Comfort Keepers Employment Application

Carefully and accurately fill out all fields. When ready, click "Submit" below.



1. How did you hear about us?
2. Are you legally eligible for employment in the United States?
Yes No
3. Do you have a Valid CA drivers license?
Yes No
4. Do you have your own reliable vehicle?
Yes No
5. Are you an insured driver on your vehicles insurance policy?
Yes No
6. Are you willing to transport clients in your vehicle?
Yes No
7. Are you willing to provide personal care services?
Yes No
8. Tell us about your personal care experience
9. You must be able to lift at least 50lbs, do you believe that you can physically care for clients with or without accomodations.
Yes No
10. What does your current availability look like? (Days and hours you are available to work) Please be detailed.
11. Are you willing to work multiple short shifts in one day?
Yes No
12. We cannot guarantee you would always have hours. Is this something you can work with?
Yes No
13. Are you seeking hourly or a 24 hour Personal Care Attendent Position
14. Have you had any training in Alzheimers Disease or Dementia? Please explain.
15. How many years of experience do you have caring for the elderly?
16. Can you tell me about your caregiving experience.
17. We complete background checks, criminal and motor vehicle, is there anything we should be aware of prior to gathering this info
18. What is your email address