Application Request

Welcome! Please complete the fields below if you are interested in applying with our organization. Minimum age is 16 if you know the family with whom you are applying to work. Our staff will review your entries and forward our electronic application to you if you meet our minimum qualifications and current openings. Should you have any questions, please contact our HR Department at (805) 384-0983 x862

First Name *Please list your legal first name, no nicknames.

Last Name *Please list your full legal last name.

Email *

Phone *Please list area code with phone number as (###)###-####

Home City + Zip Code *Please list the City where you currently reside and the Zip Code

How did you hear about us? *Please choose an option below. If other, please list source in statement of interest section.

CISS Referring Family If one of our respite families is requesting we hire you to support them, please list the full name of the child/adult with whom you are applying to work, #months/years you have known them, and if/how you are related to them.

Languages Spoken Please list the languages in which you consider yourself fluent. If you'd like an application in Spanish you may call our office or list that here.

Statement of Interest *

Why do you feel you'd be a good fit for our organization and our families?

Special Needs Experience *

Please check all diagnoses below in which you have personal, volunteer, or paid experience caring for someone.Autism SpectrumBehavioral InterventionCerebral PalsyDown SyndromeIntellectual DisabilityMental Health ConditionsPhysical DisabilitiesSeizuresNONEOTHER (please list details in next question)

Experience Detail *

All applicants for our special needs respite program must demonstrate that they have paid or volunteer experience caring for a child or adult who has a developmental disability. If none, put N/A.

Childcare Employment/Volunteer Experience *

All applicants in our Foster Care program must demonstrate that they have had work or volunteer experience providing childcare.

Personal Experience *

Please describe any personal and volunteer experience that you believe qualifies you for this position and how many months or years of experience you have.

Education *

Please list any degrees you have attained and the subject area (eg. BA in Psychology). If none past high school diploma, put N/A.

Job Requirements *

Do you meet our minimum job requirements of being able to pass a background check showing no prior misdemeanor or felony convictions, including no DUI's in the last five years? Are you able to safely lift a minimum of 50lbs, and are you free from all communicable diseases?YesNot Sure

Availability *

Please list your general availability for the next few weeks with day and start/end times (eg. Mon-Fri 4pm-8pm, Sat-Sun 10am-11pm). Most of our services are provided after school and on weekends.

Cities Willing to Work *

Please check all of the geographical areas below in which you are willing to work. If you are applying to work with the one CISS family you already know, check N/A.East County - Moorpark and Simi ValleyEast County - Thousand Oaks and WestlakeEast County - Agoura and CalabasasCentral County - Camarillo and SomisCentral County - Oxnard and Port HuenemeWest County - VenturaWest County - OjaiWest County - Santa Paula, Fillmore, PiruN/A - Only the home of the family I am applying to support

Which of our programs are you interested in? *

Please select all that applyRespite Caregiver for one family I already know (Dept. 100)Respite Caregiver for multiple families (Dept. 200)Respite Caregiver for Foster & Kinship Families (Dept. 230)Independent Living Skills Instructor (Dept. 260)

Thank You Our Human Resources and Family Services staff will be reviewing your entries and getting back to you in the next few work days. Thank you for your interest!

Application Request

Verification