Apply for Registered Nurse (RN) Consultant

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Registered Nurse (RN) Consultant
ID:1023
Department:Clinical Services
Location :Baldwin Park, CA
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:
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Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Application for Employment
Please complete the FULL APPLICATION or your application will not be considered. Do NOT reference your resume in any part of the application.
PERSONAL INFORMATION
Yes   No
Yes   No
Yes   No
Yes   No
EMPLOYMENT DESIRED
Full Time   Part Time   Seasonal
Yes   No
Yes   No
EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School 1

Yes   No

School 2

Yes   No

School 3

Yes   No

School 4

Yes   No

School 5

Yes   No
EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

Employer 1

Yes   No

Employer 2

Yes   No

Employer 3

Yes   No

Employer 4

Yes   No

Employer 5

Yes   No
REFERENCES

Please provide three references (not relatives).

Reference 1

Reference 2

Reference 3
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.

Covid-19 Prevention and Safety
Please answer all questions honestly and completely. Hope House takes pride in providing the healthiest and safest environment to actively prevent the spread of Covid-19 in our facilities. We do everything possible to ensure the safety of our employees and residents.
* Are you willing to take weekly Covid-19 tests to ensure a safe environment for our residents and employees?
Yes
No
* Have you received any vaccinations for Covid-19?
Yes
No
* If yes, how many doses have you received?
1
2
1st Booster
2nd Booster
* If you have not received any doses of the Covid-19 vaccine, are you willing to begin the Covid-19 vaccination process as required for the job?
Yes
No
* If you have not received any Covid-19 vaccinations, do you have a medical reason that would prevent you from receiving a Covid-19 vaccination?
(Please type "NA" if you answered yes to previous question)
Registered Nurse Consultant - Experience & Availability for Client Observation & Meetings
Please answer honestly and completely. Your availability as an Registered Nurse Consultant to perform the required duties is needed to determine compliance and assure that the medical needs of the residents are monitored.
* Are you able to attend monthly meetings (in person or remotely) or submit reports of your findings/recommendations on the fourth Friday or every month to discuss interdisciplinary team reviews?
Yes
No
* Are you able to provide observation hours during the afternoons, evenings, weekends and other off school hours for the residents as needed or scheduled?
Yes
No
* Do you have experience in working as an Registered Nurse for intellectually and physically disabled persons as a consultant or in another capacity?
Yes
No
* If so, how many months/years of experience do you have?
* Do you have experience in working with individuals with intellectual disabilities that have moderate to severe behavioral episodes?
Yes
No
* If yes, please describe your experience and how it was documented and communicated with others to provide guidance.
* In your experience, can you describe the type of observation or care you have provided in the registered nursing field?
Registered Nurse Questions
Please answer the following required questions regarding your experience in the field of working with individuals with developmental disabilities.
* Do you have at least 1 year of experience of working with individuals with developmental disabilities?
Yes
No
* Do you have experience working with individuals with DD who have behavioral disorders?
Yes
No
* If so, please write a short description of your experience with behaviors. If none please state N/A.
* Do you posses a valid driver license?
Yes
No
* Do you have active medication passing status?
Yes
No
* What type of Nursing experience do you have?
* This position is part-time. Are you ok with working between 8 to 24 hours per week?
Yes
No
Writing Sample - Registered Nurse Consultant
As part of our application process, we require a writing skills sample. Please write a paragraph of at least 100 words about the topic below.
* Write about your experience as a Registered Nurse Consultant. What challenges have you overcome? Do you have any experience with individuals with intellectual disabilities?
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

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