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Certification Certificartion No. License Expiration Action
“Please rate your ability for the following duties, 0=No Experience, 5 = Very Experienced”

Duties / Rating 0 1 2 3 4 5
Standing Shower
Sitting Shower
Bed Bath
Tub Bath
Shaving
Oral Care
Grooming
Skin Care
Perineum care
Toileting
Transfers
Dressing
Tube Feeding
Assist w/ exercise regimen
Meal preparation
Medication reminders
Ambulation assistance
Cleaning
Laundry
Change linen
Equipment / Rating 0 1 2 3 4 5
Transfer Board
Hoyer lift
Gait belt
Hospital bed
Wheel chair
Oxygen concentrator
Walker
Bedside commode
Nebulizer
Shower chair
Cane
Disease / Rating 0 1 2 3 4 5
Alzheimer's
Diabetes
Parkinson's
Heart Condition
Multiple Sclerosis
Stroke
Cancer
Osteoporosis
Asthma
Developmental Disabilities
COPD
HIV
Dementia
Arthritis
Aphasia



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Caring Senior Service is an equal employment opportunity employer. The Company’s policy is not to unlawfully discriminate against any applicant or employee on the basis of race, color, sex, religion, national origin, age, military status, disability, genetic information or any other consideration made unlawful by applicable federal, state, or local laws. The Company also prohibits harassment of applicants and employees based on any of these protected categories. It is also Caring Senior Service’s policy to comply with all applicable state and federal laws respecting consideration of unemployment status in making hiring decisions.


Note to Applicants: Smoking is prohibited in all indoor areas of Caring Senior Service unless designated smoking areas have been established by a particular office in accordance with applicable state and local law.

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