Apply for Washington Caregivers Needed for Oregon Assignment

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Summary
Title:Washington Caregivers Needed for Oregon Assignment
ID:1582
Department:Client Services
Salary Range:$27.00
Location:Federal Way/ Redmond, Oregon
Resume
Resume:
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Opt-In Confirmation
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Cover Letter:
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Redmond Oregon Caregiver Assignment Application Questions
* Are you legally authorized to work in the United States?
Yes
No
* Do you understand that, if selected, you must complete required employment eligibility verification, payroll/tax documentation, background check authorization, orientation, and all required onboarding steps before being cleared to work?
Yes
No
* Which area are you currently applying from?
Federal Way
Tacoma
Other Washington area
I am not currently located in Washington State
* Do you understand this position is a facility based caregiver assignment in Redmond, Oregon?
Yes
No
* Are you willing and able to relocate or temporarily relocate to Redmond, Oregon for this assignment?
Yes
No
* What is the earliest date you would be available to start or travel for the Redmond, Oregon assignment?
* Do you currently have an active Washington HCA or CNA credential?
Yes
No
* Which active credential do you currently have?
HCA
CNA
Both HCA and CNA
NAR only
HCA or CNA pending
None of the above

Please enter your active Washington HCA or CNA credential number.

Examples: HCA HM12345678 or CNA NC12345678.

Do not enter a pending, expired, or NAR credential. If you do not have an active Washington HCA or CNA credential, enter N/A.

* Washington HCA or CNA Credential Number
* Are you available for a full time facility assignment, with weekly hours based on resident care needs and the assigned facility schedule?
Yes
No
* Do you have full open availability and understand that shifts may include days, evenings, overnights, weekends, and holidays if assigned?
Yes
No
* Are you willing and able to work shifts that may range from 10 to 18 hours depending on the assigned schedule?
Yes
No
* Do you understand that limited assignment planning support, including temporary lodging or transportation related support, may be reviewed case by case and is not guaranteed unless approved before placement?
Yes
No
* Do you have reliable phone access and are you able to communicate promptly with the office regarding onboarding, travel planning, schedule updates, and assignment readiness?
Yes
No
* Which current documents or certifications do you have? Select all that apply.
Active Washington HCA
Active Washington CNA
Current CPR certification
Current Food Worker Card
75 hour training certificate or proof of caregiver training
Nurse Delegation Core
Nurse Delegation Diabetes
None of the above

Application Acknowledgment

I certify that the information I provided in this application is true, complete, and accurate to the best of my knowledge. I understand that false or misleading information may result in disqualification from hiring consideration or termination if discovered after employment begins.

I understand that this application does not create a contract or guarantee of employment.

I understand that selected candidates must complete all required onboarding steps before being cleared to work, including employment eligibility verification, payroll and tax documentation, background check authorization, orientation, and required company or assignment specific documents.

I understand that selected candidates may be required to provide documentation of active credential status, required training, and other job related onboarding requirements before placement.

If I need assistance or a reasonable accommodation to complete the application or interview process, I understand I may contact the hiring team.

* Signature
* Date
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
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Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
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Veteran Status: (Please check all that apply)
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
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I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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