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Placer County Human Resources Department
#2020-14320-01


Supplemental Questionnaire

Last Name First Name
 

 

SUPPLEMENTAL QUESTIONNAIRE

PHYSICAL THERAPIST - II

This is the supplemental questionnaire for the classification of Physical Therapist - II.  This is the examination for this recruitment and will be used to determine your examination score. 

The supplemental questionnaire and the application are administered as two separate documents.  The supplemental questionnaire is the only item used to determine your examination score which will, in turn, determine your ranking and placement on the eligible list. 

NOTE: Resumes, letters, and other materials will not be evaluated nor considered as responses to the items in this supplemental questionnaire. In addition, responses to this questionnaire will not be used for determining minimum qualifications for this position.

By continuing in this examination process, you are certifying that all information provided in the supplemental questionnaire is true to the best of your knowledge.


 

I have read and understood the above instructions.


 

SECTION I - MINIMUM QUALIFICATIONS (NON-SCORED)

This section will not be scored but may assist with determining how the applicant reports meeting the minimum qualifications for this position.   Applicants responding "No" are encouraged to review the minimum qualifications for this opportunity.


1.

Do you possess two years of responsible physical therapist experience, including one year in pediatric rehabilitation, and a Bachelor's degree from an accredited college or university with major course work in physical therapy or a related field? A Master's degree in physical therapy is desirable. 

Yes No
2.

Do you possess a current license as a physical therapist issued by the State of California Physical Therapy Board?

Yes No
 

If yes, indicate your license number below.


 

SECTION II - EXAMINATION QUESTIONS (SCORED)

Please answer based on your training and/or experiences the following questions.  Based on your checked responses, your job-related training and experience will be scored and then ranked. Narratives provided by applicants describing training and/or experience will not be scored but will be available to the hiring authority and maybe utilized for interview and selection determinations.

INSTRUCTIONS:  For each item, select the one choice that best corresponds with your relevant training and/or experience.


1.

Evaluating, planning and providing physical therapy for children in a clinic setting.  This includes the following:  evaluating muscle strength, tone, sensation, balance responses, range of motion, and functional activities including gait; providing gait training; and assessing effectiveness of treatment and modifying treatment as appropriate.

I have no or very limited experience performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
1a.

If you indicated any experience or skill above, please give specific examples of the above listed assignments and describe below.

2.

Instructing parents in home exercise program and use of assistive devices such as orthotics, standers, or gait trainers.

I have no or very limited experience performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
2a.

If you indicated any experience or skill above, please describe below.

3.

Ability to intermittently walk, stand, bend, squat, climb, kneel, twist, lift and reach while assisting patients in moving to and from treatment area and in providing treatment and instructional activities. 

I possess no or a very limited amount of this ability.
I possess this ability but have not applied it in a job setting.
I have applied this ability under close supervision.
I have applied this ability independently under normal supervision.
I have used this ability to train or provide consultation to others.
3a.

If you indicated any ability above, please describe below.

4.

Evaluating the effectiveness and applicability of orthopedic and therapeutic equipment such as wheelchairs, orthotics and walkers.

I have no or very limited experience performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
4a.

If you indicated any experience above, please describe below.

5.

Independently performing physical therapy evaluations, providing treatments and educating patients and their parents/caregivers.

I have no or very limited experience performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
5a.

If you indicated any experience above, please describe below.

6.

Keeping clinical notes and records and preparing related reports.

I possess no or a very limited amount of this knowledge or skill.
I possess this knowledge or skill but have not applied it in a job setting.
I have applied this knowledge or skill under close supervision.
I have applied this knowledge or skill independently under normal supervision.
I have used this knowledge or skill to train or provide consultation to others.
6a.

If you indicated any experience above, please describe below.

7.

Giving breathing exercises.

I possess no or a very limited amount of this knowledge or skill.
I possess this knowledge or skill but have not applied it in a job setting.
I have applied this knowledge or skill under close supervision.
I have applied this knowledge or skill independently under normal supervision.
I have used this knowledge or skill to train or provide consultation to others.
7a.

If you indicated any experience above, please describe below.

8.

Working and partnering with teachers, school-based therapists, medical personnel (doctors, nurses, etc.) and vendors.

I have no or very limited experience performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
8a.

If you indicated any experience above, please describe below.


 

Thank you for completing the examination portion of the application process. We encourage applicants to review their answers for accuracy prior to submitting.

Please Save & Continue to move forward to the next tab. 

Be sure to select the "Submit" button once the application has been completed.  You will receive confirmation that the application has been submitted.  

A notice of your status will be sent to you.