EVADEL HOME CARE LLC

Compassion, Love and Trust are the essence of caregivers

7243 KELVIN AVE. # 102 WINNETKA, CA. 91306 Phone:(818) 518-6742 Fax: (818) 835-9346 www.evadelhomecare.net

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION
Last First DATE OF APPLICATION:______________

Name: _______________________________________________________________________________________
Middle

Address: _____________________________________________________________________________________
Street Street (Apt) City/State City/State Zip Zip

Alternate Address: _____________________________________________________________________________ Contact Information: (_____) _____--________

Home Telephone

(_____) _____--_______
Mobile Telephone

__________________________
Email

How did you learn about our company? ___________________________________________________________________

POSITION SOUGHT: _________________________ Desired Pay Range: ________________

Hourly or Salary

Available Start Date:______________ Are you currently employed? _________________

Date of Birth:_________-____-________ Sex: F M

Social Security Number: __ __ __ -- __ __ -- __ __ __ __

EDUCATION
Name and Location Graduate? Degree? Major / Subjects of Study

High School College or University Specialized Training, Other Education Driver License No. Policy Number: Vehicle Make/Model Insurance Carrier:

EMERGENCY CONTACT
Incase of emergency, Please notify Name: Address: Name: Address: 1 EVADEL HOME CARE LLC Relationship: Telephone: Relationship: Telephone:

PREVIOUS EXPERIENCE
Please list beginning from most recent Dates Employed Company Name Location Role/Title Job notes, tasks performed and reason for leaving: _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Dates Employed Company Name Location Role/Title Job notes, tasks performed and reason for leaving: _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Dates Employed Company Name Location Role/Title Job notes, tasks performed and reason for leaving: _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Dates Employed Company Name Location Role/Title Job notes, tasks performed and reason for leaving: _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ Dates Employed Company Name Location Role/Title Job notes, tasks performed and reason for leaving: _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ _______________________________________________________________________________________________________

Authorization to Obtain and Disclose Information I, ________________________________________, hereby authorize EVADEL HOME CARE LLC to contact my former employers and the personal references I have given with regard to my job performance and character. If this position requires that I drive my employers vehicle, I agree to show my employer proof of current insurance on my vehicle and proof of a valid drivers license. I also agree to cooperate with my employer in obtaining a copy of my driving record, with the understanding that my employer will pay any necessary costs. I understand that my employer may check public court records for cases, civil or criminal, listed under my name.

EVADEL HOME CARE LLC

EMPLOYMENT AGREEMENT -- EVADEL HOME CARE LLC EMPLOYEE

This Employment Agreement for Evadel Home Care LLC ( the Agency ) is made and effective this [DATE] ____________________, BETWEEN: __________________________________________( the Employee ), and Evadel Home Care LLC, a licensed non-medical home care agency and registered by the State of California, with its head office located at: 7243 Kelvin Ave. #102 Winnetka, CA. 91306. In consideration of Evadel Home Care LLC (the Agency) accepting my application for employee, I further certify and agree to the following items (initial every line). _____ 1. APPOINTMENT The Employee is hereby employed by Evadel Home Care LLC to render such services and to perform such tasks as may be assigned by the E.H.C.. The E.H.C. may, in its sole discretion, increase or reduce the duties, or modify the title and job description, of the Employee from time to time, and any such increase, reduction or modification shall not be deemed a termination of this Agreement. _____ 2. ACCEPTANCE OF EMPLOYMENT Employee accepts ________________________ (position) employment with Evadel Home Care LLC upon the terms set forth above and agrees to devote all Employees time, energy and ability to the interest of the E.H.C., and to perform Employees duties in an efficient, trustworthy and business-like manner. _____ 3. DEVOTION OF TIME TO EMPLOYMENT I shall devote the Employees best efforts and substantially all of the Employees working time to performing the duties on behalf of the E.H.C.. The Employee shall provide services during the hour that are scheduled by the E.H.C. management. The Employee shall be prompt in reporting to work at the assigned time and location. _____ 4. NO CONFLICT OF INTEREST Employee shall not engage in any other business while employed by the E.H.C.. Employee shall not engage in any activity that conflicts with the Employee duties to the E.H.C.. Employee shall not provide any service or any aid or assistance to any party that competes with the service offered by the E.H.C.. Employee shall not provide any services to clients or prospective clients of the E.H.C. outside of the provision of services for the E.H.C., whether such services are provided with or without compensation or remuneration. _____ 5. EVADEL HOME CARE LLC PROPERTY Employee acknowledges and agrees that while employed by the E.H.C. the Employee may be provided with company phone and other property of E.H.C. after he/she signed up 7 clients to E.H.C.. The use and possession of the such items shall be subject to any policies, requirements or restrictions established by the E.H.C.. On request of the E.H.C., the Employee shall immediately deliver any such item to the E.H.C. Upon termination of employment, Employee shall have the affirmative duty to return any such item to the E.H.C. whether a request is made or not. The obligation to return E.H.C. property shall extend and include any and
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all work product, client property, proprietary rights, intangible property, and all other property of the E.H.C. regardless of the form or medium. _____ 6. COMPENSATION The E.H.C. shall pay the Employee such daily rate / hourly per client compensation as determined by the E.H.C. Payment shall be every 20th of the month for the service rendered during the 1st day thru 15th day of the month and every 5th for the service rendered during 16th day and 31st day of the month. Employee is required to submit timesheet on timely basis to insure timely pay. List of the holiday mentioned on the Daily Time Sheet that will be only be consider with the Client/Patient signature. Employee will notify E.H.C. for any Gift given by the Client/Patient for the E.H.C. Employee records to ensure no financial abuse or any complaints from Client/Patient and or family member be filed on the future. _____ 7. WITHHOLDING All sums payable to Employee under this Agreement will be reduced by all federal, state, local, and other withholdings and similar taxes and payments required by applicable law. A 1099 statement will be supplied to the Employee by January 31st for the previous calendar year. _____ 8. QUALIFICATIONS OF EMPLOYEE The Employee shall satisfy all of the qualification that are established by the E.H.C. _____ 9. TERM OF AGREEMENT There shall be no guaranteed term of employment. Employee acknowledges and agree that Employee shall be an Evadel Home Care LLC Employee and that Employees employment may be terminated at any time by E.H.C. if any sexual, malicious, indecent act, physical and/or financial abuse with Client/Patient, Co Workers, especially Caregivers. _____ 10. FEES FROM EMPLOYEES WORK The E.H.C. shall have exclusive authority to determine the fees, or a procedure for establishing the fees, to be charged to clients by the E.H.C. for services that are provided by the Employee. All sums must be paid by check or money order payable to Evadel home Care LLC in the way of fee. _____ 11. CLIENTS AND CLIENTS RECORDS The E.H.C. shall have the authority to determine who will be accepted as client of the E.H.C., and the Employee recognizes that such clients accepted are clients of the E.H.C. and not the Employee. All client records and files of any type concerning clients of the E.H.C. shall belong to and remain the property of the E.H.C., notwithstanding the subsequent termination of the employment. _____ 12. TERMINATION Each party agrees to give the other two ( 2 ) weeks notice of termination, except when physical, emotional, or financial abuse occurs, In which case termination will be immediate. _____ 13. CLIENTS and REFERRAL Employee acknowledges and agrees that any client and all work referral of the Employee that is accepted and signed up during the Employees employment with the E.H.C. is the exclusive property/client of the E.H.C.. This shall include any and all trade secret, confidential information, patents, trademarks, ideas, concept, plans, business plans, business concepts, techniques, logos, web pages, database, software,
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program, plug ins, applications, brochures, marketing plans, and concepts, and all other ideas and work product of the Employee. _____ 14. RESTRICTIVE COVENANTS The Employee acknowledges that the E.H.C., through its employment of the Employee, has provided the Employee with confidential information, business and professional contacts, training and experience, and the ability to service and otherwise have access to the E.H.C.s clients. The Employee further acknowledged that such confidential information, business and professional contacts, training and experience, and the ability to service and otherwise have access to the E.H.C.s clients are the result of his employment by the E.H.C. In consideration of the foregoing and of the benefits generally provided to the Employee by the E.H.C. pursuant to the terms of this Agreement and otherwise, the Employee agrees to abide and be bound by the restrictions and prohibitions of this Articles, which restrictions are intended by the parties to extend to any and all activities of the Employee, whether as an independent client, partner or joint venture, or as an officer, director, agent, employee, or salesman for any person, firm, partnership, corporation, or other entity, or otherwise. _____ 15. HIRING The Employee agrees that during the Employees employment with the E.H.C. and for period of working years following the termination of this Agreement, whether the termination shall be voluntary or involuntary, or with or without cause, the Employee will not attempt to hire any other employee or caregivers of the E.H.C. or otherwise encourage or attempt to encourage any other employee or caregivers of the E.H.C. to leave the E.H.C. employ. _____ 16. CONFIDENTIALITY; DISCLOSURE; PROPRIETARY INFORMATION Employee recognizes and acknowledges that all records with respect to clients, business associates, customer or referral lists, contracting parties and referral sources of the E.H.C. and all personal, financial and business and proprietary information of the E.H.C., its employee, officers, directors and shareholders obtained by the Employee during the term of this Agreement and not generally known in the public (the Confidential Information) are valuable, special and unique and proprietary assets of the E.H.C.s business. The Employee hereby agrees that during the term of this Agreement and following the termination of this Agreement, whether the termination shall be voluntary or involuntary, or with or without Information in full or in part, in written or other form, to any person, firm, corporation, association or other entity, or utilize the same for any reason or purpose whatsoever other than for the benefit of and pursuant to authorization granted by the E.H.C.. _____ 17. SOLICITATION The Employee further agrees that during the term of this Agreement and following the termination of this Agreement, whether the termination shall be voluntary or involuntary, or with or without cause, the Employee will not, in any manner or at any time, solicit or encourage any person, firm, corporation or other business entity who are clients, business associates or referral sources of the E.H.C. to cease doing business with the E.H.C. or to do business with the Employee. _____ 18. NON-COMPETIOTION WITH E.H.C. CLIENTS Employee agrees that during the term of the Employees employment with the E.H.C. and for a period of working years fallowing the cessation of the relationship with the E.H.C., the Employee shall not provide any service to or lend any aid or service to the client of the E.H.C..

EVADEL HOME CARE LLC

_____ 19. ACKNOWLEDGEMENT The Employee acknowledges that when this Agreement is concluded, the Employee will be able to earn a living without violating the foregoing restrictions and that the Employees recognition and representation of this fact is a material inducement to the execution of this Agreement and to Employees continued relationship with the E.H.C.. _____ 20.REPRESENTATION AND WARRANTY OF EMPLOYEE The Employee acknowledges and understands that the E.H.C. has extended employment opportunities to Employee based upon Employees representation and warranty that is in good health and to perform the work contemplated by this Agreement for the term hereof. _____ 21. MODIFICATION No change or modification of this Agreement shall be valid unless the same be in writing and signed by the parties hereto. _____ 22. ENTIRE AGREEMENT This Agreement contains the entire agreement and supersedes all prior agreement and understandings, oral or written, with respect to the subject matter hereof. This Agreement may be changed only by an agreement in writing signed by the party against whom any waiver, change, amendment, modification, or discharge is sought. _____ 23. NOTICES Any and all notices or other communication provided for herein shall be given by registered or certified mail, return receipt requested, in case of the E.H.C. to its principal office, and in the case of the Employee to the Employees residence address set forth on the first page of this Agreement or to such other address as may be designated by the Employee. IN WITNESS HEREOF, each party to this Agreement has caused it to be executed at 7243 Kelvin Ave. #102 Winnetka, CA. 91306 on the date above.

Evadel Home Care: Name: ___DUANE S. WAIDER, _______________ Signature: ____________________ ( C.E.O. ) Date: ________________ Name:____ADELCARMEN J. WAIDER__________ Signature:_____________________ ( C.A.O. ) Date: ________________ Employee: Name: ________________________________ Signature: ____________________ Date:________________

EVADEL HOME CARE LLC