Official SealSan Joaquin County Human Resources Division


#0219-RH3031-01
Supplemental Questionnaire

Last Name
First Name
1

Do you possess at least one (1) year of full-time paid work experience as an Operating Room Technician I in San Joaquin County?

Note: If you respond yes, go to question #4.

Yes No
2

Do you possess at least one (1) year of full-time (40 hours per week) paid work experience as a surgical or operating room technician in an acute care hospital within the past five (5) years?

Yes No
 

Please describe the specific duties performed as an operating room or surgical technician for an acute care hospital. If you do not possess experience in an acute care hospital, please note "N/A" below:

3

Have you successfully completed an approved Operating Room/Surgical Technician training or program within the past five (5) years?

(NOTE: Must provide proof of successful completion with employment application in order to be considered; submit with application when prompted for resume, send to msneed@sjgh.org, or fax to 209-468-6271)

Yes No
 

If yes, provide the following information:

  1. Name of institution
  2. Type of certification (ie: Surgical Technologist, Operating Room Technician, etc.)
  3. Date of program completion
4

This position will require employees to work rotational assignments of "on-call" duty. When on-call, employees must be able to report to San Joaquin General Hospital's OR Department within 30 minutes of being contacted.

By selecting "yes", you are indicating that you understand that during your rotational assignment, you are required to report to the San Joaquin General Hospital's OR Department within 30 minutes of being contacted for on-call duty.

Yes No
5

This recruitment is being conducted to fill full-time as well as part-time positions. The OR Department operates 24 hours a day, 7 days a week. Both full-time and part-time staff must be able to work rotating shifts that include nights, weekends, and holidays. Overtime shifts may also be required.

Please indicate the type of employment for which you would like to be considered. Note that if selected for a part-time position, your name remains active on the eligible list for consideration for full-time positions as they become available.

I am interested in part-time opportunities.
I am not interested in part-time opportunities.