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Parents and Guardians
Please use this form to submit a Worker Signup Request.

The specific FAQ text for this form is not completed. Please go to the Information section of your page and find the appropriate link for your topic. You can also call 510-336-2900 for more information
  Regional Center Client   
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Relation to Client

     

Questions about the Worker Is the worker 18 years or older?


Does the worker live outside the home of the client?


Will you personally recommend the worker by signing the Manos Home Care worker recommendation form?


If the answer is 'yes' to all three questions, we will:
  1. Interview the worker
  2. Check the worker's criminal background
  3. Verify work eligibility by filling out the federal government's I9 form.
After the worker is cleared, the worker can start. The form must be filled out prior to the employment of the worker.
Worker Information

  

  

  

  

Other workes on the case

Are any workers being removed from the case?   

If yes, who? Worker Name: First Last

Register Email Address
If you have not registered your email address with Manos Home Care, please call 510-336-2900 so we can keep your email address on file to ensure the confidentiality of your information and your action requests.