Official SealSan Joaquin County Human Resources Division


#0818-RH2001-01
Supplemental Questionnaire

Last Name
First Name

 

You are applying for a position in Correctional Health Services, which provides health care to adult inmates at the San Joaquin County jail facility.

A candidate must successfully pass the security clearance, initiated through a background investigation conducted by the Sheriff’s Office. The background investigation requires the completion of an extensive questionnaire called “Personal History Questionnaire” and is used by the Sheriff’s Office to conduct the background investigation. 

The security clearance is a mandatory condition of employment, and the loss of the security clearance will result in termination from County employment in accordance with the rules and regulations governing County employment. 


1

Have you read the the above information and understand that passing and maintaining a security clearance is a condition of employment?
Yes No
2

Do you possess a valid license as a Vocational Nurse issued by the State of California, Board of Vocational Nurse and Psychiatric Technician Examiners; or, a valid Interim Permit issued by the Board? (A copy of the license must be submitted with the employment application.)
Yes No
3

If you answered yes, please identify:

  • Vocational Nurse license number
  • Date of expiration