1165 MANAGER, DEPARTMENT OF PUBLIC HEALTH (PEX-1165-102789)
CHIEF NURSING OFFICER
LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER
MINIMUM QUALIFICATION SUPPLEMENTAL QUESTIONNAIRE
PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY
The purpose of this Supplemental Questionnaire is to assist with evaluating possession of the Minimum Qualifications(i.e. required education, experience, and licensure/certification) and Desirable Qualifications for the 1165 Manager, Department of Public Health - Chief Nursing Officer, Laguna Honda Hospital and Rehabilitation Center position.
IMPORTANT NOTE: Attaching a resume does not substitute for submitting a completed application. Your application’s Education, Professional Licenses, Certifications, or Registrations, and Employment Record sections should clearly demonstrate how you satisfy this position’s Minimum Qualifications. Do NOTtype “see resume” or leave the above-mentioned application sections blank.
It is suggested that you allow ample time to submit your application and Supplemental Questionnaire responses before the filing deadline. If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with and supported by the information on your application (i.e. Education, Professional Licenses, Certifications, or Registrations & Employment Record sections) and are subject to verification at any time.
As a reminder, all qualifying education, licensure, registration, certification, and experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the education, licensure, registration, certification, and experience you are about to describe in the applicable sections of your application, you will not receive credit. If you are copying an old application, please take the time to update applicable sections before submitting your application.
1a.
Please select the highest level of education that you have completed.
DO NOT INCLUDE UNITS THAT ARE IN PROGRESS
High School Diploma or equivalent
Associate's degree
Bachelor's degree
Master's degree
Doctoral degree
None of the above
1b.
If you earned a Master's degree (or higher) from an accredited college or university, what was/were your major(s)? Select allthat apply.
Hospital Administration
Nursing
Public Health Administration
Other, closely related field
None of the above
2a.
How much full-time experience do you have as an administrator of a large general teaching hospital or related organization?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have some, but less than one (1) year of this experience
I have at least one (1) year, but less than two (2) years of this experience
I have at least two (2) years, but less than three (3) years of this experience
I have at least three (3) years, but less than four (4) years of this experience
I have at least four (4) years, but less than five (5) years of this experience
I have at least five (5) years, but less than six (6) years of this experience
I have at least six (6) years, but less than seven (7) years of this experience
I have seven (7) years of this experience or more
I don't have any of this experience
2b.
How much full-time complex health care administrative experience do you have?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have some, but less than one (1) year of this experience
I have at least one (1) year, but less than two (2) years of this experience
I have at least two (2) years, but less than three (3) years of this experience
I have at least three (3) years, but less than four (4) years of this experience
I have at least four (4) years, but less than five (5) years of this experience
I have at least five (5) years, but less than six (6) years of this experience
I have at least six (6) years, but less than seven (7) years of this experience
I have seven (7) years of this experience or more
I don't have any of this experience
3.
Do you have a valid Registered Nurse license issued by the California Board of Registered Nursing?
Yes
No
CERTIFICATION: I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.
Department of Human Resources