Employment Application


Employment Application


1096 Silver Lane
East Hartford, CT 06108 

• Office (860) 461-1631
• Felix Effa (Director) (203) 809 - 0875
• Georgina Effa (Manager) (860) 502 - 2602
• Albert Cobbina (Administrator) (860) 726 - 3424
• Fax (860) 206-3815

More on

SELECT BRANCHPlease select the branch your are applying to

Is any additional information relative to change of name necessary to enable Sovereign Home Healthcare, LLC to check references of prior employer?: *

If yes explain

What type of transportation do you intend to utilize to get to your assignments? *

Please note: Sovereign Home Healthcare, LLC does not provide automobile insurance coverage for your vehicle

1.  Prior Work History

2.  Prior Work History

3.   Prior Work History

4.  Prior Work History

Please List two professional references

I hereby authorize Sovereign Home Healthcare, LLC and also authorize and request employees and each person given as reference to answer all questions that may be asked, and give all information that may be sought in connection with this application or concerning me or my work habits, character, skills, or my action in any transaction. I further authorize Sovereign Home Healthcare, LLC to forward my complete personnel file to any other Sovereign Home Healthcare, LLC office at which I may seek future employment. 

I further authorize Sovereign Home Healthcare, LLC to provide all information concerning me to any individual or organization to which I may be assigned. I understand that if I am applying for or accept a Live-in assignment, it could include”Live-In” assignments during which I will reside at the client’s premises for more than one consecutive 24-hour period, and I will not be on duty for the entire duration of such assignment. Some Live-In assignments are exempt from coverage under wage and hour laws. If not exempt, 

I understand that, unless advised by Sovereign Home Healthcare, LLC, prior to or during and assignment, the work schedule for Live-In assignments provides for: Eight [8] hours sleep time Three [3] hours meal time Three [3] hours personal time Ten [10] hours on-duty or on-call I agree to notify Sovereign Home Healthcare, LLC whenever the circumstances of the case require otherwise. I agree to report to the office at the end of each assignment, if I am no longer available for work, or if my availability status has changed. I further understand that I cannot be paid until I present a time sheet signed by both the client and myself to Sovereign Home Healthcare’s office. I certify that the information herein is complete and true and that any material omission, or misrepresentation, shall be sufficient cause for dismissal. I certify that I have fully read and understand the job description provided to me with this application and if accepted for employment, will abide by the terms thereof.



Sovereign Home Healthcare offers caregiver services, providing social interaction while promoting safety, security and independence in the comfort of one's home.


For clients who need significant assistance with managing and maintaining their household, personal care attendants can also assist with personal, non medical needs such as hygiene.


These individuals assist and/or instruct an individual in maintaining a comfortable environment when the person is unable to do so alone. Homemakers/Companions assist with daily activities as needed and directed by the individual. 

What Our Clients Say About Us

Reach Us

Felix Effa (Director) (203) 809 - 0875
Georgina Effa (Manager) (860) 502 - 2602
Albert Cobbina (Administrator) (860) 726 - 3424


1096 Silver Lane
East Hartford, CT 06118 
Office (860) 461-1631 / (860) 216-6707
Fax (860) 206-3815

1227 Burnside Avenue
East Hartford, CT 06108 
Office (860)-726-4620
Fax (860)-726-4619

1503 Dixwell Avenue
Hamden, CT 06514
Office (203) 859-5833 / (475) 655-2483
Fax (475) 441-7891

68 Southfield Avenue, Suite 100 
Stamford, CT 06902
Office (203) 921-0370
Fax (203) 921-0369