Comfort Keepers® Lancaster, CA
Application Form: Bilingual Caregiver (English/Spanish)
Applicant Details:
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email Address
*
Address
*
City
State / Province
Postal / Zip Code
How did you hear about Comfort Keepers?
*
Please Select
Comfort Keepers Website
Indeed
Job Fair
Handshake
Google
Job Board
Current Employee
GAIN
Other
Were you referred by a current employee? If Yes, please provide their name:
Have you previously been employed by Comfort Keepers?
*
Yes
No
Are you at least 18 years of age?
*
Yes
No
Do you have both a valid Drivers License and vehicle insurance?
*
Yes
No
You are applying for the Bilingual Caregiver (English/Spanish) position: Are you bilingual (Spanish/English)?
*
Yes
No
Please select your proficiency level for English and Spanish from the dropdown menus below.
*
Rows
Speaking Level
Writing Level
Reading Level
English
N/A
Basic
Intermediate
Fluent
N/A
Basic
Intermediate
Fluent
N/A
Basic
Intermediate
Fluent
Spanish
N/A
Basic
Intermediate
Fluent
N/A
Basic
Intermediate
Fluent
N/A
Basic
Intermediate
Fluent
Pre‑employment requirements for this role include a criminal background check, driving record check, and drug screening/TB test. Please confirm whether you can complete these requirements.
*
I can complete all required screenings
I cannot complete all required screenings
Are you currently authorized to work in the United States?
*
Please Select
Yes
No
Will you now or in the future require sponsorship for employment visa status?
*
Please Select
Yes
No
Back
Next
Do you have at least 2 years of experience working with seniors?
*
Yes
No
Tell us about your experience:
*
Do you have any experience providing personal care (Ex: Bathing; Grooming; toileting; Incontinence care)?
*
Yes
No
Are you trained in working with clients who have dementia/Alzheimer's?
*
Yes
No
Are you comfortable providing care to both Male and Female clients?
*
Yes
No
We service the Greater Antelope Valley and surrounding areas. Are you willing and able to commute a minimum of 20 miles?
*
Yes
No
Occasionally, we may assist clients with transportation to doctor's appointments or running errands. Do you feel comfortable driving clients in your own vehicle?
*
Yes
No
Are you able to assist clients with transfers, and lift at least 25 pounds?
*
Yes
No
Are you registered with the Home Care Aide Registry (HCA)?
*
Yes
No
Back
Next
Provide your availability for each day of the week, including start and end times for each day you can work.
Caregivers are expected to be available a minimum of one weekend day, with holiday availability as needed per the client's needs. If you are only available for overnights, format your availability timeframes as (pm-am).
Are you available on Sunday(s)? If so, please provide the timeframe below.
*
Yes
No
Sunday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Sunday(s)?
*
Yes
No
Are you available on Monday(s)? If so, please provide the timeframe below.
*
Yes
No
Monday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Monday(s)?
*
Yes
No
Are you available on Tuesday(s)? If so, please provide the timeframe below.
*
Yes
No
Tuesday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Tuesday(s)?
*
Yes
No
Are you available on Wednesday(s)? If so, please provide the timeframe below.
*
Yes
No
Wednesday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Wednesday(s)?
*
Yes
No
Are you available on Thursday(s)? If so, please provide the timeframe below.
*
Yes
No
Thursday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Thursday(s)?
*
Yes
No
Are you available on Friday(s)? If so, please provide the timeframe below.
*
Yes
No
Friday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Friday(s)?
*
Yes
No
Are you available on Saturday(s)? If so, please provide the timeframe below.
*
Yes
No
Saturday(s)
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Are you available to work overnights on Saturday(s)?
*
Yes
No
Back
Next
How soon are you available to start?
*
-
Month
-
Day
Year
Date
Resume (Optional):
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I confirm that the information I provide is true. I understand this is not a job offer and that employment, if offered, will be at‑will.I understand Comfort Keepers is an Equal Opportunity Employer and does not discriminate based on any protected characteristic.I understand my information may be used for employment‑related purposes and that California law gives me rights regarding how my data is collected and used.I know that criminal history will not be asked about at this stage. Any background check would only happen after a conditional offer and in compliance with California’s Fair Chance Act.I understand caregiver roles require California Home Care Aide (HCA) registration, including fingerprinting and background clearance.By submitting my responses electronically, I agree this counts as my signature.
*
First Name
Last Name
Submit
Should be Empty: