LPN – DD Group Home II Supervisor

Full Time

Available Position(s)

Developmental Disabilities Group Home II Supervisor - LPN Selma, AL

Job Description

Developmental Disabilities Group Home II Supervisor - LPN Selma, AL. This position requires supervising a residential home, ensuring the home is staffed, and meeting Center and State requirements for the home and the care of the residents.

Prerequisites

Requires an LPN licensed by the AL Board of Nursing and a valid AL driver's license. Must be able to complete MAS training, which is provided by the Cahaba Center.

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Employment Application

Applicant

First Name

Middle Name

Last Name

Street Address

City

State

Zip Code

Telephone

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Citizenship

Position Desired

Full Time or Part Time

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Employment Experience

Start with your present or last job. List all employment experience. Email additional jobs or resume to [email protected].

1

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

2

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

3

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

Education and Training

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Graduated?

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College

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Graduated?

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College

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Graduated?

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Personal Reference

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Supplemental Information

List any other factors which you feel might be important in your application for employment including typing, office machines used, professional licenses and/or certificates, and any other experience or training not covered in the application elsewhere.

Have you ever been denied coverage under an employee fidelity bond?

Applicants for Clinical Positions:

Have you ever had your professional license suspended or revoked, or have you ever been disciplined by your license board?

Applicants for Positions that Include Driving:

Do you have a medical condition that restricts your driving ability (i.e., Insulin dependent, seizures, sight problems, etc.)?
If yes, please explain:

Affidavit

I certify that the answers given to the foregoing questions are true and correct without consequential ommissions of any kind whatsoever. I understand that any false or misleading statements are grounds for dismissal and shall not hold the Mental Health Center liable in any respect if my employment is terminated because of said falsification or omissions made by me in the questionnaire. I authorize the employers (with the possible exception of current employer), schools or persons named herein to give any information regarding my employment or physical condition, together with any information they may have regarding me whether or not it is in their records. I hereby release said employers, schools, or persons from all liability for any damage for issuing this information. If accepted for employment, I hereby authorize my participation in any group insurance and/or retirement plans for which I am eligible and in which participation is a condition of employment. I further agree to abide by all policies of the Cahaba Center.

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Note: Any item on this form which you feel tends to violate Federal or State Civil Rights of FEPC Legislations need not be completed. We are an Equal Opportunity Employer. A copy of this application is available to you on request.