LIVE-IN CAREGIVER CONTRACT

LIVE-IN CAREGIVER CONTRACT (Sample Contract)
1. Employer:
2. Employee:
Name
Name
Address
Address
Tel. # Home
3. Order of Employment
Work
Revenue Canada Employer #:
Job Title: Live-in Caregiver
A) Job Description
Child Care
Yes
Elderly
No
Yes
Number of Children
No
Age of Children
Disable
Yes
No
Care Responsibility Duties Describe:
Housekeeping Responsibilities
Yes
No
Describe: Laundry for family, Make beds for family, Clean up dishes after preparing meals for family, Care of kitchen, Ironning,
Vacumming, Dusting, Clean own bedroom and bathroom, Other tasks that are mutually agreed upon.
Will employee be required to provide pet care?
Yes
No Additional Responsibilities
Describe of house and household (number of room, household members, etc.)
B)
Yes
No
Wages and Working Conditions:
Wages and working condition must reflect provincial employment standard and prevailing wage rates
Net Pay $CND
Hours of work
Weekly
Schedule of hours
Monthly
Days off
(Which days of ?) .
Frequency of pay .
/wk
/wk
Overtime rate
/hr
To be paid after
hrs
The employer agrees to provide the employee with information regarding wages and types and approximate
amount of deduction from pay.
New Year's Day, Good Friday (Easter), Victoria Day, Canada Day,
Labour Day, Thanksgiving, Christmas Day and Boxing Day
Weeks of vacation with pay 2 /yr. Paid general holidays
Other leave
Days of paid sick leaves
Cost of room and board 85.25
/w To be paid
weekly
biweeky
/yr
semi-monthly
monthly
Accommodation
Finish private room
✘
Yes
No
Locked
Medical Coverage
Hospital and Medical Care Insurance
Airfare included
Yes
✘
No
Yes
No
Other Benefits
Private Bath ✘
Yes
EI, CPP & Old Age Security
Details
✘
Income tax deductions will be taken at source
✘
Contribution will be made by employer to Canada Quebec Pension Plan and to Unemployment Insurance
Duration of employment 2
4
Terms and Separation:
The employer and employee agree to abide by provincial labour standards regarding written notice of termination of
employment (It is recommended that a copy of the relevant portions of provincial labour standards be attached as an
appendix.) Amendment to this contract must be made in writing and agreed to by both parties.
5
No
Signature of Employer
6
I certify the duties outlined above are accurate and correct
I will abide by provincial labour standards.
I will provide a Record of Employment on termination of employment
Signature
FCIS-L-IN-C-C
Date:
Signature of Employee:
I have read the undertaking and understand it
Signature
Date: