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Please complete this questionnaire as honestly, completely and accurately as you can. Base your answers on what is normal to the current job, not special ...
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Please indicate the type of review that will be conducted:
Reclassification New Position
If this position is currently filled, has the incumbent performed the new duties for a minimum of
six (6) months?
Yes No
POSITION TYPE Regular Full Time Limited Service
REPORTS TO (Name)
The purpose of this questionnaire is to obtain current information to document the requirements of
this position and the work performed.
Please complete this questionnaire as honestly, completely and accurately as you can. Base your
answers on what is normal to the current job, not special projects or temporary assignment duties,
unless these tasks are a regular part of the job.
Indicate in one or two sentences the general purpose of the position (or why this job exists). ( For example: To operate, maintain, and repair computer equipment and to provide technical assistance to users.)
Describe specific duties and responsibilities that are essential to the purpose of this position and critical to successful performance, listing the most important first. For each duty and responsibility, describe the successful completion or result of that activity. DO NOT use acronyms or abbreviations. Use a separate sentence or paragraph for each duty and responsibility. Most positions can be described within 10 or fewer major responsibility areas. Each statement should be brief and concise. Give the best estimate of average percentage of time each duty and responsibility takes over the course of a day. Copy and attach additional information, if necessary. Marginal or occasional duties and responsibilities will be described in the next section.
Percent (%) of Daily Time
30% 20% 20% 20% 10%
100%
less than six months six months, less than one year
one year, less than three years three years to five years
five years to seven years other __________________________
Does the position require any professional certifications, licenses and or registrations?
Yes No (If No, skip to next section.)
Example: Certified Public Accountant (CPA)
TIME FRAME REQUIRED TO OBTAIN Example: Must obtain within one (1) year of employment
Yes No (If No, skip to next section.)
2. If YES , what type of vehicles? (Ex ample: passenger van, side‐ loader refuse truck.)
If YES, is this vehicle driven on city streets?
Yes No
Check the appropriate item(s) for frequency each vehicle is driven month.
Daily 1 ‐ 4 times 5 ‐ 9 times Other _____________
Regular (Class D) Driver’s License
Class A Commercial Driver’s License (CDL)
Class B Commercial Driver’s License (CDL)
Class C Commercial Driver’s License (CDL)
Other
If a Commercial Driver’s License is required please list the name/type of vehicle position is required to operate that requires the license.
FORMAL supervisory responsibility is defined as actively participating in the hiring, provides coaching/counseling and conducts performance evaluations of other City employees. If you are required to conduct and sign annual performance evaluations, you have formal supervisory responsibility.
Yes No
What is the most serious consequence, which could result from an error made in this position? Check all applicable statements below:
Errors are easily and quickly detected and would result in only minor confusion or clerical corrections.
Errors are usually detected in succeeding operations and generally confined to one division.
Errors may cause considerable interruption and delay in work output.
The effect is usually confined within the City, but may extend indirectly to outside relationships.
Errors are hard to detect, may be serious, but usually confined within the City.
Errors are hard to detect and may be serious, affecting outside relationships.
Errors could result in the death/serious injury of a person.
Yes No
If yes, please explain:
Yes No
If yes, please explain:
A. Hours: What are the normal working hours for this position (i.e., call out, shift work, mandatory overtime, holidays, weekends, etc.).
B. Location: Describe place(s) where work activities are performed (i.e., at a desk, in computer room, etc.) and any conditions that warrant special attention (i.e., high noise level, exposure to dust, etc.).
C. Physical Elements: Describe in action verbs the physical elements of the position and an estimation of how frequently these actions are performed and/or the duration of the action (i.e., sits at computer terminal and enters data 4 ‐ 6 hours per day).
Please include any additional information that will aid in the preparation/evaluation of an accurate
description of this job (attach additional page(s) if necessary).
This questionnaire was completed by:
If the position is currently filled, please have the incumbent review and sign below.
(Signature does not necessarily imply agreement, only acknowledges changes.)
If this questionnaire was completed by the current incumbent, please review the employee’s
responses carefully. If you disagree with the statements or any information is missing, please list in the
space below. The employee’s work performance will not be considered in the classification review of
this position. DO NOT CHANGE ANY OF THE EMPLOYEE’S RESPONSES.
If this request is to reclassify an existing position, briefly describe the reassignment of work, the new
function added by law or other factors, or the reorganization which changed the duties and
responsibilities of this position.