1. I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the
best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application or in
any interview is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered
by the Company. Please note that all information is subject to verification.
2. I understand that a background check is a condition of employment. I authorize Hacienda De Luna Assisted Living
LLC and/or its agents to investigate thoroughly all statements contained in my application or resume, and to conduct a
thorough investigation of my personal and professional experience and background; including without limitation, a
review of my criminal, credit, employment and all other records Hacienda De Luna Assisted Living LLC deems
appropriate under the circumstances, and I authorize former employers and references to disclose any and all
information in their possession regarding me in connection with an application for or retention of employment to the
Company and/or its agent. In addition, I release the Company and/or its agents, any former employers and all
references listed above from any and all claims, demands or liabilities arising out of or related to such investigation.
3. I understand and agree that nothing contained in this application, or conveyed during the pre-employment process,
is intended to create an employment contract. I further understand and agree that if I am hired, my employment
will be "at-will" and without fixed term, and may be terminated at any time, with or without prior notice, at the
option of either the Company or myself. No promises regarding employment have been made to me, and I
understand that no such promise or guarantee is binding upon the Company unless made in writing by an
authorized company official.
4. I understand and agree that if I receive a conditional employment offer for a position, I could be required to submit to
a pre-employment drug test and based on the position that I am applying for. If employed, I also agree to submit to a
medical examination and/or drug test at any time deemed appropriate by the Company and as permitted by applicable
law. I consent to such examinations and/or tests, and I request that the examining doctor and/or laboratory disclose to
the Company the results of the examination, which the Company will keep confidential. I understand that my
employment or continued employment, to the extent permitted by applicable law, is contingent upon satisfactory
medical examinations and/or drug test.
5. If I am offered employment, I understand that employment is contingent upon my complying with the employment
verification requirements of the Immigration Reform and Control Act.
6. I understand that Hacienda De Luna Assisted Living LLC does not unlawfully discriminate in employment and no
questions on this application are to be used for the purpose of limiting or excluding any applicant from consideration
of employment on a basis prohibited by applicable local, state or federal law.
7. I certify that I have read, or have had read to me, items, 1, 2, 3, 4, 5, and 6 above.
I understand the contents and hereby acknowledge receipt of this information.
