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Home Share Provider Pre-Screen Questions

Shared Living is about relationships and Integra is committed to finding the best match possible and we hope you are, too. This means there is no specific time line from when you submit your application and when you are introduced to a person wanting to live in home share.

Some individuals have specific care providers in mind, while others require assistance to find a suitable match. The individual is able to choose a care provider who best suits their support needs and lifestyle preferences. All Home Share providers undergo an extensive home study process and only those who are committed to fostering the essence of life will be considered. We maintain very strict privacy policies and will not give your personal information to anyone without your written consent. The information you submit in the pre-screening questions will be kept confidential.

 

Shared Living Pre-Screening Questions

Fields marked with an * are required

It is a requirement of the community care and assisted living act that individuals contracted to provide service be 19 years of age or older.



Shared Living Pre-Screening Questions


Individuals and families interested in being considered for Shared Living are required to provide or obtain:

  • Completed Application Package & Resume
  • Signed Reference Check Consent Form
  • 3 References, including at least 1 from an employer
  • Completed Home Study that includes 3-5 visits or more
  • An environment safety check of the home to assess for safety and suitability
  • Criminal Record Check & Clearance for each person over the age of 19 living in the home
  • Driver’s Abstract (annually)
  • Letter from Physician verifying good health
  • Letter from your financial institution indicating good standing
  • Proof of First Aid/CPR
  • Emergency Contact Form
  • Banking Information for Direct Deposit
  • Proof of Vehicle Insurance, where applicable (annually)
  • A signed contract when a match has been made
  • Clearance letter showing WCB Personal Optional Protection coverage
  • Signed Declaration of Confidentiality
  • Signed Release of Information for CARF
  • Copy of home insurance certificate
  • Earthquake kit with enough supplies for each person in the home for 72 hours
  • 5lb fire extinguisher (quantity depends on size of home)
  • First Aid kits in vehicle and home

Please do not click Submit more than once or reload the page.

Once you submit the pre-screening questions, a home share coordinator will follow up with you and provide you with the full application. 

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