Enhancing Lives Employment Application

Employment Application
Position Qualifications
1. Direct Support Professional (DSP): While a minimum of 1 year of relevant experience is preferred, we welcome and encourage applications from all candidates, regardless of experience level. Your passion for supporting individuals with intellectual or developmental disabilities is what we value most.

2. Program Specialist (PS): To be considered for this position, applicants must provide:
- Copies of training certificates or agency sign-in sheets and curriculum in the following areas: interpersonal dynamics, community participation, individual service planning and delivery, relationship building, and training required by licensing or agency policy.
- One of the following educational qualifications:
  - Master’s Degree (official or unofficial transcripts are sufficient if graduation date is indicated) and a resume indicating 1 year of work experience with individuals with intellectual disabilities, developmental disabilities (IDD), including Autism.
  - Bachelor’s Degree (official or unofficial transcripts are sufficient if graduation date is indicated) and a resume indicating 2 years of work experience with individuals with IDD or Autism.
  - Associate's Degree (official or unofficial transcripts are sufficient if graduation date is indicated) or unofficial/official transcripts from an accredited college or university indicating 60 credit hours, and a resume indicating 4 years of work experience with individuals with IDD or Autism.
3. Administrative Coordinator: Candidates should demonstrate 1-3 years of relevant administrative or operational experience in a supportive capacity, preferably within a similar field.

4. Licensed Practical Nurse (LPN) & Registered Nurse (RN): Applicants must possess and maintain a current license from the State Board of Nursing to be eligible for these positions.
General Requirements for All Positions
- All candidates must be at least 18 years of age.
- Must have and maintain a valid driver's license in good standing.
- Candidates must pass a criminal background check.
- Completion of state-required training is mandatory prior to employment.
Position Applying For
Please indicate what position you are applying for (check one):*

Direct Support Professional (DSP)Program Specialist (PS)Administrative CoordinatorLicensed Practical Nurse (LPN)Registered Nurse (RN)
Personal Information
Full Name*
First and Last Name
Date of Birth*

MonthDayYear
Social Security Number*
Please enter a valid format (e.g., 000-00-0000)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Autocompleted Address*
Phone Number*
Please enter a valid format (e.g., 215-222-5454)
Email Address*
example@example.com
Social Media & Portfolio Links (optional)
Linkden, Instagram, Facebook, etc.
Preferred Pronouns (optional)
Examples: she/her, he/him, they/them, ze/zir, etc.
Enhancing Lives, LLC values diversity and inclusivity. Providing your pronouns is entirely optional and will be used to create a respectful and inclusive workplace environment.
Residency Status: Have you resided in Pennsylvania for the last two years? (Please note, that if the answer is no, you may be required to undergo additional background checks.)*

YESNO
What is your availability to work? (Select all that apply)*

Full TimePart TimeTemporary/SeasonalPRN (as needed)Other
Which shifts are you available to work? (Select all that apply)*

MorningsAfternoonsEveningsNightsWeekdaysWeekendsOther
Work Eligibility and Background Information
1. Are you a U.S. citizen and eligible to work in the United States?*

YESNO
2. If no, are you legally authorized to work in the United States on an unrestricted basis?

YESNO
If you answer “No” to both questions 1 and 2, please be aware that you may not be eligible for employment with our organization at this time.
3. Can you perform the essential functions of the job for which you are applying with or without reasonable accommodations?*

YESNO
Employment History

Please enter your most recent employment history, highlighting any positions that relate to the role you are applying for. If you have only one position or no relevant jobs, you can provide what you have. To add more employers, click the "Add" button below.
Most Recent Employer Details: (Required)*
References
Professional References: Please provide three professional references (excluding relatives) who can speak to your qualifications, work ethic, interpersonal skills, and work history. While we prefer references from roles with experience working with individuals with intellectual or developmental disabilities, references from other positions are also welcome if you do not have that specific experience.

By providing your references, you acknowlege and give Enhancing Lives, LLC permission to contact them and discuss your qualifications, work ethic, skills, work history, rehire eligibility, and any other pertinent information that may be relevant to your application in accordance with Pennsylvania state law. I further agree that the references shall not be held legally liable or accountable for any statements expressed in the course of providing this information.
Authorization For Reference Check
I hereby authorize Enhancing Lives LLC to contact my provided references to discuss my work history, character, qualifications, work ethic, skills, driving record, rehire eligibility and any other relevant information. I also agree to indemnify the individuals contacted for any and all liability related to the provision of requested information to Enhancing Lives LLC. Additionally, I acknowledge that a facsimile or photocopy of this authorization shall be regarded as equivalent to the original.
Print Full Name*
First and Last Name
Signature*

Clear
Please sign using the mouse or touchscreen.
Date*

MonthDayYear
Reference 1

Please provide three references relevant to the position for which you are applying. If you have two or more professional experiences, click the "Add" button below to include additional references. If you have fewer than two professional experiences, only Reference 1 is required.
Reference 1 *
Education

Please provide details about your high school, GED, or equivalent education. To add more than one high school, GED, or equivalent education institution, please click the "Add" button below.
Please provide details about your College/University education. To add more than one college or university, please click the "Add" button below.
What relevant certifications or training do you have that are current? (Examples include CPR, First Aid, or any relevant ODP training.)*
Have you taken any courses related to psychology social work or special education? Please explain.*
Experience with Intellectual Disabilities
Do you have previous experience working with adults with intellectual disabilities? If yes, please explain.*
Can you provide examples of past situations you handled effectively (e.g., crisis intervention, communication strategies, de-escalation techniques, etc.)?*
Scenario Based Question
Skills and Qualifications
Do you have knowledge of Individualized Support Plans (ISPs)? If yes, please explain.*
Are you familiar with applicable laws and regulations e.g. (6400, ADA, HIPAA, etc.)? If yes, please explain.*
Situational and Behavioral Questions
How would you handle a situation where a client refuses to participate in an activity, hygiene tasks, or taking their medication?*
Scenario Based Question
Describe a time when you managed a difficult behavior from an individual. What approach did you take? If you have not encountered a situation where you managed difficult behavior directly, please think about a related experience where you faced a challenge with a person or group. Describe the situation and the approach you took to effectively handle it.*
Scenario Based Question
What strategies do you use to build rapport with clients and their families?*
Scenario Based Question
Commitment to Professional Development
Are you willing to undergo prerequisite and ongoing training or education for this position?*
Are you interested in attending workshops or conferences on best practices for supporting adults with intellectual disabilities?*
What is your availability for training before starting the job (days and hours)?*
Please note that training sessions will be conducted in a group format, and scheduling will be determined based on the agency's needs to ensure all staff meet required qualifications.
Additional Questions
What attracted you to this position?*
What do you believe are the most important qualities for someone working with adults with intellectual disabilities?*
Acknowledgements
I acknowledge that the information provided on this application is true and complete to the best of my knowledge. I understand that providing false or misleading information may disqualify me from consideration for employment or result in termination if I am hired.

I authorize Enhancing Lives, LLC to conduct a background check in accordance with applicable laws. I understand that this application is not a contract of employment and that if hired, my employment will be at-will, meaning that either I or Enhancing Lives, LLC can terminate the employment relationship at any time, with or without cause or notice.
Printed Name*
First and Last Name
Signature*

Clear
Please sign using the mouse or touchscreen.
Date*

MonthDayYear
Equal Employment Opportunity (EEO) Statement
Enhancing Lives, LLC is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, sex, gender, sexual orientation, national origin, ancestry, age, disability, or any other status protected by applicable law. Employment opportunities shall be provided for applicants with disabilities and reasonable accommodation(s) shall be made to meet the physical or mental limitations of qualified applicants or employees.

We believe that diversity enriches our workforce and enhances our ability to serve our clients and community. Our commitment to nondiscrimination is reflected in all aspects of employment, including recruitment, hiring, training, promotion, and termination. Enhancing Lives is dedicated to fostering an environment where everyone can thrive and contribute to our mission.
HIPPA and Privacy Acknowledgement
I acknowledge that I may have access to confidential information, including but not limited to personal health information (PHI) of clients, that is protected under the Health Insurance Portability and Accountability Act (HIPAA). I understand that if hired, I am required to maintain the confidentiality of this information while working for Enhancing Lives, LLC and thereafter.

If you understand and agree to maintain confidentiality as required by HIPAA and privacy laws, please sign below:
Signature*

Clear
Please sign using the mouse or touchscreen.
Printed Name*
First and Last Name
Date*

MonthDayYear
Data Privacy Notice
Enhancing Lives, LLC is committed to protecting the privacy of our applicants. The Data Privacy Notice outlines how we collect, use, store, and manage your personal information throughout the application process, in accordance with applicable data protection laws.

Information We Collect

Personal data collected includes name, contact information, resumes, employment history, educational backgrounds, qualifications, references and any other relevant data you choose to provide.

How We Use Your Information

We collect and process your personal data to assess qualifications, communicate application status, conduct background and reference checks, and comply with legal regulations.

Data Storage and Rentention

Personal information is securely stored and accessible only to authorized personnel. Data is retained in accordance with applicable laws and our internal policies, and with consideration for future employment openings.

Your Rights

Applicants have rights to access, correct, delete, and object to the processing of their personal data.

Contact Information

If you have any questions, concerns, or requests regarding this Data Privacy Notice, please contact: support@enhancinglivesllc.org

Consent

By submitting your application, you acknowledge that you have read and understood the Data Privacy Notice provided by Enhancing Lives, LLC, and you consent to the collection, processing, and storage of your personal information as outlined above.
Printed Name*
First and Last Name
Signature*

Clear
Please sign using the mouse or touchscreen.
Date*

MonthDayYear
Upload Files: Please upload your resume, current driver's license (front and back), highest education diploma(s), and any relevant training certifications. You can upload multiple files.*

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Application Submission
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Should be Empty:

Employment Application

Position Qualifications

General Requirements for All Positions

Position Applying For

Personal Information

Work Eligibility and Background Information

Employment History

References

Authorization For Reference Check

Reference 1

Education

Experience with Intellectual Disabilities

Skills and Qualifications

Situational and Behavioral Questions

Commitment to Professional Development

Additional Questions

Acknowledgements

Equal Employment Opportunity (EEO) Statement

HIPPA and Privacy Acknowledgement

Data Privacy Notice

Application Submission