We look forward to receiving your application. Please be prepared to provide your background, education, previous employment and additional references (optional). Please allow at least 20 minutes to fill out the form, and read a few policies that will prepare you for work. This job can be quite rewarding; thank you for taking the first step.
(Please begin with most recent employment)
If you would like to provide more references, please add them here.
Please read each policy and check the corresponding box, to confirm you agree. We also ask for your initials below that. Then, sign at the bottom of this page for all policies. This is the final section of the application process.
A Personal Care Aide (PCA) is being placed in your home to assist with activities of daily living. You are encouraged to participate with the RN in the development of your Plan of Care. We hope to be able to assign the same PCA for each visit, but this may not be possible. Should any problems occur, please feel free to discuss them with us when she makes a visit. Immediate problems should be called to the HCC Personal Care office coordinating your care.
If a patient requires supervision, a family member or other caregiver must be present when the PCA arrives and leaves so that the patient is not alone.
The PCA may perform the following activities:
According to HCC Personal Care, Inc. policies, personal care assistants are not required to have CPR certification. Personal care assistants are instructed to call 911 in an emergency.
According to HCC Personal Care, Inc policies and procedures, employees are not permitted to transport patients in any vehicle.
In the event that the employee and patient or responsible party violate this policy, the following statement will apply:
Should Patient, Responsible Party, or any other representative of Patient request that a HCC Personal Care, Inc staff member or employee use either the Patient or Responsible Party’s vehicle in conjunction with providing services, I realize that HCC Personal Care, Inc does not maintain any insurance coverage or recognize any liability for any claims arising out of the use of said vehicle in conjunction with providing services to patient. Accordingly, as a condition of HCC Personal Care, Inc providing services, I agree to release, hold harmless, and indemnify HCC Personal Care, Inc and any of its personnel for any and all liability or claims for personal injury, death, property or other damage or any other claims arising out of the use of said vehicle in conjunction with providing services to Patient.
HCC Personal Care, Inc. (HCC) prohibits and does not tolerate sexual abuse in the workplace or in any HCC related activity. HCC provides procedures for employees, volunteers, family members, board members, patients, victims of sexual abuse, or others to report sexual abuse and disciplinary penalties for those who commit such acts. No employee, volunteer, patient or third party, no matter his or her title or position has the authority to commit or allow sexual abuse.
HCC has a Zero-Tolerance policy for any sexual abuse committed by an employee, volunteer, board member or third party. Upon completion of the investigation, disciplinary action up to an including termination of employment and criminal prosecution may ensue.
Sexual abuse is inappropriate sexual contact of a criminal nature or interaction for gratification of an adult who is a caregiver and responsible for the patient or child’s care. Sexual abuse includes sexual molestation, sexual assault, sexual exploitation, or sexual injury, but does not include sexual harassment. Any incidents of sexual abuse reasonably believed to have occurred will be reportable to appropriate law enforcement agencies and regulatory agencies.
Physical and behavioral evidence or signs that someone is being sexually abused are listed below.
Physical evidence of abuse:
Behavioral signs of sexual abuse:
If you are aware of or suspect sexual abuse taking place, you must immediately report it to W. Jackson Nelms, President at 804-378-7780, extension 234. If the suspected abuse is to an adult, you should report the suspected abuse to your local social services or to the Adult Abuse & Neglect hotline at 1-888-832-3858. If the suspected abuse is to a child, you should report the suspected abuse to your local or state Child Abuse Agency. If you do not know your state child abuse agency you can call the Child Abuse & Neglect Hotline at 1-800-522-7096.
Appropriate family members should be notified of alleged instances of sexual abuse.
HCC should report the alleged sexual abuse incident to their insurance agent.
HCC prohibits retaliation made against any employee, volunteer, board member or patient who reports a good faith complaint of sexual abuse or who participates in any related investigation. Making false accusations of sexual abuse in bad faith can have serious consequences for those who are wrongly accused. HCC prohibits making false and/or malicious sexual abuse allegations, as well as deliberately providing false information during an investigation. Anyone who violates this rule is subject to disciplinary action, up to and including termination of employment or criminal prosecution.
HCC will take all allegations of sexual abuse seriously and will promptly and thoroughly investigate whether sexual abuse has taken place. HCC will use an outside third party to conduct an investigation. If HCC has a trained internal investigation team in place, the team will be used to investigate the incident. HCC will cooperate fully with any investigation conducted by law enforcement or other regulatory agencies. It is HCC’s objective to conduct a fair and impartial investigation. HCC hereby provides notice that it has the option of placing the accused on a leave of absence or on a reassignment to non-patient contact pending the investigation and subsequent assessment.
HCC will make every reasonable effort to keep the matters involved in the allegation as confidential as possible while still allowing for a prompt and thorough investigation.
Child Abuse & Neglect, in Virginia: Child Protective Services – Toll-Free Hotline: Dial “1” & then 800-552-7096 Or Outside Virginia: (804) 786-8536
Adult Abuse & Neglect, In Virginia Adult Protective Services – Toll-Free Hotline: Dial “1” & then 888-832-3858
I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer's service, whenever it is discovered.
I give the employer the right to contact and obtain information from all references, employers, and educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.
I understand it is this company’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for a reasonable accommodation as required by the ADA.
I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.
