Official SealHuman Resource Services Department

Supplemental Questionnaire

Last Name
First Name

Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants. 

Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position.  Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process.  A resume will not be accepted as a substitute for properly completed responses.

Information provided in your responses to the supplemental questionnaire regarding your employment experiences must also be detailed in the Work Experience section of the application for this recruitment.  Please be sure to list all employers and required information, on your application, especially if you are referencing those employers in your responses to the supplemental questions.

The supplemental questions were designed to elicit your experience as it relates to the current recruitment in order to identify the best qualified candidates for this position.  Only the best and most suitably qualified candidates will be invited to participate in the oral interviews. 

By selecting yes below, you certify your understanding that all applicants who meet minimum qualifications are not guaranteed to move forward in the process.  Do you understand the above statement?

Yes No

Do you possess a valid Certificate of Registration as an Environmental Health Specialist issued by the California State Department of Health Services? If "YES" please list your registration number and date of issuance, if "NO" type N/A.


Do you possess a valid California Driver's License? If "YES" please list your CDL# and expiration date.  If "NO" enter N/A.


Have you graduated from an accredited college or university with major work in Environmental Health science or a related field, AND do you have the equivalent of three years of full-time experience as a Registered Environmental Health Specialist performing a full range of Environmental Health work in a public agency?

Yes No

Describe your involvement with regulatory or community organizations as part of your duties. Please include your experience/interaction with California Department of Public Health (CDPH) and CalRecycle (Solid Waste program), if any.


Describe your experience working in the general food and recreation programs and provide details on your experience working in the special events and mobile food components of the food protection program. Provide the length of time (in years) you worked in these specialty areas.


Describe your experience developing a program where you were either the sole developer or worked as the lead of a team that developed the program. Describe who your partners were, what the objective was, the final outcome, and what, in retrospect, you should have done differently, if anything.


Please describe, in detail, your experience handling the following:

  • a challenging call (on-call situation)
  • a challenging request for service
  • a challenging complaint

This position may require you to supervise staff who may have been your professional equals performing tasks which may include, but may not be limited to, those listed below.  Please describe your experience with each.

  • setting schedules
  • dealing with any and all resistance
  • ensuring that everyone is accountable for their actions
  • writing and presenting performance improvement and disciplinary notices
  • dealing with staff disagreements and bringing everyone to a consensus.