PLEASE READ THIS CAREFULLY BEFORE SUBMITTING YOUR EMPLOYMENT APPLICATION TO
DAVIS IN-HOME CARE, INC.

I certify that the information contained in this application is true and correct to the best of my knowledge. I understand that falsification of this information or material omission may result in the refusal to hire or the termination of my employment at any time, regardless of the time elapsed before discovery.

I give the Company the right to make a thorough investigation of my past employment, education, criminal history, motor vehicle record, and other matters related to my suitability for employment. Additionally, I authorize the references I have listed to disclose to the Company any and all letters, reports and information related to my work records, without giving me prior notice of such disclosure. I release all persons or entities from all liability for any damage that may result from furnishing information to the Company. I also release the Company and all of its employees from all liability for any damage that may result from the Company’s reliance on the information furnished.

My employment with the Company may be contingent upon my successful completion of a post-offer fingerprint test or blood, urine and/or other medical tests for alcohol, drugs and controlled substances. Prior to testing, I agree to sign the Company’s authorization forms wherein I will agree to submit to such testing and to authorize the release of the results to the Company. The substance tests will be conducted at the Company’s expense by a facility selected by the Company.

I must produce applicable documents showing that I am a United States citizen or alien lawfully authorized to work in the United States, within the time frame specified by the Company, to meet the Immigration Reform and Control Act of 1986 requirements. If I cannot do so, I understand that my employment will be terminated in accordance with the law. As a further condition of my employment, I understand that I must supply other documentation, such as a DMV report and TB test certificate.

In consideration of my employment, I agree to conform to the Company’s policies, rules and regulations. I understand and agree that my employment is at-will, and therefore, my employment and compensation can terminate, with or without cause, and with or without notice, at any time, at my option or the Company’s option. I further understand and agree that this at-will employment relationship as defined above will remain in effect throughout my employment with the Company, or any of its parent or affiliated companies, unless it is modified by a specific, express written employment contract which is signed by the President of the Company and me. This represents an integrated policy with respect to the at-will nature of the employment relationship.

This application is valid for 60 days from the date signed. If you wish to be considered for employment subsequent to this date, a new application must be completed.

Our location:
Davis In-Home Care, Inc.
2627 Manhattan Beach Blvd., Suite 204
Redondo Beach, CA 90278

For additional information, call (310) 297-9125 ext 2#