Parent Provider Application - STATEWIDE - Arizona Autism United - Career Page (original) (raw)

First Name_*_

Last Name_*_

Email Address_*_

Phone_*_

What's your highest level of education completed?*

What COUNTY do you reside in?*

In order to qualify for the Parent Provider role, your child MUST be approved for Habilitation and/or Attendant Care services through the Arizona Division of Developmental Disabilities (DDD).

If your child has not been approved for these services and you need help, please contact our Family Support Team by visiting www.AZAunited.org/supportcall

Is your child currently approved for Habilitation or Attendant Care Services through DDD?*

Communication Requirement: All applicants must be able to communicate proficiently in English (both verbal and written). Are you able to meet this requirement?*

AZA United defines the Parent Provider role as parents, legal guardians, or other adults serving in a primary caregiving "parenting" role. Which role best describes your relationship to the individual receiving DDD services?*

DDD/AHCCCS have additional policies for parents providing services to minor children. Are you planning to provide DDD services to an individual who is a minor (less than 18 years old)?*

Is your child already receiving services from another Parent Provider?*

If there is another Parent Provider, are they set up with AZA United or another agency?*

If there are two Parent Providers, do both live in the same household?*

PLEASE NOTE: Attendant Care services are currently limited to Maricopa County, the Tucson area, and Prescott/Flagstaff areas due to internal staffing limitations for in-person Attendant Care Monitoring requirements.

If your child is approved for Attendant Care (ATC) services by DDD, are you planning to provide ATC services as a Parent Provider?*

ATTENDANT CARE (ATC) has additional requirements that are due after hire, such as Fundamentals of Caregiving level 1 (an all-day in person training class), regular in-person monitoring visits with a Field Trainer, and 6 hours of yearly continuing education requirements. Do you agree to these requirements if planning to provide ATC to your learner?*

Are you a current AZA United employee? If yes, please contact a member of the HR team for further assistance.*

How much experience do you have caring for others? This includes caring for your own child, caring for other family members, babysitting, professional experience, etc.*

Describe your experience caring for others.*

Has your child ever received any services from AZA United?*

Parent Providers for AZA United are classified as independent contractors, and not employees. Please confirm that you are willing to move forward with this process as an independent contractor.*

Are you currently authorized to work in the United States?*

This role requires you to be at least 18 years old. Are you at least 18 years of age?*

Applying for this position requires you to disclose your criminal history. Are you willing to complete a form to disclose your criminal history? We will provide the form later.*

This position requires a valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety. Please note that certain offenses may disqualify you from obtaining this card. In addition, you will be required to disclose your criminal history as part of the hiring process. Please confirm your understanding of these requirements.*

This role requires successful completion of an Arizona Central Background Check, which includes screening against the Department of Child Safety (DCS) Central Registry and the Adult Protective Services (APS) Registry. Any substantiated findings in either registry will result in disqualification from the role. No exceptions or appeals will be accepted. Please confirm your understanding of this requirement_*_

This position requires the following certifications: CPR, First Aid, Article 9. It is the applicant's responsibility to obtain these certifications. AZA United will provide options and may offer some classes for you to complete these certifications. Are you willing to obtain these certifications if you do not already have them?*

To submit timesheets and data reports, this position requires a personal email account, basic computer skills, and a GPS-enabled smartphone with Internet access.

Are you able to meet these requirements?*

AZA United exclusively uses direct deposit to pay Parent Providers. No physical paychecks are available. As a Parent Provider, you must provide online bank account info to the Payroll Department in order to receive payment for services provided. Is this acceptable to you?*

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