offical seal
Human Capital Management
#201015-I11B-08


Supplemental Questionnaire

Last Name First Name
 

 

ATTENTION!

 Please verify that you meet the education and experience requirements listed in the job bulletin before completing the following supplemental questionnaire. The questions below will be used for scoring purposes, in lieu of a written exam.


1.

Please check all supervisory tasks you have performed.

Approve time and leave
Conduct employee evaluations
Train subordinate staff
Develop and maintain a 24-hour staffing schedule
Use progressive Discipline or corrective action
Provide coaching
Comply with FLSA, FMLA, or Workers Compensation
Review other's work and provide feedback
Facilitate groups or meetings
Maintain confidential records
Written communication with superior or subordinate staff
Maintain inventory and logs with accuracy
Maintain recruiting and retention numbers
Delegate tasks to meet deadlines
I have no experience with any of these tasks
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

2.

What is your experience understanding and implementing the chain of command?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
3.

What experience do you have giving detailed oral or written instructions and information to others?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
4.

Please check all experience you have with security tasks.

Identifying contraband
Performing facility searches
Facilitating movement
Responding to an emergency
Handling evidence
Providing transportation for detainees
Applying restraints
Tool or key control
Operating handheld radios
Providing outside perimeter security
Monitoring video surveillance
Intervention of physical assaults
Facility access or visitor screening
Participating in court proceedings
Performing pat downs or strip searches
Editing or reviewing reports
Weapon retention and control
Employing defensive tactics
Proper use of PPE
Using basic office equipment
I have no experience with any of these tasks.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
5.

What experience do you have managing aggressive and non-aggressive behavior through verbal and physical intervention using prescribed and approved techniques?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
6.

What safety and security experience do you have performing routine duties in the care, custody and treatment of inmates?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
7.

What experience do you have with the enforcement of institutional rules and regulations in a secure facility?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
8.

Do you have any state certifications for law enforcement?

Commissioned peace officer
Reserve officer
Armed security
Unarmed security
I have no state certifications for law enforcement.
 

Please list your certification type and number. If you indicated "no state certification", then please write N/A below.

9.

What experience do you have managing multiple tasks with deadlines?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
10.

Please check all of the following certifications you have obtained.

Firearms instructor
Defensive tactics instructor
CPR/First-aid instructor
Substance abuse or mental health
Inflammatory agents
Electronic equipment
PREA (Prison Rape Elimination Act)
Suicide prevention
I have none of the certifications listed above.
 

Please list the type of certification(s), date you received the certification(s), and location where you received the certification(s) as indicated in the response above. If you indicated "no certification", then please write N/A below.

11.

Check all experience you have with firearms and firearms safety practices.

In a law enforcement or correctional setting
In a military setting
In my personal life
I have no experience with firearms.
 

Please list where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.

12.

What experience do you have presenting findings in clear, logical, impartial and properly documented written reports?

I have written reports as a regular part of my job. I reviewed and edited the work of subordinates.
I have written reports as a regular part of my job. My work was subject to supervisor review.
I have written reports for a college course.
I am familiar with this task or have received some training on it.
I have no experience with report writing.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

13.

Please check the organizations with which you have experience maintaining partnerships.

Law enforcement
Fire departments
State, city, county, and federal agencies
Private sector organizations
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

14.

What experience do you have interpreting and following detailed instructions?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

15.

When given limited information, what experience do you have asking follow-up questions and conducting interviews to get more information?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

16.

Do you have experience analyzing complex situations or detailed information and implementing appropriate courses of action?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

17.

What experience do you have in the mediation, resolution, and investigation of employee sexual harassment and workplace violence?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

18.

What experience do you have finding and applying agency or organizational policies and procedures to appropriate situations?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above. If you indicated "no experience", then please type N/A below.

19.

What is your experience supervising employees in a security setting?

I have supervised other employees for five years or more.
I have supervised other employees for less than five years.
I have never supervised other employees.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
20.

How many employees have you supervised at one time?

1-10 employees
11-20 employees
More than 20 employees
I have no experience supervising other employees.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

21.

What experience do you have motivating employees to stay on task?

I have frequently motivated employees to stay on task.
I have sometimes motivated employees to stay on task.
I almost never motivated employees to stay on task.
I have never motivated employees to stay on task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.