Work Availability and Certification Questionnaire

Availability

Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday

0600 - 0900 ☒ ☒ ☐ ☒ ☒ ☒ ☒
0900 – 1500
☒ ☒ ☐ ☒ ☒ ☒ ☒
1500 – 1800
☒ ☒ ☐ ☒ ☒ ☒ ☒
1800 - 2300
☒ ☒ ☐ ☒ ☒ ☒ ☒
2300 – 0700
(active night shift) ☒ ☒ ☒ ☒ ☒ ☒ ☒
Sleepover shifts
(allowance paid) ☒ ☒ ☒ ☒ ☒ ☒ ☒
Questions

Do you have a current driver’s licence? If yes, is it automatic or manual? Yes ☒ No ☐

If yes, is it automatic or manual? Automatic

Do you have a suitable vehicle for transporting participants who have funding for transport? Yes ☒ No ☐
Do you have a current first aid certificate? Yes ☒ No ☐
Do you have current medication administration qualifications? Yes ☐ No ☒
Do you have a current National Police check? Yes ☒ No ☐
Do you have a current Working with Vulnerable People Card? (Can get one when I get job) Yes ☐ No ☒
Are you willing and able to swim with participants? Yes ☐ No ☒
Are you willing to undergo a medical if you are successful? Yes ☒ No ☐
The Disability Support Professionals role involves use of slide sheets, manual, standing and overhead hoists and working under pressure. Is this Yes ☐ No ☒
likely to cause any difficulties for you?
St Giles and ARC are smoke free workplaces. Disability Support Professionals are paid for the duration of their shift, which means they are not Yes ☐ No ☒
entitled to leave the premises to smoke a cigarette. Will this present any difficulties for you?
Are you willing to work a variety of short and long shifts (short shifts can be one hour in duration)? Yes ☒ No ☐
If yes, how many short shifts in a week are you able to work? Depend on how much i have to travel and the per hour rate.

How far are you willing to travel to provide support to participants? (please circle) 10 km 20 km 30km 40km 50km+

GEN-Frm-113_1 Authorised by: Chief Executive Issued: 22/05/2019 Page 1 of 1