I understand that all statements made on this application for employment are subject to the verification of Kind Hearts Home Care and I release all persons, companies, or institution from any and all liability or responsibility for supplying such information. I further understand that misrepresentation of facts is sufficient cause for rejection of this application or discharge if I am later employed.

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I understand that my completion of this application and its acceptance by Kind Hearts Home Care does not imply nor guarantee that an offer or employment will be forthcoming.  If employed, I understand that I will be employed as an "at will" employee of Kind Hearts Home Care. Under the "at will" employment relationship either Kind Hearts Home Care or I may terminate my employment relationship at any time with or without notice for any reason not in violation with the law.

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I understand that by signing the employment application, I am agreeing to screening for criminal background and child abuse history clearance if needed, drugs, and alcohol, education and/or licensure checks which may be conducted prior to and at any time during employment. I understand that this application remains current for three (3) months. Any offer of employment screening process, including the receipt of satisfactory references, successful completion of a two step PPD and/or Chest X-Ray, and receipt of a criminal background check with is satisfactory of Kind Hearts Home Care.

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A Criminal Record Background Investigation Report must be obtained for all employees hired. Conviction of a crime listed in the Older Adults Protective Act will result in a denial of employment. By my signature below I affirm that I have been advised that as a condition of my employment, criminal history background clearance must be obtained from the Pennsylvania State Police and/or the Federal Bureau of Investigation. I understand that Act 169 or 1996 and Act 13 or 1997 prohibit the employment of persons convicted of certain crimes, and that this information is being obtained in compliance with this act. I authorize Kind Hearts Home Care to deduct the cost of the preemployment criminal record background investigation report and/or child abuse history clearance on myself from my first paycheck. The cost of these reports is $10.00 each. IfI have been a resident of Pennsylvania for less that two years, and additional criminal record background check will be obtained from the Federal Bureau of Investigation at a cost to me of $30.52. The original of this report will be held on file in the Human Resources Department.

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I certify that the information provided by me in this application is true and correct to the best of my knowledge. I further certify that I have read and understand all parts of this application. I agree that if I am employed by Kind Hearts Home Care, I will abide by all rules, regulations, policies and procedures set forth by Kind Hearts Home Care.