Daughterly Care Community Services

Transcription

1 Daughterly Care Cmmunity Services Emplyment Registratin Applicatin Frm Please ensure yu bring the fllwing dcumentatin t yur interview. CHECKLIST If yu are nt an Australian resident: current wrk visa & passprt. Driver s Licence (we will cpy riginal) First Aid Certificate (we will cpy riginal) Training, qualificatin certificates and written references (we will cpy riginal) Cpy f current car registratin (we will cpy riginal) Cpy f current car insurance (we will cpy riginal) Yur Actin Cpy f yur current Plice Check (under 3 mnths ld) Cpy f yur current Wrking with Children Check Yur superfund details including accunt & spin numbers Tax file number fr ATO Tax Declaratin Frm Yur 6 digit Bank, State and Branch (BSB) and accunt details fr yur bank Next Step: cmplete emplyment registratin frm belw. Printed 31 July, 2018 includes wages Page 1

2 Daughterly Care Cmmunity Services Emplyment Registratin Applicatin Frm Thank yu fr applying fr a psitin with Daughterly Care Cmmunity Services Limited. Befre cmpleting this frm: D yu realise Daughterly Care Cmmunity Services specialises in prviding care fr lder peple and peple living with Dementia, living in the cmmunity. Please nte the list f items t bring WITH yu t yur interview, as indicated n Page 1 f this dcument. Until yu supply the items listed we CANNOT give yu wrk, s t fast track yur emplyment with us please bring them with yu t yur interview. If yu have been fund guilty r have charges pending fr theft, fraud, serius driving ffences r any frm f aggressin twards anther persn please d nt apply fr a psitin with us. We will nt emply yu. T be emplyed by us yu must have a Plice Check that is less than ne mnth ld. We plice check ur new staff each mnth fr 12 mnths after they start wrk fr us, s if yu have pending charges please dn t apply fr wrk with us. 1. Yur persnal details First Name: Surname: Middle Name: Date f birth: Hme Address: Pstal Address: Telephne numbers: Address: Hme: Mbile: Wrk: Cuntry f birth: Fax Number: D yu have a car yu can use fr wrk? Are yu an Australian citizen r permanent resident? Have yu been a citizen r permanent resident f a cuntry ther than Australia since turning 16? If yes, which cuntry? If n, d yu have a current wrk visa? (We need t sight riginal) D yu have a tax file number? (We d NOT pay cash) Printed 31 July, 2018 includes wages Page 2

3 D yu hld a current First Aid Certificate? (We must sight and have a cpy) If NO, certificate curse must be cmpleted within three mnths frm cmmencement date, at yur cst. (This is cmpulsry except fr RN & ENs) Certificate N: Expiry Date D yu hld a current Plice Clearance Certificate? Certificate N: (We must sight and have a cpy) Expiry Date D yu hld a current Wrking with Children Check? (We must sight and have a cpy) Certificate N: Expiry Date Applicants can fill ut an nline frm at Hw did yu hear abut Daughterly Care Cmmunity Services? If yu were recmmended t DCCS, was it via: DCCS staff member Client Health Prfessinal Ntice Bard Press Ad Are yu seeking emplyment thrugh a placement service? 2. Yur previus emplyment Please prvide details f the LAST 4 psitins yu have held (mst recent first): Name f Emplyer: Emplyer Phne Number: Yur psitin title: Persn yu reprted directly t: Dates Emplyed: Frm: t: Reasn fr leaving: D yu have a written statement f emplyment r reference frm this emplyer? If n, why nt? Printed 31 July, 2018 includes wages Page 3

4 Name f Emplyer: Emplyer Phne Number: Yur psitin title: Persn yu reprted directly t: Dates Emplyed: Frm: t: Reasn fr leaving: D yu have a written statement f emplyment r reference frm this emplyer? If n, why nt? Name f Emplyer: Emplyer Phne Number: Yur psitin title: Persn yu reprted directly t: Dates Emplyed: Frm: t: Reasn fr leaving: D yu have a written statement f emplyment r reference frm this emplyer? If n, why nt? Name f Emplyer: Emplyer Phne Number: Yur psitin title: Persn yu reprted directly t: Dates Emplyed: Frm: t: Reasn fr leaving: D yu have a written statement f emplyment r reference frm this emplyer? If n, why nt? Is there any prir emplyment, in additin t the abve 4 psitins that is relevant t caring fr lder peple in their hme? Printed 31 July, 2018 includes wages Page 4

5 3. Yur wrk interests & availability fr wrk With hurly wrk we aim t give yu a mix f regular nging, shrt term and ne ff clients. Wrking with lder peple, their needs change quickly, s we emply yu as a casual. When peple first start with us they generally receive ne ff and shrt term wrk and we build up their nging clients ver time. We have many staff wh have wrked as nging casuals fr ver 10 years and received lng service leave. We are an emplyer f prfessinal carers wh chse t stay with us. The way we like t wrk is that yu tell us: a) WHEN yu are AVAILABLE; b) What SORT f wrk yu prefer, e.g. hurly during day, active nights, inactive nights, live in; and c) IDEALLY hw many hurs a week yu want t wrk with Daughterly Care Cmmunity Services and we use that infrmatin and yur skill set t match yu t apprpriate clients. With hurly wrk each jb is 2 hur minimum (many lnger) and we run them tgether and yu are paid mileage fr kms in between immediately successive jbs. Hurly Day Care 6am t 8pm Mn t Fri 6am 8pm Sat Sun Public Hliday Hurly Night Care 8pm t 6am Mn t Fri 8pm 6am Sat Sun Active ver Night care Mn Fri Active Hur Sleepvers Sat Active Hurs Sleepvers Sun Active Hurs Sleepvers Inactive Overnight Care 10pm t 6am Mn Fri Inactive Sleepvers Sat & Sun Inactive Sleepvers Live In Care Each 24 shift (Mn-Fri) Each 24 shift (Saturday) Each 24 shift (Sunday) Mileage With clients in yur car $28.60 per hur % super $34.07 per hur % super $45.42 per hur % super $55.35 per hur % super $32.00 per hur % super $34.07 per hur % super $45.42 per hur % super $29.80 per hur % super $32.10 per hur % super $42.80 per hur % super $ % super $ % super $ % super $ % super $ % super 78c per km (Where yu drive immediately between successive clients 78c per km + 27c per km i.e. $1.05 is paid fr yur time) Explanatin f Sleepvers: Inactive sleepvers nrmally start and/r end with a cuple f hurs f hurly rate wrk. Inactive sleepvers are where yu get wken up 2 r fewer times a night and yu are paid a flat fee frm 10pm t 6am. Hwever if yu are wken up 3 r mre times by the client the whle night is paid as active hurs at the hurly rate. If an active sleepver is bked in advance yu wuld nt expect t sleep at all. Live in care is NOT paid at active rates. If a client has a change in pattern and is up during the night then this needs t be reprted s that slutins can be fund r a different type f care put in place. Printed 31 July, 2018 includes wages Page 5

6 One f the benefits f wrking with Daughterly Care Cmmunity Services is: Every Australian emplyee can earn $18,200 per annum tax free, hwever because Daughterly Care Cmmunity Services is a registered Nt-Fr-Prfit Charity, ur emplyees can earn an extra $18,450 per annum tax free if they chse t salary package. S, yu can earn up t $36,750 per annum tax free. Shuld yu be accepted fr emplyment, as part f the rientatin prcess, we will explain this t yu in detail. Please indicate with a tick what type f wrk yu are willing t d fr Daughterly Care Cmmunity Services: Respite / Persnal care? Husekeeping and hme help? Live in? Overnight care? Please indicate when yu are available t wrk fr us. Daughterly Care Cmmunity Services prvides services 7 days a week, day and night, vernight and n a live-in basis. We try ur best t match the hurs that yu want t wrk t suitable wrk we have available. Please TICK when yu are available t wrk i.e. in the mrning, afternn, evening r night. The earliest Start Time fr hurly wrk: Time Mn Tue Wed Thu Fri Sat Sun The latest Finishing Time fr hurly wrk: Definitely NOT available t wrk n this day: MAY be available (need t be negtiated): Available fr INACTIVE Sleepvers Available ACTIVE Sleepvers Available fr Live in/24 hrs Ideally, hw many hurs per week d yu want t wrk fr Daughterly Care Cmmunity Services? D yu have a limit n the number f hurs yu can wrk e.g. in receipt f a pensin, visa requirements? If yes, please state the number f hurs yu can wrk a week s we can stick t yur limit: D yu have any time ff planned in the next 3 mnths that we need t plan arund. If yes, please give details: Printed 31 July, 2018 includes wages Page 6

7 With Live-in care, yu can wrk frm 2 t 5 days a week. Hw many days a week wuld yu like t wrk and what days f the week can yu wrk? With Live-in care, we need t cver 7 days f the week n a regular nging basis. Are yu prepared t wrk half r all weekend n an nging basis? We give pririty t staff wh are prepared t wrk part r all f the weekend. Any ther explanatin f yur availability r planned hlidays in the next 3 mnths. 4. Yur wrk experience T assist ur C-Ordinatrs match yu t the mst apprpriate jbs and identify training needs, please cmplete this fr ur prfile sectin n ur database. During ur interview yu will be questined regarding yur experience. Please tick the fllwing that applies t yu: Task Persnal Care Experience 1. Assist shwering FEMALE client (client can wash sme parts f their bdy, yu need t wash rest) Have had experience N experience, but wuld feel cmfrtable trying NOT cmfrtable ding 2. Assist shwering MALE client (client can wash sme parts f their bdy, yu need t wash rest) 3. Full shwer - FEMALE client (client cannt wash any parts f their bdy s yu need t) 4. Full shwer - MALE client (client cannt wash any parts f their bdy s yu need t) 5. Dressing FEMALE client 6. Dressing MALE client 7. Assist FEMALE client t tilet (taking t tilet, assisting t sit prperly n tilet, steady when client stands, help pull up pants client wipes themselves) 8. Assist MALE client t tilet (taking t tilet, assisting t sit prperly n tilet, steady when client stands, help pull up pants client wipes themselves) 9. Full assistance t FEMALE client with tileting (i.e. as abve plus wipe the client) 10. Full assistance t MALE client with tileting (i.e. as abve plus wipe the client) 11. Assisting FEMALE client t change pad (steady client & help pull up pad) 12. Assisting MALE client t change pad (steady client & help pull up pad) 13. Full assistance t FEMALE client t put pad n (i.e. yu put n & pull up) 14. Full assistance t MALE client t put pad n (i.e. yu put n & pull up) Printed 31 July, 2018 includes wages Page 7

8 Task Have had experience N experience, but wuld feel cmfrtable trying Mre Cmplex Persnal Care (Nte: These skills are nt needed t care fr mst f ur clients, hwever if yu have this experience we like t knw). 15. Changing urine catheter bags NOT cmfrtable ding 16. Changing clstmy bwel bag 17. Taking bld sugar levels (i.e. prick finger fr bld) 18. Using Kylie Sheet n bed 19. Ding pressure area care e.g. rubbing cream, ensuring pressure kept ff area 20. Putting tablet under tngue e.g. fr Angina Pain 21. Mnitring seizures 22. Tube peg feeds 23. Giving bed spnges 24. Placing client n bed pan Transfers Experience 25. Able t help client transfer 26. Experienced t transfer client by hist full hist and standing hist, i.e. knwledge f different sling & standing hist 27. Experienced using Pelican Belt 28. Experienced rlling, turning client in bed with slide sheet Dementia Experience 29. Experienced with early nset dementia 30. Capable f handling challenging behaviurs assciated with dementia 31. Capable f caring fr 2 dementia clients at nce Palliative Care Experience 32. Basic palliative client care: Basic knwledge f medicatin Oral hygiene Skin care Different stages f end f life Knwledge f palliative end stage f life Disabilities Experience 33. Caring fr physically disabled children / adults 34. Caring fr intellectually disabled children / adults 35. Caring fr adults with mental health issues Printed 31 July, 2018 includes wages Page 8

9 Families Experience 36. Caring fr new brn babies Task Have had experience N experience, but wuld feel cmfrtable trying NOT cmfrtable ding 37. Caring fr tddlers 38. Caring fr families with 2 r mre children Number f Years f Experience 39.The number f years yu have been paid/emplyed t care fr lder peple 40.The number f years yu have cared fr peple suffering dementia 41.Number f years yu have cared fr newbrns 42.Number f years yu have cared fr tddlers 43.Number f years caring fr children Qualificatins Held 44. Age Care Qualificatins yu hld (Cpy f certificate r registratin required). Nne Partial Certificate III (Certificate f Attainment) Certificate III Assistant in Nursing Certificate III in Cmmunity Care Certificate III in Aged Care Ex-Registered Nurse (registratin nt current) Ding Registered Nurse training Registered Nurse (registratin current) Enrlled Nurse (registratin current) Endrsed Enrlled Nurse Mthercraft Nurse/Midwife Certificate IV in Disabilities Nanny Other: 45. Any ther qualificatins yu hld, including thse utside the care industry, r care curses yu have cmpleted. (Cpy f certificate r registratin required). 46. Have yu cmpleted manual handling training? D yu have a manual handling certificate that we can cpy? 47. If yu dn t have Cert III/IV r higher, at sme pint in the future, the Gvernment will make it mandatry. Are yu willing t underg Cert III/IV training with yur wages paid by DCCS? One day per mnth (assignments dne in yur time) Clients yu will care fr 48 Will yu care fr a client wh smkes IN their hme? Run it past me maybe, maybe nt Sme psitins require the emplyee t be a ttal nn-smker. Can yu fill these psitins? 49. Will yu wrk with pets? Yes, if safe Printed 31 July, 2018 includes wages Page 9

10 If n, state why (e.g. allergic): 50. Clients yu wn t wrk with r type f wrk yu wn t d? Other infrmatin abut yu 51. Why d yu want t be a Caregiver? 52. D yu smke? N Yes, if s, hw many per hur? Per day? D yu wear a patch whilst wrking with clients? 53. D yu have access t a car fr wrk? 54. D yu have current driver s licence? (We will need a cpy) Licence N: State issued: Grup (i.e. A B C) Expiry Date: 55. Wuld yu feel cmfrtable driving a client s car Maybe 56. Type f car yu CAN drive: Aut Manual Bth 57. Des yur car have wrking air cnditining? 58. D yu have Car Insurance? Car Insurance Expiry date: Green slip nly Third party prperty Cmprehensive (cmpulsry within 3 mnths. f cmmencement date) 59. Fr HOURLY wrk - hw far are yu prepared t drive fr a 4 hur jb? klms (Live in Carers ignre) 60. D yu, r have yu ever had a bad back/neck? If Yes. Please describe: Yes and I m careful nt t d anything at wrk that might aggravate it 61. D yu, r have yu ever had any ther injury r disability that we shuld take int cnsideratin when scheduling yu fr wrk? If Yes. Please describe: Printed 31 July, 2018 includes wages Page 10

11 62. Is there anything else abut yurself that we shuld knw t supprt yur applicatin? If Yes. Please describe: 63. D yu have any allergies? If Yes. Please describe: 64. Hw wuld yu prefer t receive yur timesheet (mst caregivers chse ): Fax Australia Pst (takes between 2-5 wrking days) Please nte t receive timesheets by yu MUST have a printer. What is yur address: 65. D yu speak any languages ther than English: If yes. Please state: 66. Name 3 meals yu wuld feel cmfrtable cking lder peple that yu feel an lder persn wuld enjy: Are yu vegetarian r vegan? Are yu cmfrtable cking meat fr clients? 68. Are yu Australian citizen? If nt, a cpy f yur residency r wrking visa is required. Australian citizen Australian resident Have wrking visa expires n: 69. Can yu play any musical instruments? If yes. Please state: 70. Can yu sing t clients? If yes. Please state: 71. D yu have any special skills, interests, hbbies, passins that might help us match yu t clients? Please state: 72. If yu have cared fr a parent/family member, what was yur rle and hw ften did yu care fr them? Please be specific and list tasks yu undertk: 73. D yu realise we specialise in dementia? D yu feel cmfrtable caring fr lder peple living with memry lss/cnfusin/dementia? Printed 31 July, 2018 includes wages Page 11

12 74. If applying fr live-in-care wrk please answer the fllwing: a. D yu keep a client s hme t a prfessinal level regarding cleanliness? b. D yu have dependent children r animals living with yu? If yes, what arrangements will be in place t care fr them in yur absence? If yes. Please explain: c. Once a client accepts yu and prvided yu like caring fr the client, live-in-care tends t be regular n-ging wrk, are yu able t cmmit t regular nging wrk? If yes. Please explain: d. If the client s family was cming ver fr afternn tea, list 5 different fds that yu culd yu cnfidently ck fr afternn tea: Please answer these questins abut dementia: Questin If a client repeats herself cnstantly, hw d yu handle that? Yur written answer If yu were tld the main rle f yur visit was t prvide a meal fr a client and ensure she ate the meal and the client refused t eat saying she has eaten, but yu knw she hasn t, what wuld yu d yu? If a client living in the cmmunity refused t let yu in fr a service, what might yu say t get in t d the service? Printed 31 July, 2018 includes wages Page 12

13 6. Yur health and well-being (legally yu are required t answer these questins accurately and truthfully): Prviding cmmunity supprt services can be physically demanding and emtinally taxing at times. D yu have an existing physical, medical r psychiatric cnditin that we may need t take int cnsideratin when scheduling yur wrk? If yes, please describe yur cnditin: D yu have steprsis? If yes, please describe Have yu ever claimed Wrker s Cmpensatin? If yes (please prvide a cpy f yur final fit fr pre-injuries medical certificate ) and: describe hw the injury happened what date did the injury happened hw much time did yu have ff wrk hw much time were yu n suitable duties if yu were n suitable duties, hw many hurs did yu wrk per week What restrictins r limitatins did yu have n yur certificate What date did yu cme ff Wrkers Cmpensatin Please nte - we may need yu t visit ur Dctr and we may need t speak t yur Dctr t ensure yu are fit t wrk fr Daughterly Care Cmmunity Services. D yu have a bad back/neck? If yes (please prvide details): D yu have a sre shulder, hip r bulging spinal discs? If yes (please prvide details): Please Be Aware Of Sectin 79 Wrker s Cmpensatin Bard And Assistance Act Where it is prved that the wrker has, at the time f seeking r entering emplyment in respect f which she/he claims cmpensatin fr a disability, wilfully and falsely represented himself/herself as nt having previusly suffered frm the disability, the Bard may in its discretin refuse t award cmpensatin which therwise wuld be payable. I acknwledge cmpletely that the deliberate giving f false infrmatin, with respect t any f the abve areas, shall lead t dismissal. Name:.. Signature:.. Printed 31 July, 2018 includes wages Page 13

14 6. Yur Referees Please prvide the names, addresses and telephne numbers f 4 (r mre) peple yu DIRECTLY REPORTED TO wh can make infrmed cmments abut yur RECENT r relevant wrk experience and abilities. Als include ne reference frm a clse family member wh knws yu well. This is yur character reference. Emplyer s Full Name: Emplyer s Psitin (in relatin t yu): Cmpany Name & Address: Telephne Number: Address: Emplyer s Full Name: Emplyer s Psitin (in relatin t yu): Cmpany Name & Address: Telephne Number: Address: Emplyer s Full Name: Emplyer s Psitin (in relatin t yu): Cmpany Name & Address: Telephne Number: Address: Emplyer s Full Name: Emplyer s Psitin (in relatin t yu): Cmpany Name & Address: Telephne Number: Address: Full Name f a Clse family member wh knws yu well: In relatin t yu: Telephne Number: Address: Printed 31 July, 2018 includes wages Page 14

15 7. Previus cnvictins? Have yu been subject t disciplinary prceedings fr miscnduct r terminated by an emplyer? If yes, please prvide details: Have yu EVER been cnvicted f theft, fraud, pr driving, drugs, drink driving and aggressin t anther persn? If yes, please prvide details: Are yu under Plice investigatin r have plice charges pending fr theft, drugs, fraud, pr driving, drink driving, and aggressin t anther persn? If yes, please prvide details: Yur declaratin: By signing this applicatin I cnfirm that the details in this applicatin are crrect and I have infrmed yu f all matters f significance. I understand that prviding false infrmatin, including mitting relevant infrmatin in my applicatin frm, will result in instant dismissal. I authrise investigatin f all statements in this applicatin frm and reference list. Signed Date The Next Step: Thank yu fr taking the time t cmplete this applicatin. If yu have relevant experience, t fast track yur applicatin please call us n t make an appintment fr an interview. Alternatively please mail yur frms t us at PO Bx 670 Narrabeen NSW 2101 (Attentin: Rs Atkinsn) r yur applicatin frm t rs.atkinsn@daughterlycare.cm.au. If yu have nt heard frm us ne week after yu have mailed yur frm please ring us t ensure we received it. Printed 31 July, 2018 includes wages Page 15