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Step 1 of 7 - Contact Info

Cell Phone Provider: What Is Your Current Health Insurance Status: How Did You Here Of Us:

Step 2 of 7 - Personal Information

Are you a CNA?
Are you trained or certified in CPR?
Are you a smoker?
Are you older than 18?
Do you have a valid drivers license?
Do you have a vehicle in good working order?
Have you been convicted of a misdemeanor or felony?
Have you lived outside of Michigan in the last 10 years?
Have you Worked For Or Applied With Affordable HomeCare?
Do you know any other languages besides English?
What is the highest level of education you completed?
When Did You Complete High School?

Step 3 of 7 - Working Information

Are you currently employed?
Are you able to work with animals?
Can you pass a drug test?
Do you have any injuries that would affect the job you are applying for?
On a regular basis, are you able to lift/transfer more than 20 pounds?
What career opprtunity are you interested in?
How much experience do you have in this industry?
What city best represents the area you are comfortable working in?
What best describes the weekly hours you desire?
How far are you willing to travel to get to work?

Step 4 of 7 - Skills

Select which skills you know how to do
Vital Signs Check All

Ambulation and Exercise Check All

Medical Equipment Check All

Infection Control Check All

Elimination Check All

Safety Techniques Check All

Transfer and Lifting Check All

General Care Check All

Client Types Check All

Food and Fluids Check All

What Other Skills or Qualifications Do You Have?

Step 5 of 7 - Work References

If you do not have enough work references you can use "N/A" in the required fields

1st Work Reference

Reason for Leaving:
2nd Work Reference

Reason for Leaving:
3rd Work Reference

Reason for Leaving:
4th Work Reference (optional)

Reason for Leaving:
Additional References:

Step 6 of 7 - Availablity


What is your availablity for work?

Instructions: Use your mouse to select your availablity. You can select times individually or click and drag to select multiple times. Click HERE to reset your availablity.

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Please Double Check

Is this summary of your availability correct?

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Step 7 of 7 - Job Description



This position is part time / on-call only
Definition of live in care: Staying with a Client 24 hours around the clock until you are relieved after set amount of days worked.
Definition for hourly care: Staying with a Client during the hours scheduled and providing the following services.
Job Duties: Homemaking services and basic non-medical care. The environment, accommodations and cleanliness of the Client’s home may vary drastically. Duties include but are not limited to the following: 1.) HOUSEKEEPING: (10% of your shift should be dedicated to housekeeping) Contribute to the maintenance and comfort of the client as necessary. Duties include meal preparation, thoroughly cleaning bathrooms and kitchen daily, washing dishes, bed making, dusting, vacuuming, mopping and laundry and any other light housekeeping duties as requested. 2.) PROVIDE COMPANIONSHIP AND GENERAL SUPPORT:
  • A. Provide physical and emotional support.
  • B. Help maintain good standards of personal hygiene and nutrition.
  • C. Monitor and record activities of daily living and food/beverage intake.
  • D. Promote mental alertness through reading, games, conversation and other activities as indicated.
  • E. When appropriate, help Client develop highest functional self-help skills by providing meal planning and preparation, list making and shopping as necessary.
  • F. Encouraging Client to do whatever they can for themselves, but provide whatever personal support they might need.
  • G. MUST be compassionate!
  • A. Help with bath, mouth, skin, hair and nail care.
  • B. Help with toileting: Getting to bathroom, bedpan, commode, incontinence care and changing of adult briefs.
  • C. Help in and out of bed or chair.
  • D. Assist with ambulating, transfer or lift 50lbs regularly.
  • E. Promptly report changes in Clients condition or accidents to Office.
  • F. Provide pressure ulcer prevention.
4.) QUALIFICATIONS: The ability to:
  • 1. Follow oral and written directions.
  • 2. Record detailed daily documentation, includes: service journals, activity logs and progress notes.
  • 3. Be sympathetic toward the elderly or infirm.
  • 4. Demonstrate high personal grooming and hygiene standards.
  • 5. Provide nutritious meal preparation and follow special, diabetic, low salt, soft, etc.
  • 6. Maintain good housekeeping and sanitation methods.
  • 7. Tolerate mood swings and redirect difficult behaviors.
  • 8. Adapt to various personalities and changing physical conditions.
  • 9. Adapt to a wide variety of environments, accommodations and cleanliness of Client’s homes.
  • 10. Cooperate and communicate with supervisory personnel.
  • 11. Protect the Clients privacy and rights.
  • 12. Be on time to assignments and call if not able to.
  • 13. Regularly lift 25lbs or more over your head.
  • 14. Drive in unfavorable conditions on a regular basis.

Version 2016
I have read and understand the above job description