THANK YOU FOR YOUR INTEREST IN WORKING FOR SOUTH FLORIDA PEDIATRIC HOMECARE, INC.
South Florida Pediatric Homecare, In. is looking for GREAT nurses and non-skilled hourly care workers. Please review our initial requirements and contact us for an appointment. In order to ensure that SFPH continues to give the highest quality care for our clients , we do require all applicants to fill out our application packet in addition to obtaining a satisfactory score on our assessments packet.
SFPH is required to maintain a personnel file on all professional staff registered with our company. All new hires are required to submit the following:
Copy of current RN/LPN/CNA License
HHA’s – 75 Hours HHA Certificate
CPR Card
Social Security Card
Alien Registration Card or Employment Authorization Document
Drivers License from the State of Florida
Auto Insurance Card
Physical (signed by MD) current within 6 months of employment including PPD/TB test or Chest X-Ray results
Initial four hour HIV/AIDS certificate and current 1 hour update
OSHA, Domestic Violence and Medical Error Update
Hepatitis Vaccination Record - Consent or Declination form signed
Two professional references
* All candidates must be able to complete a level 1 background screening performed by FDLE.
APPLICATION:
Would you work Full-Time?
Would you work Part-Time?
Were you previously employed by us?
List any friends or relatives working for us.
Have you been convicted of a crime?
(note: Conviction of a criminal offense will not necessarily preclude your employment)
If your application is considered favorably, on what date will you be available for work?
Person to be notified in case of accident or emergency?
Record of Education
Last Year Completed
9
10
11
12
Did you Graduate?
Last Year Completed
1
2
3
4
Did you Graduate?
Last Year Completed
1
2
3
4
Did you Graduate?
Military Service Record
Were you in the U.S. Armed Forces?
Dates of Duty:
From
To
Personal References(Do not include relatives or former employers)
Employment Record
From
To
From
To
From
To
Have you ever been bonded?
May we contact the employers listed above?
This institution does not discriminate in hiring or in any other decision on the basis of race, color, sexy, citizenship, national origin, ancestry, Vietnam era veteran status, or on the basis of age or physical or mental disability unrelated to ability to perform the work required. No question on this application is intended to secure information to be used for such descrimination.
I voluntarily give this institution the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies or corporations supplying such information. I consent to take the physical examination and such future physical examinations as may be required by this institution at such times and places as the institution shall designate. I understand that an offer of employment may be contingent on passing the physician examination which relates to the essential duties I would be required to perform.
I understand that my employment is at will and that either party is free to terminate the employment relationship at any time without cause. I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form.
If employed, I will be required to complete an Employment Verification Form (I-9) and within three days show satisfactory evidence of identity and eligibility for employment.
By clicking the submit button, You agree to any and all terms above.
