Department of Human Resources

2322 Nurse Manager
Specialty: Nurse Manager Maternal Child & Adolescent Health
 Supplemental Questionnaire

The purpose of this Supplemental Questionnaire is to determine if you meet the minimum qualifications of a 2322 Nurse Manager in the Maternal Child & Adolescent Health specialty, and to determine your knowledge, skills, and abilities in job-related areas that have been identified as critical for satisfactory performance in this specialty.

Responses to supplemental questionnaire items must be supported by the information provided in the body of your application (i.e. Higher Education; Professional Licenses, Certifications, or Registrations; Employment Record) in order to receive appropriate credit, and are subject to verification. Verification of experience, licensure, and possession of valid certifications/certificates may be collected at any time during or after the selection process.

INSTRUCTIONS: Please answer all applicable questions by choosing the best response that matches your education, experience, certifications, licenses, and/or by providing the information requested.

Part One: Education & Experience Qualifications

Instructions For Questions 1 - 6:

Please answer all applicable questions by choosing the best response that matches your education, experience, certifications, and licenses.

Do you possess a valid permanent/temporary (including interim permit) California Registered Nurse License issued by the California Board of Registered Nursing?

As a reminder, all licenses must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the license you are about to describe in the "Professional Licenses, Certifications or Registrations" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

Do you have a California Public Health Nurse (PHN) certificate?

As a reminder, all education must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the certificate you are about to describe in the "Professional Licenses, Certifications, or Registrations" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

What is the highest level of education that you have completed?

As a reminder, all education must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the education you are about to describe in the "Education" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

How much verifiable full-time equivalent work experience do you possess working as a Registered Nurse in a general acute care hospital, ambulatory clinic, or community/public health setting, within the last five (5) years? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

How much verifiable full-time work experience do you possess in a nursing supervisor capacity, within the last five (5) years?  (Full-time experience is equivalent to 40 hours per week).

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

How much verifiable full-time equivalent work experience do you possess working as a health care provider in a community/public health setting? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

Part Two: Supplemental Questionnaire

Instruction for Questions 7 - 11:

All applicants are required to complete the supplemental questionnaire as part of the online application process. The questionnaire will be used to assess each candidate’s possession of the minimum qualifications and their knowledge, skills and abilities as it pertains to the position.

Responses to items on the supplemental questionnaire must be supported by the information provided on the application. This information is subject to verification. Please be sure to include all relevant education and experience in the work history and education sections of the application. Resumes are not used or reviewed to determine whether you meet the minimum qualifications or to determine your score/rank. A resume should not be submitted to substitute for a completed application. If you write "see resume" on the application, or on the supplemental questionnaire, your application may be rejected.

If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with the information on your employment application and are subject to verification.

By continuing, you hereby certify that you are the author of the information supplied in this supplemental questionnaire.  You understand that any false or incorrect statements may result in your disqualification or dismissal from employment with the San Francisco Department of Public Health and City and County of San Francisco.  You also understand and agree that the information provided is subject to verification.

Which of the following valid American Heart Association Cardiopulmonary Resuscitation (CPR) certificates do you possess?

As a reminder, all certifications must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the license you are about to describe in the "Professional Licenses, Certifications or Registrations" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

Which of the following electronic medical records software systems do you have experience using?

If you selected "Other" in question 8A, please specify below. If you did not select "Other", please write "N/A".

How much verifiable full-time equivalent work experience do you possess as a health care provider serving a diverse urban population? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

How much verifiable full-time equivalent work experience do you possess providing lactation services? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

Which of the following certifications do you possess?

As a reminder, all certifications must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the license you are about to describe in the "Professional Licenses, Certifications or Registrations" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

If you selected "Other" in question 11A, please specify below. If you did not select "Other", please write "N/A".

How much verifiable full-time equivalent work experience do you possess as a health care provider serving a pregnant and postpartum, diverse urban population? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.

How much verifiable full-time equivalent work experience do you possess working in a public health program that serves pregnant women, infants, and children within the last five (5) years?  (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications.  If you do not include the experience you are about to describe in the "Experience" section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update the appropriate section before submitting your application.