Lacasahealthcare
Overview
Apply for Licensed Vocational Nurse - LVN. Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required. Title:
Licensed Vocational Nurse - LVN ID:
LC-1002 Location:
Glendale Discipline:
Licensed Vocational Nurse (LVN) Salary Range:
$30.00 - $31.00 / hr Time of Shift:
AM, PM Job Status:
Full Time Hours:
NA Resume Supported formats: Word, PDF, RTF, Text, and HTML. - or Upload from: Contact Information * First Name: * Last Name: * Address 1: Address 2 * City: * State: * Phone: * Email: Application for Employment PERSONAL INFORMATION * Are you legally eligible to be employed in the United States?
Yes / No * Are you at least 18 years or older?
Yes / No * Have you ever worked for this Company before?
Yes / No If Yes, please provide details (Where/When/Job Title) * Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
Yes / No If no, please explain EMPLOYMENT DESIRED When would you be available to begin work? Type of employment desired
Full Time • Part Time • Seasonal Hourly rate/salary desired Are you currently employed? If so may we inquire of your present employer? If presently employed, why are you considering leaving? EDUCATION Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended. School 1
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 2
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 3
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 4
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 5
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major EMPLOYMENT HISTORY Give your full employment record, starting with your current or most recent employment Employer 1
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 2
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 3
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 4
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 5
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving REFERENCES Please provide three references (not relatives). Reference 1
Name Relationship Phone Number Email Reference 2
Name Relationship Phone Number Email Reference 3
Name Relationship Phone Number Email Certifications & Licenses * Do you hold any professional licenses or certifications? Yes / No Please list all licenses and certifications you hold * Have you ever had any actions taken against you or warnings, disciplinary actions, or other limitations placed upon your license by any state board? Yes / No * Have you ever been, or are you currently excluded, debarred, or suspended from participation in any Federal or State healthcare programs or in Federal procurement or non-procurement programs? Yes / No Please use the space below for additional information in correlation with any of the above three questions: * Please select all of the skills with which you have had experience working: Bi-Pap / C-Pap Care & Management Central Line G-Tube Catheterization TPN Tracheostomy Ventilator IV Therapy Location Applying For Please state the location you are applying for: (City, Zip Code) COVID-19 Screening * Have you traveled outside of the United States in the last 14 days? Yes / No If Yes, please state the location * Have you had contact with anyone who has tested positive for COVID-19 in the last 14 days? Yes / No * Have you experienced any of the following symptoms in the last 14 days? Fever greater than 100.4 Cough Shortness of breath or difficulty breathing Consistent fatigue Muscle or body aches New loss of taste or smell Congestion or runny nose Diarrhea Are you currently experiencing a temperature over 100 degrees Fahrenheit, difficulty breathing or coughing? If you have answered Yes to any of the first two questions, please contact your primary care provider or your State Department of Health for further directions. California Department of Health - COVID-19 Information Line: 1-833-4CA4ALL (1-833-422-4255) If you have answered No to the first two questions but Yes to any of the remaining questions, please contact your healthcare provider. Please DO NOT visit a medical facility unless your symptoms are severe or if you are severely ill. Meanwhile, do not get close to anyone with a compromised immune system or other underlying health conditions. * Have you received both doses of your COVID-19 Vaccine? Yes / No If you have received two doses of your COVID-19 Vaccine, have you also received your booster shot? How did you hear about us? AUTHORIZATION The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary. I understand that I am required to abide by all rules and regulations of the company. * Signature (type name) * Date I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility. Copyright 2025 La Casa Health Care. All rights reserved. Powered by ApplicantStack™ Hiring Software
#J-18808-Ljbffr
Apply for Licensed Vocational Nurse - LVN. Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required. Title:
Licensed Vocational Nurse - LVN ID:
LC-1002 Location:
Glendale Discipline:
Licensed Vocational Nurse (LVN) Salary Range:
$30.00 - $31.00 / hr Time of Shift:
AM, PM Job Status:
Full Time Hours:
NA Resume Supported formats: Word, PDF, RTF, Text, and HTML. - or Upload from: Contact Information * First Name: * Last Name: * Address 1: Address 2 * City: * State: * Phone: * Email: Application for Employment PERSONAL INFORMATION * Are you legally eligible to be employed in the United States?
Yes / No * Are you at least 18 years or older?
Yes / No * Have you ever worked for this Company before?
Yes / No If Yes, please provide details (Where/When/Job Title) * Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
Yes / No If no, please explain EMPLOYMENT DESIRED When would you be available to begin work? Type of employment desired
Full Time • Part Time • Seasonal Hourly rate/salary desired Are you currently employed? If so may we inquire of your present employer? If presently employed, why are you considering leaving? EDUCATION Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended. School 1
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 2
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 3
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 4
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major School 5
Name Location Did you Graduate? Yes / No Degree Received Subjects Studied/Major EMPLOYMENT HISTORY Give your full employment record, starting with your current or most recent employment Employer 1
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 2
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 3
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 4
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving Employer 5
Job Title From To Company Name Company Address Company Phone May we Contact? Yes / No Responsibilities Reason for Leaving REFERENCES Please provide three references (not relatives). Reference 1
Name Relationship Phone Number Email Reference 2
Name Relationship Phone Number Email Reference 3
Name Relationship Phone Number Email Certifications & Licenses * Do you hold any professional licenses or certifications? Yes / No Please list all licenses and certifications you hold * Have you ever had any actions taken against you or warnings, disciplinary actions, or other limitations placed upon your license by any state board? Yes / No * Have you ever been, or are you currently excluded, debarred, or suspended from participation in any Federal or State healthcare programs or in Federal procurement or non-procurement programs? Yes / No Please use the space below for additional information in correlation with any of the above three questions: * Please select all of the skills with which you have had experience working: Bi-Pap / C-Pap Care & Management Central Line G-Tube Catheterization TPN Tracheostomy Ventilator IV Therapy Location Applying For Please state the location you are applying for: (City, Zip Code) COVID-19 Screening * Have you traveled outside of the United States in the last 14 days? Yes / No If Yes, please state the location * Have you had contact with anyone who has tested positive for COVID-19 in the last 14 days? Yes / No * Have you experienced any of the following symptoms in the last 14 days? Fever greater than 100.4 Cough Shortness of breath or difficulty breathing Consistent fatigue Muscle or body aches New loss of taste or smell Congestion or runny nose Diarrhea Are you currently experiencing a temperature over 100 degrees Fahrenheit, difficulty breathing or coughing? If you have answered Yes to any of the first two questions, please contact your primary care provider or your State Department of Health for further directions. California Department of Health - COVID-19 Information Line: 1-833-4CA4ALL (1-833-422-4255) If you have answered No to the first two questions but Yes to any of the remaining questions, please contact your healthcare provider. Please DO NOT visit a medical facility unless your symptoms are severe or if you are severely ill. Meanwhile, do not get close to anyone with a compromised immune system or other underlying health conditions. * Have you received both doses of your COVID-19 Vaccine? Yes / No If you have received two doses of your COVID-19 Vaccine, have you also received your booster shot? How did you hear about us? AUTHORIZATION The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary. I understand that I am required to abide by all rules and regulations of the company. * Signature (type name) * Date I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility. Copyright 2025 La Casa Health Care. All rights reserved. Powered by ApplicantStack™ Hiring Software
#J-18808-Ljbffr