Apply for Personal Care Assistant / CNA

Become a Care Professional >> Personal Care Assistant / CNA >> Apply

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 555 Executive Place. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 910-484-7200.

Summary
Title:	Personal Care Assistant / CNA
ID:	2030
Job Type:	Part-Time
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Opt-In Confirmation
	By submitting this application, I consent to receive SMS updates from Home Instead at 8883164617 regarding my employment application. My information will not be shared or used for any other purposes. This application is powered by ApplicantStack on behalf of Home Instead . SMS messages will only be sent by Home Instead and are used exclusively for hiring-related communications when you have subscribed to receive SMS communications.
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

	- or Upload from:


Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Additional Information

* How did you hear about Home Instead?

If applicable, please specify:

Care Pro References

BASIC INFORMATION

* Have you ever submitted an application here before?

Yes No

If yes, when?

* Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?

Yes No

WORK HISTORY

MOST RECENT EMPLOYER

* Are you currently working for this employer?

Yes No

If yes, may we contact?

Yes No

* Company Name:

* City:

* State:

Company Phone:

Dates Employed - From:

Dates Employed - To:

Duties:

Reason for Leaving:

REFERENCES

If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

Professional References

Full Name	Phone Number	Best Time of Day to Call	Email	Relationship (No Relatives)	Number of Years Known
*	*	AM PM		*
*	*	AM PM		*

Personal References

Full Name	Phone Number	Best Time of Day to Call	Email	Relationship (No Relatives)	Number of Years Known
*	*	AM PM		*
*	*	AM PM		*

APPLICANT NOTE

Keneri, LLC is an independently owned and operated Home Instead® franchise 555 Executive Place Fayetteville, NC 28305 (910) 484-7200

Eriken, LLC is an independently owned and operated Home Instead® franchise at 293 Olmsted Blvd Suite 11-1 Pinehurst, NC 28374 (910) 484-7220.

This application will be valid for 60 days. If you need further assistance for any phase of the employment process, please notify the HR department for either location and every reasonable effort will be made to meet your needs in a reasonable amount of time.

This application that you have completed online is intended for use in evaluating your qualifications for employment with us, an independently owned and operated Home Instead franchise. This is not an employment contract. Please be sure that you answered all appropriate questions completely and accurately. False or misleading statements during the interview and on your application materials are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, or any other protected class status under applicable law..

CERTIFICATION

I certify that I have read and understand the applicant note above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts in this application process may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle driving records. I also understand that the use of illegal drugs is prohibited when carrying out my job responsibilities. I am willing to submit to drug screening if requested to detect the use of illegal drugs prior to and during employment, as allowed under applicable law.

I understand that this application is not a contract for employment.

By typing your name below you are electronically signing this document.

* Signature (type full name):
* Date:

Care Pro Application Questions

* Do you have a valid drivers license?

	Yes
	No

* Do you always have access to your vehicle?

	Yes
	No

* Are you listed as a driver on the car insurance policy?

	Yes
	No

* What days and times are you available to work each week? Please list your availability (for example: Monday–Friday 8am–12pm, Saturday–Sunday 7am–3pm).

* How many hours a week are you looking for?

	0-10
	10-20
	20-25
	25+

* We require our Care Pros to work every other weekend. Are you able to work every other weekend?

	Yes
	No

* Are you at least 23 years old?

	Yes
	No

* How many miles are you willing to work with a client?

	0-10
	0-20
	0-30
	0-40

* Why do you want to be a Care Professional (Care Pro) with Home Instead?

* Will you work with a client who smokes?

	Yes
	No

* Will you work with a client who has dogs?

	Yes
	No
	Small Dogs Only

* Will you work with a client who has cats?

	Yes
	No

* Do you have a current CNA license in the state of North Carolina?

	Yes
	No

* Do you have experience with a gait belt?

	Yes
	No

* Do you have experience with a Hoyer lift?

	Yes
	No

* Do you have experience with persons with dementia and Alzheimer's?

	Yes
	No

* As part of our hiring process, we complete both a background check and driving record check. Is there anything in your history that could present an issue

	Yes
	No

If Yes, Please describe.

* How long have you lived in North Carolina?

	Less than a year
	1-5 years
	over 5 years

DO NOT USE

Background Check Notice and Disclosure

Keneri, LLC, d/b/a an independently owned and operated Home Instead franchise ("the Company"), is providing you with notice that it may order a consumer report may be obtained for employment purposes as part of the pre-employment background investigation and at any time during your employment.

The Company may order an “investigative consumer report.” Such reports typically include information from personal interviews, most commonly from an applicant’s prior employers and references. Should an investigative consumer report be requested, you will have the right to request a complete and accurate disclosure of the nature and scope of the investigation requested and a written summary of your rights under the Fair Credit Reporting Act.

The background report may contain information concerning your character, general reputation, personal characteristics, mode of living and criminal history. Information may be obtained from private and public record sources, and for investigative consumer reports, from personal interviews as noted above.

Authorization for Procurement of Consumer Report

Pursuant to the federal Fair Credit Reporting Act, I authorize Keneri, LLC, d/b/a an independently owned and operated Home Instead franchise ("the Company and its designated agents and representatives to order a consumer report and/or an investigative consumer report to be generated for employment, promotion, reassignment or retention as an employee.

I understand that, to the fullest extend allowed by law, information contained in my employment application or otherwise disclosed to the Company by me in the hiring process or during my employment may be utilized for the purpose of obtaining consumer reports.
I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: verification of Social Security number; current and previous residences; employment history, including all personnel files; education; references; credit history and reports; criminal history, including records from any criminal justice agency in any or all federal, state or county jurisdictions; birth records; motor vehicle records, including traffic citations and registration; professional credentials and licenses and any other public records. I authorize the complete release of these records or data pertaining to me that an individual, company, firm, corporation or public agency may have.
I authorize and request any present or former employer, school, law enforcement and all other federal, state and local agencies; federal, state and local courts, financial institution or other persons having personal knowledge of me to furnish the Company or its designated agents with any and all information in their possession regarding me in connection with an application of employment.
I understand that, pursuant to the federal Fair Credit Reporting Act, if any adverse action is to be taken based upon the consumer report, a copy of the report and a summary of the consumer’s rights will be provided to me.
If hired, or if already employed, this authorization shall remain on file and shall serve as an ongoing authorization for the Company to obtain consumer reports, at any time during my employment, for employment purposes. Further, if hired, or already employed, my signature below authorizes the Company to supply my employment history with the Company to a consumer reporting agency.
My signature below signifies my receipt and understanding of the "Background Check Notice and Disclosure" and authorizes the Company to obtain consumer reports regarding me.

* First Name

* Last Name

Middle Initial

Maiden/Previous Names

* Home Address

* City

* State

* Zip Code

* Social Security Number

* Date of Birth

Driver's License Number

Issuing State

* Signature (type name)

* Date

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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