Copy of Interview Checklist

Interview Checklist

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We are an equal opportunity employer

Pre-hire Interview

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Address
/hour for Respite
for PCA
/hour for Companion.
Ae these rates acceptable?
Our policy is that we cannot hire convicted felons. Would anything be likely to show up on their criminal history to prevent us from hiring? Orientation is a 4-hour session for all employees. Direct care staff have an additional 4 hours of orientation. If the above is agreeable to both agency and the caller, please ash the caller to come in to fi11 out an application and criminal history form. They will be called for orientation scheduling once the approved criminal history results come baclr from the State.
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liberty Home Care New Hire Questions

Employment Offer Letter

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with Liberty Home Care.
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as identified below:
You will report directly to the Agency Director of your office for all administrative and operational purposes.
per year per hour per visit (Circle one)
Benefits are not currently offered as we are a startup agency. We will notify you immediately when we are prepared to begin offering a benefit package consult your employee handbook or the Agency Director for other benefit information.
Agency Director

Offer accepted by:

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Availability List

Iam available at the following days and / or hours:

Mon
Tue
Weds
Thurs
Fri
sat
sun
ONLY list towns you are willing to travel to.

Employee Direct Deposit Authorization

Instructions
Employee: Fill out and return to your employer.
Employer: Save for your files only.
This document must be signed by employees requesting automatic deposit of paychecks and retained on file by the employer. Do not send this form to intuit. Employees must attach a voided check for each of their accounts to help verify their account numbers and banks routing numbers.

Account 1

Account 1 type:
Account 2 type:
Max. file size: 100 MB.
(the "Company”) to send credit entries(and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below and to other accounts I (we) identify in the future (the "Account").This authorise the financial institution holding the Account to post all such entries. I agree that the ACH transaction authorized herein shall comply with all applicable U.S. Law. This authorization we be in effect until the company receives a written termination notice from and had a reasonable opportunity to act on it.
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Documents Needed Format

On day of completing application, the hiring Staff MUST process Criminal Background checks. Must be in the employee's file before 1" visit is scheduled.
You must do an online check (Professionals) for license in good standing. Print the verification page out for employee file.
Proof of car insurance (registration showing insured status) if applicable
TB Test Results
Identification: Driver‘ s license (current)
2nd form of identification
Current copy of professional license
Training certificate (if applies)
Social Security card
Criminal Check returned
Immigration documents in order (if applicable)
ChildLine Verification (18 years of age) (If applicable)
Tests to be completed with a passing score of 80%
HIPAA
Shifts Competency Checklist to be completed on or before 1" Consumers visit
Skills checklist done