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Placer County Human Resources Department
#2017-14302-01


Supplemental Questionnaire

Last Name First Name
 

 

This is the supplemental questionnaire for the classification Public Health Nurse I.  Parts I, II, and III are not scored. Part IV will be scored based on applicants’ checked responses. Narratives provided by applicants describing training and/or experience will not be scored but will be available to the hiring authority for interview and selection determinations.

PART I: MINIMUM QUALIFICATIONS (NOT SCORED)


1.

Do you possess a Bachelor's degree from an accredited college or university with major course work in nursing? If no, you are encouraged to review the job posting and the minimum qualifications for this position. 

Yes No
2.

Do you possess of a valid license as a Registered Nurse issued by the California Board of Registered Nursing?  If no, you are encouraged to review the job posting and the minimum qualifications for this position. If yes, please be sure to complete the license/certificate section of your application.

Yes No
3.

Do you possess of a valid certificate as a Certified Public Health Nurse issued by the California Board of Registered Nursing? If no, you are encouraged to review the job posting and the minimum qualifications for this position. If yes, please be sure to complete the license/certificate section of your application. 

Yes No

 

PART II: SPECIALIZED SKILLS (NOT SCORED)


1.

Are you English/Spanish bilingual?  (Placer County may administer a Spanish Language Skills Examination as part of the selection process.)

Yes No
2.

Are you English/Russian bilingual?  (Placer County may administer a Russian Language Skills Examination as part of the selection process.)

Yes No

 

PART III: ASSIGNMENT PREFERENCES (NOT SCORED)


 

Please select the assignment areas you are interested in:

Maternal, Child, & Adolescent Health - Improve the health of California's women of reproductive age, infants, children, adolescents and their families including providing pregnant women with enhanced services in the areas of nutrition, psychosocial and health educational services with their prenatal care, resulting in decreased low birth weight rates and health care costs. Includes the Fetal Infant Mortality Review (FIMR)/Child Death Review Team (CDRT) which review fetal, infant, and child deaths to determine if contributing factors represent system problems and to implement interventions involving policy, system and community changes. Includes Comprehensive Perinatal Services Program (CPSP) to recruit, enroll, and monitor CPSP Providers. Includes Sudden Infant Death Syndrome (SIDS) Program to provide education about SIDS, grief counseling, and risk reduction strategies.
Teenage Pregnancy & Parenting - The Teenage Pregnancy and Parenting Program (TAPP) is a free and voluntary case management program for pregnant and parenting teens, including teen fathers. The program ensures health and wellbeing of teen parents and their children by connecting families with appropriate services and being a support and advocate for the family.
Adult and Elderly In-Home Visitation Case Management - Public Health Nurses strive to improve the health, function, and quality of life of older adults through active living and wellness education, medication and personal needs assessment, medical equipment assistance, medical health information, food program assistance, medical insurance referrals and comprehensive personal needs assessments (including fall risk).
California Children's Services (CCS) - California Children's Services (CCS) is a statewide program that provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children under age 21 with CCS-eligible medical conditions. Examples of CCS-eligible conditions include, but are not limited to, chronic medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae. Clients must also meet financial and residential eligibility criteria.
Child Health and Disability Prevention (CHDP) is a preventive program that delivers periodic health assessments and services to children and youth of families with limited resources in California. CHDP provides care coordination to assist families with medical appointment scheduling, transportation and access to diagnostic and treatment services. The CHDP program is responsible for the enrollment and quality assurance of clinics and clinicians providing CHDP health assessments.
Foster Care - Public health nurses in the HCPCFC work with county child welfare services agencies and departments of probation to address the medical, dental, mental and developmental needs of children and youth in foster care. They provide their professional health care expertise and knowledge of the community to the caseworkers, foster care parents and providers, health care providers and others on the foster care team.
Immunizations - Provides leadership and support to public and private sector efforts to protect the population against vaccine-preventable diseases through technical assistance, surveillance, research, evaluation, information, education, vaccine management, bioterrorism/preparedness planning, and improving immunization levels in the community.
Communicable Disease Control - Partners with the Public Health Laboratory, medical care providers in the community, and the California Department of Public Health to prevent and control the spread of infectious diseases including foodborne illness, tuberculosis, sexually transmitted diseases, and HIV. Conducts surveillance and provides education to individuals and groups to reduce incidence and prevent additional cases.
Sexual Assault Forensic Examinations - Coordinates a multi-agency response system of intervention and care to assist sexual assault survivors in regaining control over their lives and restoring their dignity. The team seeks to counter the experience of sexual assault with a sensitive and competent multi-disciplinary response, to restore well-being to victims, and bring responsible persons to justice.
Whole Person Care - Whole Person Care primarily provides services to Placer County residents who are experiencing homelessness. The PHN works on a Multi-Disciplinary Team providing health education, nursing assessment and treatment, case management, and referral. Whole Person Care team members provide much of their services in a field-based setting.

 

PART IV:  TRAINING AND EXPERIENCE - Please answer the following questions based on your training and/or experience. Based on your checked responses, your training and experience will be scored and ranked. Narratives provided by applicants describing training and/or experience will not be scored, but will be available to the hiring authority for interview and selection determinations.


1.

Mark the boxes that correspond with the software programs and/or health care systems/programs with which you have paid or unpaid experience using:

MS Word
MS Excel
MS Outlook
Other word processing program(s) and/or healthcare software/system(s)
None of the above
 

If you indicated experience above, please describe your level of proficiency and the frequency of use for each program. For proficiency, use the following: basic, intermediate, or proficient. For frequency, use the following: rarely during a normal workday, less than half of a normal workday, or regularly throughout a workday.

Please also include any other software programs and/or healthcare software/system(s) with which you have experience using while performing your duties as a nurse.

2.

Please describe your paid or unpaid experience providing nursing care services for the efficient operation of a public or private clinic, medical center, or health and social service agency/provider:    

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience performing these tasks, please describe below.

3.

Please describe your paid or unpaid public health nursing experience working with special population groups, such as pregnant women, parenting families with young children, infants, children in foster care, or children with special needs:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience in performing this task, please describe below.

4.

Please describe your paid or unpaid public health nursing experience working with special population groups, such as the elderly, or culturally, economically, or geographically disadvantaged individuals:    

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience in performing this task, please describe below.

5.

Please describe your paid or unpaid public health nursing experience maintaining patient charts, case management records, medical reports, and documentation of findings:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience in performing this task, please describe below.

6.

Please describe your paid or unpaid public health nursing experience performing case management through observation, history taking, physical examination, analysis, documentation of findings, and development of nursing plan:

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience in performing this task, please describe below.

7.

Please describe your paid or unpaid public health nursing experience making home or field site visits to provide families and/or individuals with health supervision and guidance: 

I possess no or very limited training or experience performing these tasks.
I possess limited training and/or experience performing these tasks.
I have some experience performing these tasks but would need additional training.
I have performed these tasks independently under normal supervision.
I have extensive experience performing these tasks and have trained and/or supervised others in the performance of these tasks.
 

If you indicated experience in performing this task, please describe below.


 

Thank you for completing the supplemental questionnaire portion of the application process. Please Save & Continue to move forward to the next tab. Be sure to select the "Submit" button once the application has been completed. You will receive confirmation that the application has been submitted.

Please review the Selection Plan on the Job Posting for next steps in the recruitment process.