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#0718-EH2105-EX
Supplemental Questionnaire

Last Name
First Name

 

In addition to the standard application, responses to the following questions will be required. Please submit responses along with your employment application to the San Joaquin County Human Resources Division.  These questions will be reviewed in evaluating your qualifications.


 

Please indicate which education background you possess:

  • Bachelor’s degree in Nursing, Health Science, Business Administration or closely related field
  • Master’s Degree in Nursing, Health Care Administration, Business Administration or closely related field

Bachelor's
Master's
N/A
 

Specify University Name and Degree/Major Obtained:

 
Do you possess current registration as a Nurse in the State of California? If yes, please provide the license number and expiration date below:

 

For the questions below, please provide a detailed description of your experience including employer name, position title and dates of employment.


1.

Please describe your management experience in the administration of nursing departments in an acute care hospital. Include in your answer: the number of staff who reported directly to you and the scope of your administrative responsibilities.

2.

Please describe your experience in the development/preparation of departmental financial (budgetary) documentation. Include identification of the budget range (estimate dollar value), brief explanation of budget process and budget due date (annual, semi-annual, etc). If you do not possess this experience, please note “N/A”.

3.

Please describe your experience developing and implementing policies, guidelines and protocols to improve patient satisfaction ratings.

4.

Please describe any experience you possess in the area of process/performance improvements and development of practices and/or principles related to patient safety.