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*WE ARE AN EQUAL OPPORTUNITY EMPLOYER*

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EMPLOYMENT AVAILABILITY

Date available to begin work

Availability

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EMPLOYMENT HISTORY
*List your employment record in chronological order, beginning with your current or most recent employer.

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Date of employment:

End Date

Supervisor Name

Supervisor Contact Number

Position Title

Reason for Leaving

Duties and Responsibilities

Company Name

Company Address

Date of employment:

End Date

Supervisor Name

Supervisor Contact Number

Position Title

Reason for Leaving

Duties and Responsibilities

Company Name

Company Address

Date of employment:

End Date

Supervisor Name

Supervisor Contact Number

Position Title

Reason for Leaving

Duties and Responsibilities

EDUCATION

Type Of School

School Name

School Address

Number of Years Completed

Date Attended

Major or Degree

PLEASE PROVIDE 3 PERSONAL REFERENCES

Name

Relationship

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Name

Relationship

Phone Number

Name

Relationship

Phone Number

GENERAL

Why do you want to work at MLS and what attracts you to a caregiver position?

Is there anything else you'd like to add about yourself?

Acceptance

I certify that the information contained in the application is true and correct to the best of my knowledge. I authorize the references, schools, and previous employers listed to provide Minnesota Lifestyle Solutions with any and all information they may have. I release all parties and persons listed, MLS or any of its members or employees from all liability for any damage, except that resulting from misrepresentation which might result from furnishing this information. I further understand that employment is on an “at will” basis and employment is not guaranteed for any term and may be terminated by the co-op or myself for any reason at any time, with or without notice.

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Job Description

Major Function/Purpose:

ILS is direct training from staff person to address the identified skill development needs of a person in the areas of:

Communication Skills
Community living and mobility
Interpersonal skills
Reduction/elimination of maladaptive behavior
Self-care
Sensory/motor development involved in acquiring functional skills

Reporting Relationship: Program Supervisor

Qualifications:

Essential Functions:

Essential functions of the job are listed in bold and tasks involved in completing the necessary functions are listed underneath.

A. Teach and maintain skills in all areas of each person’s life.

Increase the person’s independence by teaching skills so tasks and activities may be performed with decreased dependence on caregivers
Increase the person’s opportunities to interact with people without disabilities who are not paid caregivers
Provide daily schedules, routines, environments and interactions similar to those of people without disabilities of the same chronological age
Provide skill training in an environment where the skill will be used
Support development of decision-making skills and informed choices in all aspects of daily living, including selection of service providers, goals and methods, location and decor of residence, roommates, daily routines, leisure activities and personal possessions.

B. Provide Direct Care.

Provide role modeling to enable the person to increase independence in daily living skills and learn appropriate ways of interacting in the home and community settings.
Provide client with supervision, which includes but is not limited to:
- Increase independence in performing tasks/activities
- Provide training in environment where skill is used
- Increase client’s opportunities to use and participate in a variety of community resources and activitie
- Increase client’s opportunities to develop decision making skills and choices.
Supervise the client’s living skills in meal preparation, hygiene, and daily living skills.

Careers

Job Description

Major Function/Purpose:

Reporting Relationship: Program Supervisor

Qualifications:

Essential Functions:

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