**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1
Do you possess a Bachelor's degree from an accredited college or university?
Yes
No
2
Describe your professional experience one or more areas of compliance, licensing and/or inspection; legislative, legal, regulatory; or quality of care in residential care settings, such as nursing homes/long term care, assisted living, or group homes.
Please include name of employer, job title, dates of employment, and hours worked per week. This information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
3
Describe your experience in a supervisory or managerial position. Please include the amount of employees that you supervised.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
4
Describe your experience planning, developing or implementing plans of correction to ensure health care quality.
Please include name of employer, job title, dates of employment, and hours worked per week. This information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
Department of Budget and Management