Long Term Care
Long Term Care
Home Care Job Application
Thank you for choosing to Make a Difference
Where do you want to work?
Please Choose a County or Counties you are interested in working in.
What kind of Certification do you have? Or Need?
LPN or RN
Special Education Endorsement
I would like to apply to receive my HCA Certification
Great ! Please make sure you have doubled checked that the new regulations for exempt employees still work in your favor.
Which long-term care workers do not have to be certified as home care aides?
Great ! We have an excellent program for those who qualify and have a desire to receive their
. There are minimum requirements to qualify as you can see on this application. If you would like to go further in this process, please check that you understand the qualifications.
To Qualify for the HCA Certification Program workers must:
Please check stating you understand and feel you have the qualifications for the HCA Certification Program
Have a open schedule - flexible for clients needs including afternoons, evenings and weekends
Able and willing to work 5 days a week and a min of 20 hrs
Be willing and able to do 75 hours of online training
Have a clean criminal history
Have experience and heart to care for others
I Understand the Qualifications of the HCA Cert. Program
Days available for work
Please choose the days you are available to work
What is your specific availability for Sunday's?
What is your specific availability for Monday's?
What is your specific availability for Tuesday's?
What is your specific availability for Wednesday's?
What is your specific availability for Thursday's?
What is your specific availability for Friday's?
What is your specific availability for Saturday's?
Times of the day
Please Choose times of the day you are available
Have you had any certifications or trainings in the past?
Please check all that apply to you.
CNA Certification or Training
HCA Certification or Training
Fundamentals of Caregiving Training
What other Certificates or training's have you had, please describe.
Please check all that apply
CNA, HCA or NAR
Special Needs Care
Personal Care Family / Friends
Therapy or Dr Office
. Thank you for taking the first step to applying to Our HCA Certification Program. We will be reviewing your application and letting you know what the next step will be. Find out more about Community Support Solutions
HCA Certificate Program
and the steps to achieving your HCA Certification.
Please Pick a Date and then a Time for a Phone Interview
Date Format: MM slash DD slash YYYY
Between 11:00 - 12:00
Between 2:00 - 3:00
If we have an opening earlier is ok to give you a call?
Thank you! If an earlier opening comes available we will be sure to give you a call.
Community Support Solutions @ 2019