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Conditions of Employment

I certify that the information in the employment application and any related document that I am submitting is correct to the best of my knowledge. I understand that falsification of this information is grounds for refusal to hire or, if hired, termination. I authorize any of the persons or organizations rioted in the application to give VNA California any and all information concerning my previous employment, education, or other information they might have, personal or otherwise, with regard to any of the subjects covered by the application. I authorize VNA California to request and receive such information and release VNA Califomia and all such parties from all liability for any damage that may result from furnishing such information to VNA California, its agents and representatives.

I agree that, if hired, I will follow the rules, regulations and policies of VNA Califomia and acknowledge that these rules, regulations and policies may be changed, interpreted, deleted, or added to at any time without any prior notice to me. This may include, but is not limited to, overtime, rotating or changing work assignments, locations and schedules, drug testing, weekend and night work, and other conditions that may not necessarily meet with my individual preference.

In applying for employment with VNA California, I understand and agree that, if hired, my employment would not be for a definite term or period of time, and would be at-will. I understand that under this at-will employment status I may be terminated at anytime without any obligation on VNA California’s part to provide cause or justification. By accepting employment, if offered, with VNA California, I agree to this at-will employment status. Finally, I understand that any offer of employment will be based on, among other things, my signing a written

ACKNOWLEDGMENT agreeing that my employment is at-will.

I further agree that my employment, if offered, may be subject to a physical examination, which may include a drug screen, to determine if I am physically and otherwise fit to perform the essential functions for the position for which I am being considered. I hereby agree that the results of this physical examination shall be released to representatives of VNA California.

I understand that proof of identity and lawful status to work in the United States is also required as a condition of any offered employment. I acknowledge and agree that my employment with VNA California may require that I use my own vehicle for transportation to and from assignments. I agree to furnish VNA California with a copy of my automobile insurance. Applicants whose jobs require driving must have a driver’s license valid in California and are subject to a Department of Motor Vehicles check prior to employment and as a basis of continued employment. I agree with and consent to all of the above as VNA California considers me for employment.