Enable job alerts via email!
Boost your interview chances
Create a job specific, tailored resume for higher success rate.
COMPANY SUMMARY
Support Inc. is a highly regarded service agency which serves individuals with intellectual and developmental disabilities. We have an excellent reputation for providing the highest level of care and support for our clients and our host home providers. For more information about our company, please visit us online.
POSITION
**Providing IN HOME Services for an Adult with Developmental Disabilities** Support, Inc. is looking for an EXPERIENCED Host Home Provider to contract with our company! If you live in Akron, Colorado, you now have the opportunity to open your OWN home to provide for someone with developmental disabilities.You will be contracting with our company (Support Inc.) and will be able to help someone’s quality of life. You can help someone who has significant medical concerns or behavioral challenges and make a difference. Come work for Support Inc. and get trained on how to help this individual through their life. We have many client options but want to make a perfect match so the placement can be permanent.
Provider Duties and Responsibilities
To be successful, candidates . .
Support Inc. Provides:
Support Inc. is a private community services agency.
Job Type: Contract
Salary Range: $18,000.00 to $65,000.00/year depending on the clients’ disability level
Support, Inc. is an Equal Opportunity Employer. M/F/D/V
We are required by state and federal agencies to keep certain statistical records on applicants. It will not be used in any way to discriminate against you because of your sex, race, age, sexual orientation, creed, national origin, disability or military status, gender identity, unless related to a bona fide occupational qualification as defined by the Colorado Civil Rights Commission and the Equal Opportunity Commission.
Principals only. Recruiters, please don't contact this job poster with unsolicited services or offers.
Referred By: Craigs List Indeed Jazz Goggle Website other not sure Friend/Family Member/HHP/other individual
I watched the video on what it's like to be a HHP at here yes no
Is the address above also your home address? If no, please explain in the space provided. yes No If no, please explain:
Which County is the host home in?
Are you willing to relocate to provide services?
Driver's License Number:
Vehicle Type:
Total number of people in your home (including yourself):
Please provide your daily schedule, including hours worked and any on-going time commitments:
What is the primary language spoken in your home?
Please list any other languages you are fluent in:
Are you fluent in American Sign Language? yes no
Have you ever worked for applied for Support, Inc before?
If your answer to the above question is yes, please provide dates and position:
Have you ever been a Host Home Provider before? Yes No
If the answer to the above question is yes, please list dates and agencies worked for in the space below
Are you currently providing service in your home for another agency?
If your answer to the above question in yes, please list your client's agency or agencies:
Are you currently licensed to provide foster or day care in your home?
Do you have special certifications in related field? If so, please list:
List any training you have attended, within the past year, related to serving person(s) with IDD (i.e. QMAP, First Aid, CPR, etc.) Give dates attended and be prepared to produce proof for your file. Failure to provide required proof will result in having to repeat the class:
Work History Most Recent Employer:
Dates of Employment:
Name of Supervisor:
Phone #
Residential Description of host home
Location of bedroom(s) available:
Is your home wheelchair accessible
Do you own or rent your home?
Preferences
1. I prefer to work with the following age group(s) under 21 21 to 30 30 to 50 over 50 any age
2. I prefer to work the following gender: Male: Female Transgender: No preference
3. I would like to provide a home for: One person Two people No preference
4. I feel I can accommodate an individual who: Uses a cane or walker Is non-verbal Is sight impaired Is hearing impaired Has special dietary needs Does not attend a day program Presents a runaway risk Has self-injurious behaviors Has special medical needs Uses adult Depends Requires assistance with hygiene Is loud Has seizures Has moderate behaviors Has severe behaviors Is a registered sex offender
6. What hours are you available to provide support serves to persons living in your home?
General questions:
1. Do you have any pets in your home?
2. Are you willing to provide support to individuals that would bring any of the following pets into the home? Select all that apply) Cat Dog Reptiles Rodents None of the above
3. Do you have any young children (not living with you) who frequently visit your home?
4. Do you or anyone in your home smoke?
5. Are you willing to provide support to individuals that may participate in any of the following activities? (Select all that apply) Smoke cigarettes Use recreational marijuana Use other nicotine products (vape, chewing tobacco, etc) None of the above
6. Do you have any training or experience working with individuals with severe behavior challenges? If so, describe in the space below
7. Do you have any training or experience working with individuals with high medical needs? If so, describe in the space below
8. Activities I frequently participate in:
9. Will you have a Co-Provider to help care for the PRS? If so, please complete their information below. yes No
10. Church or meetings I attend on a regular basis (please specify):
11. Other information I would like to share:
12. Please add in the space below a paragraph about your plans for the next five years, and how having an individual with IDD in your home fits into those plans:
Name of Co-Provider #1
Address of Co-Provider #1
Is this person 18 years of age or older? Yes No
Phone Number of Co-Provider #1
Email Address of Co-Provider #1
Name of Co-Provider #2
Address of Co-Provider #2
Is this person 18 years of age or older? Yes No
Phone Number of Co-Provider #2
Email address of Co-Provider #2
Name of Co-Provider #3
Address of Co-Provider Number #3
Is this person 18 years of age or older? Yes No
Phone number of Co-Provider #3
Email address of Co-Provider #3
A BACKGROUND CHECK IS REQUIRED OF ALL ADULTS LIVING IN YOUR HOME. IF YOU, OR ANYONE ELSE IN YOUR HOME HAVE BEEN CONVICTED OF A CRIME, PLEASE PROVIDE ADDITIONAL INFORMATION BELOW THAT WILL HELP SUPPORT, INC. IN PROCESSING YOUR APPLICATION:
We consider applicants for all positions without regard to race, color, religion, gender, sexual orientation, national origin, age, marital or veteran status, the presence of non-job related medical condition or disability, or any other legally protected group. I understand it might take up to three weeks to hear back regarding the status of my application yes, I understand
By stating my name below and submitting this via email, I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as many be necessary in arriving at decision. Electronically signed and dated below: