Fillable CHILD CARE WORKER APPLICATION

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CHILD CARE WORKER APPLICATION

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LONG BEACH UNIFIED SCHOOL DISTRICT
CHILD CARE WORKER APPLICATION
(This application may only be used for Child Care Worker)
Please note: Applications for this position may only be accepted every 90 days.
If you have a preferred site you would like to work at, please list here:
INSTRUCTIONS: This application is part of your evaluation for employment and it, along with all attachments, becomes
the property of Long Beach Unified School District. Answer all questions completely and accurately. All statements are
subject to verification. You may be disqualified for any false statement. Fill out this application legibly, using only black ink
or type. It is your responsibility to update addresses, phone numbers, employment availability, etc.
LAST NAME:
FIRST NAME:
MIDDLE INITIAL:
PRESENT ADDRESS: (Street and Number)
APT/UNIT:
CITY:
STATE:
ZIP:
( )
WORK PHONE: (Optional)
( ) Ext.
CELL PHONE:
( )
EMAIL:
Are you currently on a LBUSD re-employment list (laid off or reduced in calendar or hours)? **YES NO
**If yes, which classification(s)? __________________________________________________________________________________________________
Are you able to perform the essential duties of this job with or without reasonable accommodation? (Please refer to job description.) YES
NO
In compliance with the Americans with Disabilities Act, if you require any reasonable accommodation in the employment process or in performing the
essential duties of the position, please attach a statement to your completed application.
During your entire employment history, have you ever been terminated or forced to resign due to misconduct or unsatisfactory service? Yes No
If Yes, complete the information below.
Employer Name:______________________________________________________ Termination Date:_________________________________________
Reason for termination:_________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________
___________________________________________________________________________________________________________________________________________________________
EXPERIENCE/EDUCATION/TRAINING: List work or volunteer experience and any education and/or training you have completed that allows
you to meet or exceed the experience requirements for the position.
EMPLOYER NAME, ADDRESS & DATES EMPLOYED
SUPERVISOR NAME, TITLE & PHONE NUMBER
POSITION / TITLE & JOB DUTIES:
REASON FOR LEAVING:
EMPLOYER NAME, ADDRESS & DATES EMPLOYED
SUPERVISOR NAME, TITLE & PHONE NUMBER
EDUCATION AND TRAINING
HIGH SCHOOL DIPLOMA
OR EQUIVALENT OR
DEGREE OR CERTIFICATE
EDUCATION AND TRAINING
DEGREE OR
CERTIFICATE
POSITION / TITLE & JOB DUTIES: REASON FOR LEAVING:
I Certify that I have No previous Work Experience / Education / Training
PLEASE SUBMIT COMPLETED APPLICATIONS TO: cdcjobs@lbschools.net
LONG BEACH UNIFIED SCHOOL DISTRICT
CHILD CARE WORKER SUPPLEMENTAL APPLICATION
Name:____________________________________
1. This positi
on requires graduation from high school or equivalent or enrollment in an accredited California
college. Do you meet this requirement? ___Yes ___No
2. Are you willing and able to work in an indoor and outdoor environment, playgrounds, including uneven
terrain? ___Yes ___No
3. Are you willi
ng and able to work evening and varied hours? ___Yes ___ No
4. Are you willi
ng and able to work in seasonal heat and cold or adverse weather conditions? ___Yes ___ No
5. Are you willing and able to work with exposure to fumes, dust, odors, and potential contact with blood and
other bodily fluids? ___Yes ___ No
6. Are you willi
ng and able to sit, walk and stand for extended periods of time? ___Yes ___ No
7. Are you willi
ng and able to bend and twist at the waist and stoop and kneel? ___Yes ___ No
8. Are you willing and able to lift and carry supplies weighing up to 50 pounds? ___Yes ___ No
9. Do you possess t
he dexterity of hands, fingers, and feet to operate playground and office equipment?
___Yes ___ No
10. Are you willi
ng and physically able to twist and turn to monitor student activities? ___Yes ___ No
11. Are you willing and physically able to hear and speak to exchange information? ___Yes ___ No
12. Are you physical
ly able to see to monitor activities of children? ___Yes ___ No
CERTIFICATION OF APPLICANT – (Read carefully before signing)
BY CHECKING THE "ACCEPT" BUTTON I HEREBY DECLARE: UNDER PENALTY OF PERJURY, THAT ALL STATEMENTS
MADE IN THIS APPLICATION ARE ACCURATE AND COMPLETE AND THAT ANY FALSE STATEMENTS OF MATERIAL FACTS OR
INCOMPLETE INFORMATION MAY SUBJECT ME TO DISQUALIFICATION OR TERMINATION. I AUTHORIZE RELEASE OF ANY
PRIOR EMPLOYMENT INFORMATION OR RECORDS TO VERIFY STATEMENTS MADE ON THIS APPLICATION AND RELEASE
FROM LIABILITY ANY PERSONS OR ORGANIZATIONS FURNISHING INFORMATION.
Signature____________________________________________________________________________ Date_____________________
FOR OFFICE USE ONLY - DO NOT WRITE IN THE SPACE BELOW
Approved:
Date: _____________
Reviewer: _____________
Incomplete: (Give reason below)
Date: ______________
Reviewer: ______________
Rejected: (Give reason below)
Date: ____________
Reason: ______ Reviewer: __________
Reason(s):_________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
ACCEPT
PLEASE SUBMIT COMPLETED APPLICATIONS TO: cdcjobs@lbschools.net
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LONG BEACH UNIFIED SCHOOL DISTRICT
CHILD CARE WORKER SUPPLEMENTAL EXAMINATION
Name:____________________________________ Date:_____________________
1. When a child has a temper tantrum, it is best to:
a. ignore the behavior while maintaining student safety
b. grant his wish without comment about his behavior
c. tell him loudly that he is acting like a baby and will be punished if he doesn't stop at once
2. If you make a serious error, you should:
a. call attention to it and suggest a way of correcting it
b. say and do nothing unless someone mentions it
c. let the supervisor discover it and correct it
3. A worker being trained on a job receives some instructions, which he does not understand. For maximum speed
and accuracy in doing the job, the worker should:
a. ask the instructor to explain the parts that are not clear
b. go ahead and work as far as he can
c. complete the task and ask questions later
4. During a fire drill it is most important that a Child Care Worker:
a. remain calm
b. get out of the school immediately
c. wait to see what they are told to do
d. have the youngest go out first
5. A Child Care Worker must keep information confidential regarding any student/family.
a. True
b. False
6. A Child Care Worker is expected to make every effort to protect students and to provide a safe and healthy
environment.
a. True
b. False
7. A student who demands special attention from a Child Care Worker should be:
a. made to wait longer than others for the attention
b. treated in a fair manner like other students
c. ignored because he is too demanding
8. The best approach to use when working with children is to:
a. set a low standard of achievement
b. lead them to make good choices of their own
c. discourage individuals from performing above the group
9. Which one of the following techniques is best when it comes to classroom rules?
a. be easy going some times and strict at other times
b. be strict at all times in order that the students will take you seriously
c. apply the rules evenly from day to day
PLEASE SUBMIT COMPLETED APPLICATIONS TO: cdcjobs@lbschools.net
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CHILD CARE WORKER APPLICATION

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Completed 18 January 2021

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