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Domestic, childminder & nanny placements
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Family profile form
Name
Surname
Street Address
Town
Suburb
Postal Address
E-mail Address
Home Tel
Work Tel
Mobile No
Fax No
Person responsible for payment
Family Religion
Home Language
How many family members residing at the above address
Specify Children: Name, Age
Can the children swim?
Yes
No
Do any of the children have allergies or special needs? Please specify.
Specify Elderly people in need of care
Do any of the Adults smoke?
Yes
No
Specify all other household staff
What pets do you have?
What is the size of your house?
Small one level
Medium one level
Large one level
Small two levels
Medium two levels
Large two levels
Are you aware of any transport problems?
No
Yes
Maybe
Select if you have previously employed a:
Nanny
Childminder
ElderlyCare Worker
Domestic Worker
Describe what happened to your last domestic worker?
Requirements by Employer
Nature of work (Please choose)
Proffesional Nanny(Only looking after babies no house duties, more expensive, South African Aupair)
Childminder(Can also do house duties,salary same as domestic worker)
Domestic worker only
Care Worker
Specific Requirement (Answer each of these)
Sex
Female
Male
Either
Age preference
Qualifications
Level of Qualification
Choose Option
Trained
Experience
Both
Language
Religion
Would you consider foreign nationals e.g. Zimbabwe
Choose Option
Yes
No
Other Nationality
Personality & Character selection:
Quiet
Old Fashioned
Introvert
Outgoing
Modern
Extrovert
Other issues (Would you allow):
Smoking (Yes)
Smoking (No)
Boyfriends/Husbands/Friends (Yes)
Boyfriends/Husbands/Friends (No)
Use Of Telephone (Yes)
Use of Telephone (No)
Is there exceptions to other issues:(Explain)
Specific Duties
Stimulating Activities
Able to Drive
Able to swim
Light chores(tidying up after children)
Cooking (which meals)
General cleaning
Laundry/ironing or both
Changing Nappies
Cleaning & making bottles
Bathing of children
Helping with children when family goes out
Parties
Grocery Shopping
Extra murals for children at school(e.g. fetching etc)
Basic first aid
Taking to Doctor/Dentist
Care of sick child
Mending
Newborn baby care
Caring for pets - please specify
Frailcare and Care workers - please specify duties
Please elaborate on the following
How and when do you expect to communicate with employee
Discipline (your family philosophy)
Family holidays-Do you require the employee to accompany you?
Employee's flexibility to work extended hours
Employees working conditions:
Working Hours Full -time(Time & which days)
Working Hours Part-time(Time & which days)
Time Off (Day & Time)
Duration of Contract
Date of commencement
Date of Termination
Short fixed term contract
Remuneration
Salary Minimum
Salary Maximum
Select Payment Intervals(Rate)
Monthly
Weekly
Hourly
Leave Info
Part-time hourly paid workers: 1 hour per 17 hours worked
Preferable date's employee should take leave?
Sick Leave Info
Accomodation
For live in in candidates - Nature of accommodation(must have shower or bath, toilet and basin, doors, windows, bed, electricity)
Select your choice
Choose Option
Live in Full Time
Live in Part Time(when?)
Live Out
Occasional sleep in(Example?)
Please specify:
Vehicle
Choose one of the following
No Car option
Car & Insurance supplied by employer
Use of employer's car on/off duty?
Employee to use own car?(Employer to pay AA rate for petrol & maintenance)
Select a Date suitable for a interview with candidates Mon - Fri (8h00 - 15h00)
Suitable Time
Terms and condition on the left hand side in the menu bar.
Select if you did read the terms & Conditions and agree to it.
Please supply your e-mail address
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