G.C.J. ARF Employment Application
Thank you for your interest in joining G.C.J. ARF. Starting pay is $19.00 per hour. Experience is not required; we provide training.
Applicant Information
Full Legal Name
*
First Name
Middle Name
Last Name
Preferred Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Best Way to Reach You
Phone call
Text
Email
Are you at least 18 years of age?
*
Yes
No
Can you provide proof of legal authorization to work in the United States if hired?
*
Yes
No
Have you worked for G.C.J. ARF or a related program before?
Yes
No
If yes, when?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Position and Availability
Starting pay is $19.00 per hour.
Position Applying For
*
Direct Support Professional (DSP)
Staff
Employment Desired
*
Full-time
Part-time
Either
Available Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shifts Available
*
Day
Evening
Overnight
Weekends
Days Not Available
How Did You Hear About Us?
Website
Indeed
Friend or family
Current employee
Other
Qualifications and Certifications
Experience is not required for the Direct Support Professional position.
Do you currently have CPR and First Aid certification?
*
Yes
No
Certification expiration date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Do you have reliable transportation to get to work?
*
Yes
No
Do you have a valid California driver license, if assigned to drive?
*
Yes
No
Have you supported people with developmental disabilities as a job or otherwise?
*
Yes
No
If yes, where and for how long?
Have you completed DSP training (Year 1 or Year 2) or other caregiving training?
*
Yes
No
Which training?
Have you supported medications in a care setting?
*
Yes
No
Languages spoken fluently
*
English
Spanish
Tagalog
Other
Other language
Education
A high school diploma or equivalent is preferred but not required.
Highest level completed
*
Please Select
Some high school
High school diploma or GED
Some college
Associate degree
Bachelor's degree or higher
School 1 Name
*
School 1 City and State
*
School 1 Diploma, Degree, or Certificate
*
School 2 Name
School 2 City and State
School 2 Diploma, Degree, or Certificate
Additional certifications or training
Employment History
List your most recent job first. Include volunteer or caregiving work if applicable.
Employer 1 Name
*
Job Title
*
City and State
*
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor Name
First Name
Middle Name
Last Name
Dates Employed From / To
*
Main Duties
*
Reason for Leaving
May we contact this employer?
*
Yes
No
Employer 2 Name
Job Title
City and State
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor Name
First Name
Middle Name
Last Name
Dates Employed From / To
Main Duties
Reason for Leaving
May we contact this employer?
Yes
No
Employer 3 Name
Job Title
City and State
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor Name
First Name
Middle Name
Last Name
Dates Employed From / To
Main Duties
Reason for Leaving
May we contact this employer?
Yes
No
Resume Upload
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Optional resume upload accepted formats: PDF, Word, or image files.
Do not list past pay rates.
Professional References
Reference 1 Name
*
First Name
Last Name
Reference 1 Relationship to Applicant
*
Reference 1 Company
*
Reference 1 Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 1 Email
*
example@example.com
Reference 2 Name
*
First Name
Last Name
Reference 2 Relationship to Applicant
*
Reference 2 Company
*
Reference 2 Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2 Email
*
example@example.com
Reference 3 Name
*
First Name
Last Name
Reference 3 Relationship to Applicant
*
Reference 3 Company
*
Reference 3 Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 3 Email
*
example@example.com
Background Clearance and Health Screening
G.C.J. ARF does not ask about conviction history on this application. Consistent with the California Fair Chance Act, background checks are conducted only after a conditional offer of employment is made. Because our home is licensed by the California Department of Social Services, Community Care Licensing Division, every new hire must complete Department of Justice and FBI fingerprint clearance (Live Scan), a health screening and TB clearance, and Form I-9 employment eligibility verification before the first shift.
If offered a position, are you willing to complete Live Scan fingerprinting, a health screening and TB clearance before your first shift?
*
Yes
No
Equal Opportunity and Voluntary Information
G.C.J. ARF, Inc. is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, gender identity or expression, sexual orientation, age (40 and over), physical or mental disability, medical condition, genetic information, marital status, military or veteran status, reproductive health decision making, or any other status protected by California or federal law. If you need a reasonable accommodation to complete this application or to interview, contact careers@blessedcarehomes.net or call (925) 350-7987.
Are you a veteran? (optional)
Yes
No
Prefer not to say
Applicant Certification and Signature
I certify that my answers on this application, and on any resume or attachment I provide, are true and complete to the best of my knowledge. I understand that false, misleading, or missing information may result in my application not being considered or, if I am hired, in separation from employment. I authorize G.C.J. ARF, Inc. to contact the employers and references I listed, except any employer I marked No for contact, and to verify my education and certifications. I understand that if I receive a conditional offer, employment depends on DOJ and FBI fingerprint clearance (Live Scan), health screening and TB clearance, and Form I-9 verification. I understand that this application is not a contract of employment; if hired, my employment is at will as permitted by California law. I understand that my application is kept confidential.
I have read and agree to the statements above
*
Agree
Printed name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Applicant signature
*
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