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Human Capital Management
#170926-Z21C-04


Supplemental Questionnaire

Last Name First Name
 

 

ATTENTION!

 Please verify that you meet the education and experience requirements listed in the job bulletin before completing the following supplemental questionnaire. The questions below will be used for scoring purposes, in lieu of a written exam.


1.

In what settings do you have food preparation experience? Check all that apply.

Hospitals
Institutions
Schools
Commercial business
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
2.

What experience do you have following written diet orders and restrictions?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
3.

What experience do you have defrosting and cleaning refrigerators, walk-in coolers, ice makers, drink dispensers, grills, grease traps, vent hoods and related equipment?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
4.

What experience do you have operating a commercial dishwasher or hand washing pots, pans, dishes, silverware and other cooking or baking utensils?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
5.

What experience do you have ordering food for a commercial or institutional food service kitchen?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
6.

Which of the following certifications do you have?  Check all that apply.

Certified Food Safety Manager
Food Handler Certification
Certified Dietary Manager
ServSafe® Certification
School Nutrition Professional as certified by the USDA
I currently do not hold any of the above certifications.
 

Please list the county or organization granting the certification as indicated in the response above. If you indicated "no certifications", then please write N/A below.

7.

What experience do you have establishing and maintaining effective working relationships with other professions? Check all that apply.

Food and drink vendors
Equipment Repair People
Regulatory agencies (e.g. Department of Health)
Private sector organizations (e.g. insurance companies or utilities)
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
8.

What experience do you have planning menus and preparing projected menu plans?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
9.

What experience do you have interpreting recipes, special dietary menus, and menu instructions?

I have supervised others performing this task.
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have not yet performed this task on the job but I have had education or training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

10.

What is your highest level of education in culinary arts, food management or a similar field?

Master’s degree
Bachelor’s degree
Associate’s degree
None of the above
 

Please list the school where you gained your degree as indicated in the response above. If you indicated "none of the above", then please write N/A below.