Official SealSan Joaquin County Human Resources Division


#0421-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.


1.
Do you possess current registration as a Nurse in the State of California? If yes, please provide the license number and expiration date below:
2.

Please indicate if you possess the following degree(s) from an accredited college/university.

This information should also be clearly identified in the Education section of the employment application.

Bachelors degree - Nursing (BSN)
Masters degree - Nursing (MSN)
Masters degree - Administration - Health Care, Business or Public Administration
Other (clearly identify the degree and discipline in the Education portion of the application)
None of the above

 

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


3.

Please describe your management experience in the administration of Nursing departments including Labor and Delivery, NICU or Pediatric departments in an acute care setting. Include in your answer: the number of staff who reported directly to you and the scope of your administrative responsibilities. Describe any programs implemented or proposed.  What was the outcome of your program recommendations?

4.

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”.

5.

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

6.

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