Thank you for your interest in a position with the Department of Veterans Affairs (VA). Your responses to this assessment questionnaire, in conjunction with the other portions of your completed application, will be evaluated in making selection decisions. The assessment part of the questionnaire includes questions about your eligibility, minimum qualifications, and KSAs (knowledge, skills and abilities) related to this position.
Please choose the answers below that best describe your employment and experience. If you choose (A) to answer questions 1, 2, 3, or 4, you must provide a copy of your most recent SF-50, Notification of Personnel Action, proving your career-conditional or career tenure.
1. Are you a permanent employee of the Boise VA Medical Center (and outlying clinics)?A. Yes.
2. If you are a permanent employee of the Department of Veterans Affairs (Not the Boise VAMC)?A. Yes.
3. If you currently are a permanent employee of another federal agency (NOT VA)?A. Yes.
4. Are you a former federal employee with reinstatement eligibility (Not a current federal employee)? To be eligible for reinstatement, you must have served in a career appointment, or served in a career-conditional appointment within the past three years.A. Yes.
5. Are you a 30% OR MORE COMPENSABLY DISABLED VETERAN? To be eligible, you must have retired from active military service with a service-connected disability rating of 30% or more, OR have a rating by the Department of Veterans Affairs showing a compensable service-connected disability of 30% or more.A. Yes.
6. Are you eligible for a VETERANS RECRUITMENT ACT (VRA) APPOINTMENT? (You can only choose this answer for vacancies announced at or below the GS-11 grade level or an equivalent grade.) To be eligible, you must have been separated under honorable conditions (this means an honorable or general discharge). Also, you must be: a disabled Veteran; OR a Veteran who served on active duty in the Armed Forces during a war, or in a campaign or expedition for which a campaign badge has been authorized (you must have received the campaign badge or medal); OR a Veteran who, while serving on active duty in the Armed Forces, participated in a United States military operation for which you received an Armed Forces Service Medal; OR a recently separated Veteran (separated within the past three years).A. Yes.
7. Are you eligible for a VETERANS EMPLOYMENT OPPORTUNITY ACT (VEOA) APPOINTMENT? This means that you have Veteran Preference or you are a Veteran separated after substantially completing at least 3 years of continuous active duty service performed under honorable conditions (this means an honorable or general discharge).A. Yes.
8. Are you eligible for some other NONCOMPETITIVE APPOINTMENT? This includes appointment based on an interchange agreement, severe disability, eligibility of some military spouses, or similar authorities. Please visit http://www.opm.gov/hr_practitioners/lawsregulations/appointingauthorities/index.asp to see information about interchange agreements and other noncompetitive appointments. MILITARY SPOUSES: please visit http://www.fedshirevets.gov/job/shams/index.aspx for more information about appointment eligibility.A. Yes.
If you chose A, please tell us the type of appointment for which you are eligible (for example, Schedule A, military spouse eligible, etc).
Duties require constant physical effort, such as standing, walking, bending, kneeling, pushing and pulling of various carts, climbing ladders and stairs, lifting light weight items (10-20
Lbs.) on a continuous basis (8 hours a day) and heavier weight items, ranging from 21-50 lbs on a occasional basis (less than 1 hour per day). Incumbent must be able to operate and transport heavy equipment such as floor scrubbers, linen carts, trash carts, dollies, etc., on a daily recurring basis. Carts and equipment may weigh in excess of 300 lbs.
9. Are you able to meet these physical requirements?A. Yes.
The following statement pertains to your agreement to have a physical examination.
10. This position requires a pre-employment physical examination. If selected, do you agree to have a physical examination?A. Yes.
SCREEN OUT ELEMENT
11. From the descriptions below, choose the one letter beside the statement that best describes the highest level of experience that you possess and that demonstrates your ability to perform the duties of a Housekeeping Aid without more than normal supervision. This is a screen-out element. Failure to meet a minimum level will result in an ineligible rating. Select only ONE letter:A. I have no vocational training and I have no experience related to this position of Housekeeping Aid.
The following statements pertain to your work practices.
Demonstration of Competencies - This section evaluates your level of proficiency in the competencies (knowledge, skills and abilities) needed to perform the duties of this position. For each task below, choose the statement from the list below that best describes your experience and/or training. If you are not applying online, please darken the oval corresponding to that statement in Section 25 of the Qualifications and Availability Form C. Please select only one letter for each item.A- I have no vocational training and I have no experience related to this position of Housekeeping Aid.
12. Clean bathroom areas.
13. Clean stairwells, balconies, elevators, steps, docks, and trash pickup points.
14. Wax floors using power cleaning equipment.
15. Maintain supplies of clean linens for the facility (for example, collect soiled linen, replenish linen delivery carts, stock linen in various using areas throughout the facility and prepare and issue out surgical linen packs).
16. Perform duties to maintain the facility, such as ice and snow removal, moving furniture, setting up rooms for meetings, and collecting trash and waste materials).
The following statements pertain to your ability to Interpret Instructions, specifications, etc.
17. Follow oral instructions.
18. Carry out written instructions in work orders.
19. Comply with written safety requirements and guidelines when using chemicals in cleaning.
20. Follow manufacturer's instructions for cleaning or maintaining equipment.
The following statements pertain to your ability to use and maintain tools and equipment.
21. Operate powered equipment such as wet-dry vacuums, wall-washing equipment, scrubbers, and rug shampooers.
22. Use a variety of hand tools such as brooms, mops, and shovels.
23. Change brushes and accessories in floor cleaning equipment.
24. Clean equipment daily.
25. Report any needed repairs to his/her supervisor.
The following statements pertain to safety.
26. Use appropriate sanitation procedures in handling contaminated materials.
27. Apply proper isolation techniques.
28. Observe safety regulations when handling power equipment.
29. Comply with safety requirements for using cleaning supplies.
Certification of Understanding - Select the appropriate answer to the statement below. Failure to provide an answer will result in your not being considered for this position.
30. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled; I may be denied an appointment; or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated and that responding "No" or providing no response to this item will result in my not being considered for this position.A. Yes, I understand the information provided above and certify that the information provided in this questionnaire is true, correct, and provided in good faith.
Resume Reminder - Your resume must include the following information for each job listed:
• Job title.
• Duties (be as detailed as possible).
• Month & year start/end dates (e.g. June 2007 to April 2008).
• Full-time or part-time status (include hours worked per week).
• If you are a former or current Federal employee (military or civilian), please provide the series and grade or pay grade (rank) and the date of last promotion.