenings for retention, promotion or reassignment , unless revoked by you in writing. Company also reserves the right to share your report with any third-party for whom you will be placed to work with as a representative of Company.
Acknowledgement and Authorization
By signing below you acknowledge receipt of a copy of the A Summary of Your Rights under the Fair Credit.
Reporting Act and certify that you have read this notice and authorization as well as the summary document.
You hereby authorize the obtaining of a consumer report and/or investigative consumer report at any time after receipt of this authorization by Company, and if you are hired, throughout your employment, as permitted by law.
You also confirm your understanding and provide consent for this report to be shared with a third-party for whom you may be placed to work as a representative of Company, if applicable.
Signature*
Date*

MonthDayYear
Date
Full Legal Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth*

MonthDayYear
Social Security Number
Driver's License
Name on Driver's License (if different from legal name)
Driver License Received
Driver License Number
State
Contact Information
Mobile Number
Email
example@example.com
Minnesota & Oklahoma applicants or employees only: Under state law you have a right to receive a copy of your consumer report, free of charge, if one is requested by Company. By checking "yes", a copy will be provided to you at the address you provide on this notice.
I would like to receive a copy of my consumer report: ( ) Yes ( ) No
New York applicants or employees only : Under state law you have the right to inspect and receive a copy of any investigative consumer report requested by Company by contacting National Crime Search, Inc. directly . You al so acknowledge receipt of a copy of Article 23-A of the New York Correction Law by signing this notice.
Washington State applicants or employees only: Under state law you have a right to request a copy of the Washington Fair Credit Reporting Act’s disclosures to consumers (RCW 19. 182.070) by contacting National Crime Search, Inc. directly.
Massachusetts/New Jersey: If you submit a request to NCS in writing, you have the right to know whether the Company ordered an investigative consumer report from NCS. You may inspect and order a free copy of the report by contacting National Crime Search, Inc. directly.
California, Maine applicants or employees only: Under state law you have a right to receive a copy of your investigative consumer report and/or
consumer credit report, free of charge, if one is requested by Company. By checking "yes" a copy will be provided to you at the address you provide on this
Notice.
I would like to receive a copy of my consumer report : ( ) Yes ( ) No
CA applicants or employees only
You acknowledge receipt of a copy of the summary of the provisions of California Civil Code section 1786.22 by signing above.
**This information will be used for background screening purposes only and no other purpose.
Checkbox
Consumer report/ investigate consumer report authorization document
By signing below, I authorize Sheraton Caregivers LLC, to order consumer reports and investigate consumer reports from any consumer reporting agency (“CRA”), to the extent allowed by law, including the current CRA, ______________. I understand that, to the extent allowed by law, the company may rely on this authorization to order additional consumer reports and investigative consumer reports from any CRA without asking me for my authorization again during any period of my employment.
For the specific purpose of preparing consumer reports and investigate consumer reports for the company, and subject to all laws protecting my privacy, I authorize the following to disclose the CRA the information needed to compile the reports: law enforcement and other federal, state, and local agencies; all courts; my past or present employers; learning institution, including colleges and universities; credit bureaus; and motor vehicle records agencies.
_________ Check to receive a free copy of the report(s) if you live or applying for work in California, Minnesota, or Oklahoma.
Checkbox
The below-requested information will be used for background screening purposes only
Full Name

First NameMiddle NameLast Name
Social Security Number
Checkbox
Driver's License
Driver License Number
Driver License State
Current Address

Street Address

Street Address Line 2

CityState

Zip Code
Applicant Signature of Acknowledgement and Authorization
Signature*
Date*

MonthDayYear
Date

Release Form

Step 2
I give permission to Sheraton Caregivers LLC to use myself, my likeness, and my artwork in photograph and/or videos in the following publications:
-Internal Publications -internal newsletter, internal website, clinical team meetings.

- Social Media -Facebook, Instagram, Twitter, LinkedIn, and any other social media accounted linked with Sheraton Caregivers, LLC.

-Outside Publications printed or digital, such as; brochures, presentations, PowerPoints, email blasts, and any other marketing materials used to shw Sheraton Caregivers, LLC services.

I acknowledge that since my participation with Sheraton Caregivers LLC is voluntary, I will receive no financial compensation.

I hereby hold harmless and release and forever discharge Sheraton Caregivers LLC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Sheraton Caregivers Professional Association of Caregivers Code of Ethics
With signing your name below, you solemnly accept the code of ethics provided below.

1.I will always treat my clients with kindness and respect.

2. I will always arrive at the client's home on time, preferably 5 minutes before the start of my scheduled hours. if I might be late, I will immediately call.

3.I will follow the Plan of Care each day for my client.

4.I will maintain a clean and organized home for my client

5. I will never leave my client unattended. If the relief caregiver Is late I will immediately call the Care Manager.

6.I will address my client by their last name unless they invite me to use their first name.

7. I will honor the client's right to privacy and confidentiality, including their identity, address, and telephone number.

8.I will keep my religious beliefs, political choices, or personal issues private and likewise respect my client's beliefs.

9.I will call 911 immediately when there is a medical emergency and then call my senior care company office or Care Manager.

10. I will not engage in financial transactions nor intimate relationships with a client or family member.

11. I will never use alcohol or illegal drugs as a professional caregiver.

12. I will only use my personal mobile phone for calls and texts during rest or break periods.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Standards of Conduct
To ensure safety and security and provide the best possible work environment, we expect employees to follow basic, common-sense rules of conduct that will protect everyone's interests and safety. It is not possible to list all the forms of behavior that are considered unacceptable in the workplace, but the following are examples of infractions of rules of conduct that may result in disciplinary action, including suspension, demotion, or termination of employment:

-Falsification of employment records, employment information or other records.

-Recording the work time of another employee, allowing any employee to record another employee's work time, or allowing falsification of any timecard, whether yours or another employee.

-Theft or the deliberate or careless damage of any Sheraton Care LLC (Company) property or the property of any employee or client.

-Use of Company materials, supplies, tools or products for personal reasons without advanced permission from management.

-Abuse of the Company's electronic resources, including sending personal emails during working time or in a manner that interferes with the employee's work performance.

-Possessing, distributing, selling, transferring, or using or being under the influence of alcohol or illegal drugs in the workplace.

-Provoking a physical fight or engaging in physical fighting during working hours or on premises owned or occupied by the Company.

-Carrying firearms, weapons, or dangerous substances at any time, on premises owned or occupied by the Company, unless state law provides otherwise. Note: This prohibition applies only to the extent allowed by applicable state law. In those states that firearm the lawfully vehicle in the locked specifically give the right to maintain a possessed in a employer's employee parking lot, employees will be permitted to maintain a firearm in their own locked vehicle in compliance with the law. Under those circumstances, employees are prohibited from removing the firearm from their vehicle or carrying it on their person or into a building.

-Using abusive, violent, threatening or vulgar language at any time during working hours or while on premises owned or occupied by the Company.
Absence of three (3) consecutive scheduled workdays without prior notice to the Company.

-Failing to obtain permission to leave work during normal working hours.

-Failing to observe working schedules, including meal and rest breaks.

-Abusing or misusing paid sick leave (note: for employees subject to mandatory sick leave laws, the provisions of the applicable policy govern sick leave issues);

-Failing to provide a certificate from a health care provider when requested or required to do so in accordance with applicable law.

-Working overtime without authorization or refusing to work assigned hours.

-Violating any safety, health or security policy, rule or procedure of the Company; and
Committing a fraudulent act or intentional breach of trust under any circumstances.
Although employment may be terminated at-will by either the employee or the Company at any time, without following any formal system of discipline or warning, we may exercise discretion to utilize forms of discipline that are less severe than termination. Examples of less severe forms of discipline include verbal warnings, written warnings, demotions and suspensions. Although one or more of these forms of discipline may be taken, no formal order or procedures are necessary. The Company reserves the right to determine which type of disciplinary action to issue in response to any type of performance issue or rule violation.

This statement of prohibited conduct does not alter or limit the policy of at-will employment. Either the employee or the Company may terminate the employment relationship at any time for any reason, with or without cause, and with or without notice. As previously set forth in this Employee Handbook, only the President/Owner of the Company or that person's authorized representative has the authority to enter into an employment agreement that alters the fact that the employment relationship is at-will, and any such agreement must be in writing signed by the
Full Name

First NameLast Name
Signature*
Conflicts of Interest
All employees must conduct themselves in such a way as to avoid actual or potential conflicts of interest. The following are examples of prohibited conflicts of interest in any aspect of their jobs:

-Acting as a director, officer, consultant, agent or employee of a supplier, customer, competitor or any entity that engages in business with the Company;

-Owning a material interest in or being a creditor of or having other financial interest in a supplier, customer, competitor or any entity that engages in business with the Company;

-Receiving from or giving to any supplier, customer or competitor gifts, gratuities, special allowances, discounts or other advantages not generally available to employees of the Company;

-Having any significant direct or indirect personal interest in a business transaction involving the Company;

-Conducting outside activities that materially detract from or interfere with the full and timely performance of an employee's job duties for the Company;

-Influencing commercial transactions involving purchases, contracts or leases in a way that would have a negative impact on the Company or its business.

If an employee has, or is considering the assumption of, a financial interest or outside employment relationship that might involve a conflict of interest or if the employee is in doubt concerning the proper application of this policy, they should promptly discuss the matter with HR Sheraton for Caregivers and refrain from exercising responsibility on the Company's behalf in any manner that might reasonably Manager be considered to be affected by any adverse interest. Failure to disclose the fact of a conflict or potential conflict may constitute grounds for disciplinary action. This policy in no way prohibits employee affiliations or activities that are protected under applicable state and federal laws, including but not limited to any activity that is protected under Section 7 of the National Labor Relations Act, which includes the right of employees to organize collectively and to speak with others about their terms and conditions of employment.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Equal Employment Opportunity
Sheraton Caregivers LLC is an equal opportunity employer. In accordance with applicable law, we prohibit discrimination against any applicant limited but based basis, or on legally-recognized including, color, sex(including lactation, religion, employee any race, pregnancy, childbirth or related medical conditions), sexual orientation, gender identity, age (40 and over), national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed service member status or any other status protected by federal, state or local law. Our commitment to equal opportunity employment applies to all persons involved in our operations and prohibits unlawful discrimination by any employee, including supervisors and co-workers. Complaint Procedure

Any employee who believes they have been harassed, discriminated against or subject to retaliation by a co-worker, supervisor, agent, client, vendor or customer of Sheraton Caregiver LLC, in violation of the foregoing policies, or who is aware of such harassment, discrimination or retaliation against others, should immediately provide a written or verbal report to their supervisor, any other member of management to report such incidents. After a report is received, a thorough and objective investigation by management will be undertaken. The investigation will be completed, and a determination made and communicated to the employee as soon as practical. The Company expects all employees to fully with any investigation conducted by the Company into a complaint of proscribed harassment, discrimination or retaliation, or regarding cooperate the alleged violation of any other Company policies, and during the investigation, to keep matters related to the investigation confidential. If we determine that this policy has been violated, remedial action will be taken, commensurate with the severity of the offense. Appropriate will action taken to deter any future harassment or discrimination prohibited by this policy. If a complaint of prohibited harassment, also be discrimination or retaliation is substantiated, appropriate disciplinary action, up to and including termination of employment, will be taken. The Equal Employment Opportunity Commission ("EEOC") and equivalent state agencies will accept and investigate charges of unlawful discrimination or harassment at no charge to the complaining party. Protection Against Retaliation

Retaliation is prohibited against any person by another employee or by SHERATON CAREGIVERS for using this complaint procedure, reporting proscribed harassment, or for filing, testifying, assisting or participating in any manner in any investigation, proceeding or hearing conducted by a governmental enforcement agency. Prohibited retaliation includes, but is not limited to, termination, demotion, suspension, failure hire or consider for hire, failure to give equal consideration in making employment decisions, failure to make employment recommendations impartially, adversely affecting working conditions or otherwise denying any employment benefit. An employee should report any retaliation prohibited by this policy to their supervisor, any management team member or to Human Resources. Employees can contact Manager to report such incidents. Any report of retaliatory conduct will be investigated in a thorough and objective manner. If a report of retaliation is substantiated, appropriate disciplinary action, up to and including termination of employment, will be taken.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Harassment Discrimination and Retaliation
It is the company's policy to investigate all claims of discrimination and harassment thoroughly and promptly. To the fullest extent practicable and permissible, the Company will maintain the confidentiality of those involved. If an investigation confirms that discrimination or harassment has occurred, the company will tale corrective action commensurate with the severity of the offense which may include disciplinary action, up to and including immediate termination of employment. Disciplinary action may be taken when an investigation reveals conduct on the part of an employee that does not rise to the level of unlawful discrimination or misconduct, but it is nevertheless inappropriate or unprofessional. Appropriate action may also be taken to deter future discrimination or misconduct. It is the responsibility of every employee to conscientiously follow the company's policies prohibiting discrimination and harassment.

This policy includes but it's not limited to discrimination and harassment by clients of Company employees. The Company does not tolerate unlawful discrimination or harassment of employees by clients. If a client discriminates against or harasses a Company employee, the employee should immediately report the discrimination and/or harassment as described in this policy. The Company will investigate the employee's complaint, and if the Company substantiates the employee's claim of discrimination or harassment by a client, the Company may take a range of remedial action involving the client, including but not limited to warnings to the client and termination of the Company's relationship with the client.

No Retaliation!

The Company will not retaliate, nor will it tolerate retaliation, against employee who in good faith report unlawful discrimination or harassment in the workplace The Company will investigate any such report and will take whatever corrective action is deemed appropriate, including disciplining or discharging any individual who is found to have violated these prohibitions against basement and retaliation.

Employees are also encouraged to behavior, that Is believed to be Illegal or unethical and, when in doubt, about the best course of action in a particular situation.

If for any reason die employee does not feel that it would be appropriate to report the complaint to his or her supervisor, the employee should immediately report it to any member of Company management or the CEO. Sheraton Caregivers prohibits retaliation against any employee for reporting incidents of unlawful harassment, discrimination or retaliation.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Handling Money, Tips, and Gifts
Sheraton Caregivers is committed to providing our clients with exceptional care.

Often our clients are unable to make rational decisions about money due to compromised cognitive or physical abilities. Even though this may not be true for all the clients we serve we much apply our policy throughout the company.

Therefore, our company policy mandates the all caregivers are NOT allowed to accept money, tips or gifts for their services from a client or family member under any circumstances. A caregiver should notify the office staff and your supervisor immediately if a client makes make such offers.

By signing this policy, you acknowledge and understand that you are NOT allowed to accept tips, gifts or money from a client or family member for any reason.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Personal Appearance
The image Sheraton Caregivers, LLC projects to the public is reflected in the appearance of our employees. Simply stated, employees should look well-groomed and should be dressed appropriately for their specific duties. Employees are expected to use good judgment in their appearance and grooming, keeping in mind the nature of the work, their own safety and the safety of co-workers, and their need to interact with the public.

[OPTIONAL: Below are a few guidelines for professional appearance:

Clothing should not constitute a safety hazard.
All employees should practice commonsense rules of cleanliness and comfort.
When jeans are appropriate for the position, the jeans must be in good condition. Tank tops, tee-shirts, jogging suits, tennis shoes, flip-flops, slippers, sandals, garments that are unnecessarily revealing, sweat pants and other similar apparel are generally not permitted.
Personal appearance should be clean. If an employee shaves, then the employee's facial hair should be clean-shaven or trimmed. If an employee does not shave, facial hair should be clean.
facial hair or should be clean-shaven
Jewelry may be restricted for safety reasons, based on the position.
We encourage employees to seek the advice of their supervisor or Human Resources if they have questions regarding appropriate dress at work. Employees who report to work improperly dressed or groomed may be instructed by their supervisor to return home to appearance change. The time that nonexempt employees are absent for this purpose will be unpaid unless state law requires otherwise.

Nothing in this policy is intended to prevent employees from wearing a hair or facial hair style that is consistent with their cultural, ethnic or racial heritage or identity. This policy will be interpreted to comply with applicable local, state or federal law.

Religious, Medical and Disability Accommodations

The Company will reasonably accommodate exceptions to this policy if required due to an employee's religious beliefs, medical condition or disability. Employees who need such an accommodation should contact their supervisor or Human Resources.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Work Outside Of Scheduled Shifts
The Company is committed to compensating non-exempt employees for all work performed in accordance with all applicable state and federal laws.

Non-employee's expected work schedules and hours reflective of their assignments hour so working Non-exempt are to Managers must approve of a non-exempt employee's work schedule and/or assignments in advance of that non-exempt employee actually working any time in excess addition to his/her scheduled shift or scheduled assignments. Non-exempt employees must report and will be paid for all work in excess of their scheduled shifts and/or assignments, but may be subject to discipline up to and including termination of employment if the work was not pre- authorized by the appropriate manager.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Acknowledgement
ONLY SIGN THIS DOCUMENT AFTER YOU HAVE READ AND UNDERSTOOD THE COMPANY'S WORK OUTSIDE OF SCHEDULED SHIFTS POLICY AND HAVE BEEN GIVEN AN OPPORTUNITY TO ASK QUESTIONS ABOUT THE POLICY.

Employment with SHERATON CAREGIVERS, LLC is at-will, unless state law provides otherwise. This means that employment may be terminated for any or no reason, with or without cause or notice at any time by the employee or by the Company. Nothing in this handbook or any statement shall limit the right to terminate at-will. This employment policy is the sole and entire agreement between the employee and SHERATON CAREGIVERS, LLC regarding the fact that employment with at-will. SHERATON CAREGIVERS, LLC. No manager is to enter into a contract of employment express or implied that changes the fact that employment with SHERATON CAREGIVERS, LLC is at-will.

Only the President/Owner of the Company or that person's authorized representative has the authority to enter into an employment agreement that alters the fact that employment with SHERATON CAREGIVERS is at-will, and any such agreement must be in writing signed by the President/Owner of the Company or an authorized representative.

I acknowledge that I understand the Company's Work Outside of Scheduled Shifts Policy and have been given adequate time to ask questions about the policy. I have no further questions about the policy but understand that, if I do have any questions in the future, I should speak with my manager.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Sheraton Caregivers Policies and Procedures Manual
I have acknowledged receipt of Sheraton Caregivers, LLC (SHERATON CAREGIVERS, LLC) Caregiver Employee Policies and Procedures Manual and that I have read and understand the policies and procedures in it. I understand that the manual describes certain policies and procedures of Sheraton Caregivers, LLC and is a guideline to assist all employees in understanding and following SHERATON CAREGIVERS, LLC policies and procedures. I further understand that the handbook is subject to change at the discretion of management and that SHERATON CAREGIVERS, LLC may change or discontinue policies and procedures as it finds necessary. Furthermore, nothing contained in the manual or any other statements, either verbal or written, concerning policy and procedure constitutes a contract of employment.

1. I understand that the agency and employees must abide by HIPPA regulations and that I have received instruction regarding HIPPA from agency.

2. I understand that the agency and employees must adhere to universal precautions and that I have received instruction regarding precaution from agency.

3. I understand that the agency and employees must adhere to the rules and expectations set out to me by the Assisted Living community and that I have received Instruction regarding caregiver conduct In the Assisted Living community from agency.

4. I acknowledge that the agency and employees have given me the Assisted living rules, dress code and regulations for conduct.

I agree that Sheraton Caregivers, LLC can terminate our employment relationship at any time, with or without cause and with or without agree notice, except that where possible due notion will be given by both. All the records are considered to be the property of Sheraton Caregivers, LLC and copying them in any way or giving information in them understand to anyone without Sheraton Caregivers, LLC's approval Is prohibited. Any violation of this policy may result in legal proceedings against me.

AGREEMENT NOT TO WORK FOR CLIENT OR FORMER

CLIENT OF SHERATON CAREGIVERS, LLC

Sheraton Caregivers, LLC spends considerable sums of money to obtain clients and to hire and match employees with these clients. Therefore, as a condition of employment, Sheraton Caregivers, LLC requires all employees to agree not to work independently for, or through another agency SheratonCaregivers, LLC client or former client for a period of one year after the last date me employee has provided services for the for any client through Sheraton Caregivers. LLC. Should I violate this agreement, and work independently for, or through another agency for a SHERATON CAREGIVERS, LLC client or former client before this one (1) year period. I agree first to pay SHERATON Caregivers, LLC a fee of $9,000

I HAVE READ, UNDERSTAND AND AGREE TO COMPLY WITH THE CAREGIVER'S EMPLOYEE AND PROCEDURES MANUAL AND AGREEMENT NOT TO WORK FOR CLIENT OR FORMER CLIENT.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Employment At Will
Employment with SHERATON CAREGIVERS, LLC is at-will, unless state law provides otherwise. This means that employment may be terminated for any or no reason, with or without cause or notice at any time by the employee or by the Company. Nothing in this handbook or any statement shall limit the right to terminate at-will. This employment policy is the sole and entire agreement between the employee and SHERATON CAREGIVERS, LLC regarding the fact that employment with at-will. SHERATON CAREGIVERS, LLC. No manager is to enter into a contract of employment express or implied that changes the fact that employment with SHERATON CAREGIVERS, LLC is at-will.

Only the President/Owner of the Company or that person's authorized representative has the authority to enter into an employment agreement that alters the fact that employment with SHERATON CAREGIVERS is at-will, and any such agreement must be in writing signed by the President/Owner of the Company or an authorized representative.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Authorization for taking and use of photographs
I authorize Sheraton Caregivers, LLC to photograph me and to use or disclose that photograph, or to use or disclose a photograph previously taken by Company, for Company's business purposes, including, but not limited to, disclosure to customers, display on internal and external Company we band posting on social media. Company may edit, copy, display, publish, or distribute the sites, photograph for its business purposes without first obtaining my consent. I understand that the photographs will become Company's property and will not be returned.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Application Form Waver
In exchange for the consideration of my job application by Sheraton Home Care (hereinafter called "the Company"),I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Sheraton Home Care, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /CEO of the Company. Both the undersigned and Sheraton Home Care may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
Full Name

First NameLast Name
Date

MonthDayYear
Date
Signature*
Caregiving Notice of Risk Caring For A Covid-19 Client
We are actively monitoring the progression of the coronavirus disease 2019 (COVID-19) pandemic, Recently, community-wide transmission of COVID-19 has occurred In the United States, including in the area where Sheraton Caregivers provides services. Community spread of COVID-19 is difficult to detect and control.

Your safety is of the utmost Importance to us! As such, we have Implemented several steps to limit your potential exposure to COVID-19. Included among those steps are:

Screening our clients and those who live with them tor symptoms of COVID-19.
Asking clients to limit their visitors.
Providing you with helpful information on how to stay healthy, including washing your hands frequently, not touching your face with unwashed hands, and using proper cough and sneeze etiquette.
Providing you with hand sanitizer, gloves, face masks, and face shields.
Providing additional training on the use of PPE, infection control practices, and on Infectious or communicable diseases.
Our goal is to prevent you from coming Into contact with a known case of COVID-19 In the client's home,

Of course, we cannot guarantee that you will not contract COVID-19 from a client. You must understand that there is a risk in performing your vital work.

To that end, we think It Is Important for you to know the groups of people the CDC has Identified as being of higher risk for severe Illness from COVID-19. Currently, the CDC has Identified the following groups:

People 85 years and older
People with chronic lung disease or moderate to severe asthma
People who have serious heart conditions
People who are immunocompromised - many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
People with severe obesity (body mass index [BMI] of 40-or higher)
People with diabetes
People with chronic kidney disease undergoing dialysis
People with liver disease for more information visit: the CDC website.
COVID-19 Policies & Procedures
Sheraton Caregivers is committed to keeping all our clients and caregivers safe during the Covid-19 pandemic. We ask all our caregiver to follow the guidelines set by the CDC and our HR when caring for a positive client.

1. Always wear the proper appropriate PPE (personal protective equipment) such as gloves, mask, shield, isolation garments etc. when providing personal care or companionship.

2. ALWAYS practice proper hygiene by washing your hands frequently (recommended
every 30 min), covering you mouth when coughing or sneezing and sanitizing surfaces you or the client may come in contact with. Follow the universal precaution for safety.

3. ALWAYS maintain the recommended 6 feet social distancing when not engaging in hands on personal direct care with your clients.

4. NON-ESSENTIAL visitor in the home should be limited.

5. ALWAYS monitor your client's symptoms and changes. If the client shows any signs of discomfort or change, please notify you supervisor immediately or follow the emergency protocol.

FOLLOW THE AGENCY AND CDC POLICY ON PUTTING ON PPE AN TAKING OFF AND DISPOSING OF USED OR SOILED PPE. FOLLOW THE CDC AND AGENCY POLICY ON PROPER HAND WASHING AT ALL TIMES.

If for any reason you need any instruction on the policy or procedure for universal precaution and safety contact the agency at 203-221-0221 and notify your supervisor for additional support.
Signature
Signing below means you are aware of the risks of taking care a COVID-19 client and you agree with Sheraton Caregiver LLC Covid-19 policy and procedures.
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Authorization For Employer's Release of Covid-19 Vaccination Status
1. Authorization: I hereby authorize my employer, Sheraton Caregivers/Care (the "Employer") to disclose whether I have been vaccinated against COVID-19 and the record of my COVID 19 vaccination ("Vaccination Information") to clients and coworkers ("Recipient")

2. Rights:

I understand that I have the right to revoke this Authorization by sending a written notice of revocation to Employer. I understand that the revocation will become effective upon receipt. I understand that any Vaccination Information disclosed pursuant to this Authorization before the effective date of a revocation will not be subject to the revocation.

I further understand that I have a right to have a physician inspect my medical records maintained by Employer. If, upon inspection of my medical records, I disagree with any of the information contained in such records, I have the right to request removal or correction of such information. If Employer does not agree to removal or correction, I have the right to place a written statement of disagreement in my medical record maintained by Sheraton Caregivers.

I also understand that I can withhold my consent to this Authorization by not signing below, but, in that case, I fail to complete Covid-19 vaccination required by the Corporation/Assisted Living/Client or responsible party request, "may not perform work for Recipient" or "accomplish my job responsibilities" or "continue in this position at Employer"].
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Sheraton Caregivers LLC

Mutual Arbitration Agreement
This mutual agreement is a contract and covers important issues relating to your rights. It is your sole responsibility to read it and understand it. You are free to seek assistance from independent advisors of your choice outside the Company or to refrain from doing so if that is your choice.

This Mutual Arbitration Agreement ("Agreement") is between Application or Employee (hereinafter "EMPLOYEE") and Sheraton Caregiver LLC and its respective successors and assigns ("Sheraton Caregiver/Care"). The Federal Arbitration Act (9 U.S.C. §§ 1et seq.) governs this Agreement. The parties understand and agree that the COMPANY is engaged in transactions involving interstate commence. EXPET AS THIS AGRREMENT OTHERWISE PROVIDES, ALL DISPUTES COVERED BY THIS AGREEMENT WIL BE DECIDED BY AND ARBITRATOR THROUGH FINAL AND BINDING ARBITRATION AND NOT BY WAY OR COURT OR JURY TRIAL.

1. Covered claim/ Dispute. Except as otherwise provided in this Agreement, this Agreement applies to any and all disputes, past, present or future, that may arise between Employee (sometimes “you” or “your”) and Sheraton Caregiver/Care, including without limitation any dispute arising out of or related to EMPLOYEE'S application, employment and/or separation of employment with Sheraton Caregiver/Care. This Agreement applies to a covered dispute that Sheraton Caregiver/Care may have against EMPLOYEE or that EMPLOYEE may have against Sheraton Caregiver/Care, its parent companies, subsidiaries, related companies and affiliates, franchisors, or their officers, directors, principals, shareholders, members, owners, employees, and managers or agents, each and all of which may enforce thNothing contained in this Agreement shall be construed to prevent or excuse you (individually or in concert with others) or the Sheraton Caregiver/Care from utilizing the Sheraton Caregiver/Care's existing internal procedures for resolution of complaints, and this Agreement is not intended to be a substitute for the utilization of such procedures. In addition, either party may apply to a court of competent jurisdiction for temporary or preliminary injunctive relief in connection with an arbitrable controversy in accordance with applicable law, and any such application shall not be deemed incompatible with or waiver of this agreement to arbitrate. The court to which the application is made is authorized to consider the merits of the arbitrable controversy to the extent it deems necessary in making its ruling, but only to the extent permitted by applicable law. All determinations of final relief, however, will be decided in arbitration.is Agreement as direct or third-party beneficiaries.

The claims subject to arbitration are those that absent this Agreement could be brought under applicable law. Except as it otherwise provides, this Agreement applies, without limitation, to claims based upon or related to the application for employment, background checks, privacy, the employment relationship, discrimination, harassment, retaliation, defamation (including claims of post-employment defamation or retaliation), breach of a contract or covenant, fraud, negligence, emotional distress, breach of fiduciary duty, trade secrets, unfair competition, wages, minimum wage and overtime or other compensation claimed to be owed, breaks and rest periods, expense reimbursement, seating, termination, tort claims, equitable claims, and all statutory and common law claims unless specifically excluded below. Except as it otherwise provides, the Agreement covers, without limitation, claims arising under the Fair Credit Reporting Act, Defend Trade Secrets Act, Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 1981, the Americans With Disabilities Act, the Age Discrimination in Employment Act, the Family Medical Leave Act, the Fair Labor Standards Act, Rehabilitation Act, the Civil Rights Acts of 1866 and 1871, the Civil Rights Act of 1991, 8 U.S.C. § 1324 (unfair immigration related practices), the Pregnancy Discrimination Act, the Equal Pay Act, the Genetic Information Non-Discrimination Act, Employee Retirement Income Security Act of 1974 (except for claims for employee benefits under any benefit plan sponsored by the Sheraton Caregiver/Care and (a) covered by the Employee Retirement Income Security Act of 1974 or (b) funded by insurance), Affordable Care Act, Uniformed Services Employment and Reemployment Rights Act, Worker Adjustment and Retraining Notification Act, Older Workers Benefit Protection Act of 1990, False Claims Act, Occupational Safety and Health Act, Consolidated Omnibus Reconciliation Act of 1985, and state statutes or regulations, if any, addressing the same or similar subject matters, and all other federal or state legal claims arising out of or relating to Employee’s employment or the termination of employment.

Additionally, except as provided in this Section 3 of this Agreement, Employee and the Sheraton Caregiver/Care agree that the arbitrator shall have exclusive authority to resolve any dispute relating to the scope, validity, conscionability, interpretation, applicability, or enforceability of this Agreement. Regardless of anything else in this Agreement or the AAA Rules (referenced below), any dispute relating to interpretation, applicability, enforceability or validity of the Class Action Waiver may only be determined by a court and not an arbitrator.

EMPLOYEE and Sheraton Caregiver/Care agree that EMPLOYEE'S acceptance of this Agreement is a condition of employment and that EMPLOYEE'S continued employment constitutes EMPLOYEE'S acceptance of the terms of this Agreement.

Excluded claims/disputes. The Agreement does not apply to: (i) claims for worker’s compensation benefits, state disability insurance or unemployment insurance benefits; however, this Agreement applies to retaliation claims related to such benefits, such as claims for worker’s compensation retaliation; and (ii) disputes that an applicable federal statute expressly states cannot be arbitrated or subject to a pre-dispute arbitration agreement.

Nothing contained in this Agreement shall be construed to prevent or excuse you (individually or in concert with others) or the Sheraton Caregiver/Care from utilizing the Sheraton Caregiver/Care's existing internal procedures for resolution of complaints, and this Agreement is not intended to be a substitute for the utilization of such procedures. In addition, either party may apply to a court of competent jurisdiction for temporary or preliminary injunctive relief in connection with an arbitrable controversy in accordance with applicable law, and any such application shall not be deemed incompatible with or waiver of this agreement to arbitrate. The court to which the application is made is authorized to consider the merits of the arbitrable controversy to the extent it deems necessary in making its ruling, but only to the extent permitted by applicable law. All determinations of final relief, however, will be decided in arbitration.

Nothing in this Agreement prevents you from making a report to or filing a claim or charge with a government agency, including without limitation the Equal Employment Opportunity Commission, U.S. Department of Labor, U.S. Securities and Exchange Commission, National Labor Relations Board, Occupational Health and Safety Administration or the Office of Federal Contract Compliance Programs or law enforcement agencies. Nothing in this Agreement prevents the investigation by a government agency of any report, claim or charge otherwise covered by this Agreement. This Agreement also does not prevent federal administrative agencies from adjudicating claims and awarding remedies based on those claims, even if the claims would otherwise be covered by this Agreement. Nothing in this Agreement prevents or excuses a party from satisfying any conditions precedent and/or exhausting administrative remedies under applicable law before bringing a claim in arbitration. The Sheraton Caregiver/Care will not retaliate against you for filing a claim with an administrative agency or for exercising rights (individually or in concert with others) under Section 7 of the National Labor Relations Act. This Agreement also does not prevent or prohibit you in any way from reporting, communicating about, or disclosing claims for discrimination, harassment, retaliation, or sexual abuse or a crime, or from making truthful statements as required by law.

Exclusion for Current Employees Only: This Agreement also does not apply to litigation between you and the Sheraton Caregiver/Care pending in a state or federal court or arbitration as of the date of your receipt of this Agreement and in which you are a party or a member or putative member of any alleged class or collective action (“pending litigation”). However, if that pending litigation is subject to a prior or existing agreement to arbitrate between you and the Sheraton Caregiver/Care, that agreement to that extent will remain in full force and effect and continue to apply to the pending litigation (“pending litigation exclusion”).

2. CLASS AND COLLECTIVE ACTION WAIVER. This Agreement affects your ability to bring or participate in class and collective actions. Both you and Sheraton Caregiver/Care agree to bring any covered claim in arbitration on an individual basis only, and not on a class or collective action basis on behalf of others. There will be no right or authority for any dispute or claim to be brought, heard or arbitrated as a class or collective action, or as a member in any such class or collective action proceeding, and the Arbitrator will have no authority to hear or preside over any such claim ("Class Action Waiver"). In the event a final judicial determination is made that the Class Action Waiver is unenforceable and that a class or collective action may proceed notwithstanding the existence of this Agreement, the Arbitrator is nevertheless without authority to preside over a class or collective action and, in that event, any class or collective action must be brought in a court of competent jurisdiction.

3. ARBITRATOR SELECTION. If the claim is not resolved via informal resolution, the parties will proceed to arbitration before a single arbitrator and in accordance with the then current American Arbitration Association (“AAA”) Employment Arbitration Rules (“AAA Rules”) (the AAA Rules are available through the Sheraton Caregiver/Care s Human Resources department, or may be found at www.adr.org or by searching for “AAA Employment Arbitration Rules” using a service such as www.Google.com), provided, however, that if there is a conflict between the AAA Rules and this Agreement, this Agreement will govern. Unless the parties mutually agree otherwise, the Arbitrator will be either an attorney experienced in employment law or a retired judge from any jurisdiction. The AAA will give each party a list of eleven (11) arbitrators drawn from its panel of arbitrators. Ten days after AAA’s transmission of the list of neutrals, AAA will convene a telephone conference and the parties will strike names alternately from the list of common names, until only one remains. The party who strikes first will be determined by a coin toss. The person that remains will be designated as the Arbitrator. If for any reason, the individual selected cannot serve as the Arbitrator, AAA will issue another list of eleven (11) arbitrators and repeat the alternate striking selection process. If for any reason the AAA will not administer the arbitration, either party may apply to a court of competent jurisdiction with authority over the location where the arbitration will be conducted to appoint a neutral Arbitrator.

4. INITIATING ARBITRATION. A party who wishes to arbitrate a claim covered by this Agreement must make a written Request for Arbitration and deliver it to the other party by hand or mail no later than the expiration of the statute of limitations (deadline for filing) that applicable law prescribes for the claim. The Request for Arbitration shall identify the claims asserted, the factual basis for the claim(s), and the relief and/or remedy sought. The Arbitrator will resolve all disputes regarding the timeliness or propriety of the Request for Arbitration and apply the statute of limitations that would have applied if the claim(s) had been brought in court.

5. RULES/STANDARDS GOVERNING PROCEEDING. The Arbitrator may award any remedy to which a party is entitled under applicable law, but remedies are limited to those that would be available to a party in his or her individual capacity in a court of law for the claims presented to and decided by the Arbitrator, and no remedies that otherwise would be available to an individual under applicable law will be forfeited by this Agreement. Each party can take the deposition of one individual witness and any expert witness designated by another party. Each party also has the right to make requests for production of documents to any party. The parties can jointly agree to more discovery, and either party can ask the Arbitrator to order more discovery. The Arbitrator will have exclusive authority to entertain requests for additional discovery, and to grant or deny such requests, based on the Arbitrator’s determination regarding whether additional discovery is warranted by the circumstances of a particular case. Each party will also have the right to subpoena witnesses and documents for the arbitration, including documents relevant to the case from third parties in accordance with any applicable state or federal law. At least thirty (30) days before the final hearing, the parties must exchange a list of witnesses, excerpts of depositions to be introduced, and copies of all exhibits to be used.

Unless the parties jointly agree in writing otherwise, the arbitration will take place in or near the city and in the same state in which Employee is or was last employed by the Sheraton Caregiver/Care. The Arbitrator shall apply the substantive federal, state, or local law applicable to the claims asserted. The Federal Rules of Evidence shall apply. The Arbitrator has the authority to hear and rule on pre-hearing disputes. Either party may file dispositive motions, including, without limitation, a motion to dismiss and/or a motion for summary judgment, and the Arbitrator will apply the standards governing such motions under the Federal Rules of Civil Procedure. Upon the request of either party, the Arbitrator will set a briefing schedule for such motions. The Arbitrator will issue a written decision or award, stating the essential findings of fact and conclusions of law. A court of competent jurisdiction will have the authority to enter judgment upon the Arbitrator’s decision/award.

6. PAYMENT OF FEES. The Sheraton Caregiver/Care will pay the Arbitrator’s and arbitration fees and costs, except for the filing fee as required by the AAA. If you are financially unable to pay a filing fee, the Sheraton Caregiver/Care will pay the filing fee, and you will be relieved of the obligation to pay the filing fee. Disputes regarding the apportionment of fees will be decided by the Arbitrator. Each party will pay for its own costs and attorneys' fees, if any, but if any party prevails on a claim which affords the prevailing party costs or attorneys' fees, the Arbitrator may award costs and fees to the prevailing party as provided by law.

7. RIGHT TO CONSULT WITH ATTORNEY. You have the right to consult with counsel of your choice concerning this agreement. After 30 days of your first receipt of this Agreement, continuing your employment with the Sheraton Caregiver/Care constitutes mutual acceptance of the terms of this Agreement by you and the Sheraton Caregiver/Care.

8. ENTIRE AGREEMENT/SEVERABILITY. Except as provided in Section 2, above regarding pending litigation, this Agreement replaces all prior agreements (oral, written, electronic) regarding the arbitration of disputes and is the full and complete agreement relating to the formal resolution of disputes covered by this Agreement. If any portion of this Agreement is deemed invalid, void, voidable or otherwise unenforceable, the unenforceable provision will be severed from the Agreement and the remainder of the Agreement will be enforceable. This Agreement will survive the termination of Employee’s employment and the expiration of any benefit. This Agreement will also continue to apply notwithstanding any change in Employee’s duties, responsibilities, position, or title, or if Employee transfers to any affiliate of the Sheraton Caregiver/Care. This Agreement does not alter the "at-will" status of Employee’s employment. Notwithstanding any contrary language in any Sheraton Caregiver/Care policy or employee handbook, this Agreement may not be modified or terminated absent consent by both parties.

9. CONSIDERATION. The Sheraton Caregiver/Care and Employee agree that the mutual obligations by the Sheraton Caregivers/Care and Employee to arbitrate disputes provide adequate consideration for this Agreement.
Agreed:

Sheraton Caregiver/Care LLC
Applicant/Employee Signature*
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Employee Direct Deposit Banking Authorization Form

Step 3
Important! Please read and sign before completing and submitting. I hereby voluntarily authorize Sheraton Caregivers LLC, either directly or through its payroll service provider, to deposit any amounts owed me, by initiating credit entries to my account (s) at the financial institution (s) of my choice (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Employer, either directly or through its payroll service provider, to my account. To the extent permitted by law, in the event that Employer or its payroll service provider deposits funds erroneously into my account (s), I authorize Employer, either directly or through its payroll service provider, to debit my account for an amount not to exceed the original amount of the erroneous credit. To the extent permitted by law, I understand that I have the right to refuse consent or revoke authorization of direct deposit at any time without fear of retaliation, and I have the right to receive any payment owed to me by other means. This authorization is to remain in full force and effect until Employer and Bank have received written notice from me of its termination in such time and manner as to afford Employer and Bank reasonable opportunity to act on it.
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