Official SealSan Joaquin County Human Resources Division


#1119-RH0201-TM
Supplemental Questionnaire

Last Name
First Name

 

Please complete the following supplemental questions for the position of Hospital Unit Clerk at San Joaquin General Hospital.  This supplemental will be utilized to best determine your qualifications for this position.


1.

Do you have one year of clerical experience involving substantial public contact in a hospital, doctor's office or medical clinic?

If yes, please be sure to complete the Employment Experience portion of your application in detail. 

Yes No
 

If yes, please identify the following:

  • Job title
  • Dates of employment
  • Name of employer (hospital, doctor's office or medical clinic)
  • Hours worked per week

 

2.

Are you substituting one year of business training in an approved school or training program for six months of the required experience?

If yes, please be sure to complete the education portion of the application in detail.

Yes No
 

If yes, please identify:

  •  School/Institution attended
  •  Dates of attendance
  •  Business training or Training program completed
  •  Certificate received
3.

San Joaquin General Hospital is a 24 hour 7 day per week facility. Position(s) may require employees to work days, pm's or night's including weekends and holidays.  Do you acknowledge and accept this type of schedule?

Yes No
4.

Some positions may be assigned to the Medical Guarded Unit of San Joaquin General Hospital, which provides direct patient care to an inmate population.

As a condition of employment, candidates assigned to the Medical Guarded Unit must successfully pass a California Department of Corrections (CDCR) background investigation conducted by the California Department of Corrections and Rehabilitation.  Candidates must also maintain their CDCR clearance for continued employment in this unit.

Would you like to be considered for positions assigned to the Medical Guarded Unit? (Only candidates expressing interest will be referred to this unit). 

Yes, I would also like to be referred to positions in the Medical Guarded Unit. I understand being assigned to this unit will require that I pass a pre-employment background conducted by CDCR as a condition of employment. I also understand that I must maintain my clearance as a condition of continued employment.
No, I would not like to be referred to positions assigned to the Medical Gaurded Unit.