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Employment Form for 24h Childcare Caregivers

This employment form for 24h Childcare caregivers it collects essential information about the caregiver's background, availability, experience and qualifications to ensure the compliance with our hiring requirements and the compliance with the applicable laws and regulations of the state.

Section 1: Caregiver Information

First name*

Last name*

Birthday

Month

Day

Year

Address*

Phone*

Email*

Social Security Number*

Section 2: Please indicate your availability:

Days of the week:*

Hours per week:*

Open to do Overnight Care? *

Yes

Do you have a reliable transportation?*

Yes

Section 3: Experience and Qualifications

Experience: Please describe your experience working with children:*

Qualifications: Please list any relevant certifications or training:*

Section 4: Professional References

⁠Please provide 2-3 professional references: (Name, Number, Relationship)*

Section 5: Emergency Contact Information

Emergency Contact Name*

Emergency Contact Number*

Section 6: Background Check Authorization

Background Check: I authorize 24h Childcare to conduct a background check on me.*

Yes

Are you legally authorized to work in the United States?*

Yes

Are you also willing to work as a driver providing school pickup or drop? *

Yes

Goverment ID

Resume Submission

CPR & First Aid Certificate

Section 7: Confidentiality Agreement

As a 24h Childcare caregiver providing care at client homes or at our center, it's essential to maintain confidentiality and protect the privacy of the families and children in our care.

This confidentiality agreement outlines the expectations and responsibilities for caregivers.

Confidentiality Obligations

Client Information: Caregivers will not disclose any information about clients, including their identity, address, or personal information.

Child Information: Caregivers will not disclose any information about the children in their care, including their identity, medical conditions, or behavioral issues.

Family Affairs: Caregivers will not disclose any information about the client's family affairs, including marital status, financial situation, or other personal matters.

Confidentiality Requirements

Non-Disclosure:Caregivers will not disclose confidential information to anyone, including friends, family members, or any other caregivers.

Consequences of Breach

Termination of Agreement: A breach of confidentiality may result in the termination of the caregiving agreement.

Liability: Caregivers may be liable for damages or losses resulting from a breach of confidentiality.

Section 8: Signature

Signature: I certify that the information provided is accurate and true. By signing below, caregivers acknowledge that they have read, understood, and agree to maintain confidentiality as outlined in this agreement in case of hired.*

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This confidentiality agreement helps protect the privacy and trust of clients and their families, ensuring a safe and secure environment for children in care.

Date*

Month

Day

Year

Phone : ‪+1(417) 318-4228‬

Email: 24hchildcare@representative.com

Home
About
Services
Contact
My Account
Refer Friends
Website Guide

Home
About
Services
Contact
My Account
Refer Friends
Website Guide