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Placer County Human Resources Department
#2022-14303-01


Supplemental Questionnaire

Last Name First Name
 

 

Public Health Nurse - II
Supplemental Questionnaire

 

This supplemental questionnaire is the examination for this recruitment. The supplemental questionnaire is the only item used to determine your examination score. 

Please note: Resumes, letters, and other attached materials will not be evaluated or taken into consideration as responses to 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. If selected for an interview, you may be required to display and respond to questions to validate your responses to this examination.


 

I have read and understood the above information.


 

SECTION I: MINIMUM QUALIFICATIONS SCREENING (NOT SCORED)

This section will not be scored but may assist with determining how the applicant reports meeting the minimum qualifications for this classification.


1.

Do you possess a bachelor''s degree from an accredited college or university with major course work in nursing? 

Yes No
2.

Do you possess a valid license as a Registered Nurse issued by the California Board of Registered Nursing? If no, you are encouraged to review the job posting and the minimum qualifications for this position. If yes, please be sure to complete the license/certificate section of your application.

Yes No
3.

Do you possess a valid certificate as a Certified Public Health Nurse issued by the California Board of Registered Nursing? If no, you are encouraged to review the job posting and the minimum qualifications for this position. If yes, please be sure to complete the license/certificate section of your application.

Yes No
4.

Do you possess two years of responsible nursing experience performing duties similar to a Public Health Nurse I with Placer County? If no, you are encouraged to review the job posting and the minimum qualifications for this position.

Yes No
4a.

If you answered yes, please briefly describe this experience below. If you do not have this experience, please type "none."


 

SECTION II: SPECIALIZED SKILLS (NOT SCORED)


1.

Are you English/Spanish bilingual?  (Placer County may administer a Spanish Language Skills Examination as part of the selection process.)

Yes No
2.

Are you English/Russian bilingual?  (Placer County may administer a Russian Language Skills Examination as part of the selection process.)

Yes No

 

SECTION III: ASSIGNMENT PREFERENCES (NOT SCORED)


1.

Please select the assignment areas you are interested in:

Maternal, Child, & Adolescent Health - Improve the health of California's women of reproductive age, infants, children, adolescents, and their families including providing pregnant women with enhanced services in the areas of nutrition, psychosocial and health educational services with their prenatal care, resulting in decreased low birth weight rates and healthcare costs. Includes the Fetal Infant Mortality Review (FIMR)/Child Death Review Team (CDRT) which review fetal, infant, and child deaths to determine if contributing factors represent system problems and to implement interventions involving policy, system, and community changes. Includes Comprehensive Perinatal Services Program (CPSP) to recruit, enroll, and monitor CPSP Providers. Includes Sudden Infant Death Syndrome (SIDS) Program to provide education about SIDS, grief counseling, and risk reduction strategies.
Adult and Elderly In-Home Visitation Case Management - Public Health Nurses strive to improve the health, function, and quality of life of older adults through active living and wellness education, medication, and personal needs assessment, medical equipment assistance, medical health information, food program assistance, medical insurance referrals and comprehensive personal needs assessments (including fall risk).
California Children's Services (CCS) - CCS is a statewide program that provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children under age 21 with CCS-eligible medical conditions. Examples of CCS-eligible conditions include, but are not limited to, chronic medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae. Clients must also meet financial and residential eligibility criteria.
Child Health and Disability Prevention (CHDP) - CHDP is a preventive program that delivers periodic health assessments and services to children and youth of families with limited resources in California. CHDP provides care coordination to assist families with medical appointment scheduling, transportation and access to diagnostic and treatment services. The CHDP program is responsible for the enrollment and quality assurance of clinics and clinicians providing CHDP health assessments.
Foster Care - Public health nurses in the Health Care Program for Children in Foster Care (HCPCFC) work with county child welfare services agencies and departments of probation to address the medical, dental, mental, and developmental needs of children and youth in foster care. They provide their professional health care expertise and knowledge of the community to the caseworkers, foster care parents and providers, health care providers, and others on the foster care team.
Immunizations - Provides leadership and support to public and private sector efforts to protect the population against vaccine-preventable diseases through technical assistance, surveillance, research, evaluation, information, education, vaccine management, bioterrorism/preparedness planning, and improving immunization levels in the community.
Communicable Disease Control - Partners with medical care providers in the community, and the California Department of Public Health to prevent and control the spread of infectious diseases including foodborne illness, tuberculosis, sexually transmitted diseases, and HIV. Conducts surveillance and provides education to individuals and groups to reduce incidence and prevent additional cases.

 

SECTION IV: TRAINING AND EXPERIENCE (SCORED)

Based on your responses to this section of the supplemental questionnaire, your job-related experience and training will be evaluated using a pre-determined formula. Scores from this evaluation will determine applicant ranking and placement on the eligible list.  

Please note that indicating you have no training and/or experience in a specific area will not automatically disqualify you from participating in this recruitment.

Instructions: For each item, please select the option that best corresponds with your relevant training and/or experience.


1.

Mark the box(es) that correspond with the software programs and/or healthcare systems/programs with which you have paid or unpaid experience using:

MS Word
MS Excel
MS Outlook
Other word processing program(s) and/or healthcare software/system(s)
None of the above
1a.

If you indicated experience above, please describe your level of proficiency and the frequency of use for each program.

For proficiency, use the following:

  • Basic,
  • Intermediate, or
  • Proficient.

For frequency, use the following:

  • Rarely during a normal workday,
  • Less than half of a normal workday, or
  • Regularly throughout a workday.

Please also include any other software programs and/or healthcare software/system(s) with which you have experience using while performing your duties as a nurse.

If you do not have this experience, please type "none."

2.

Please describe your experience providing nursing care services for the efficient operation of a public or private clinic, medical center, or health and social service agency/provider:

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

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

3.

Please describe your nursing experience identifying and assessing health needs and providing advice, counsel, and instruction related to health maintenance and promotion, preventive practices, treatment, and rehabilitation for at-risk, ill, or injured individuals:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
3a.

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

4.

Please describe your nursing experience working with special population groups such as: pregnant women, parenting families with young children, infants, children in foster care, or children with special needs:

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

If you indicated experience in performing this task, please describe below.  If you do not have this experience, please type "none."

5.

Please describe your experience maintaining patient charts, case management records, medical records and reports, and documentation of findings:

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

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

6.

Please describe your nursing experience performing case management through observation, history taking, physical examination, analysis, documentation of findings, development of nursing plan, and making referrals and conducting follow up:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
6a.

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

7.

Please describe your public health nursing experience making home or other field site visits to provide families and/or individuals with health supervision and guidance:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
7a.

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

8.

Please describe your experience representing the Health and Human Services Department to various community groups and providing information regarding Department programs, services, and policies, as well as instructional information about disease prevention, health promotion, treatment maintenance, and rehabilitation:

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

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."

9.

Please describe your experience coordinating with other private, public and/or voluntary health and social service agencies/providers in the community:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
9a.

If you indicated experience performing these tasks, please describe below.  If you do not have this experience, please type "none."


 

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