Job Questionnaire

Please complete this form and submit it with your application. *Please answer all questions

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1. Did someone refer you?
A. Yes
2. If yes, who?
Jabri woods
5. Do you have a smart phone and are you willing to use it for time keeping purposes?
A. Yes
6. Do you have access to a computer and are you willing to use it for work related tasks?
A. Yes
8. Are you willing to be a sub until full time or Part time work is available?
A. Yes
9. Are you willing to work in any LAUSD School?
A. Yes
11. Are you comfortable working with all of the following behaviors? (Hitting, Kicking, Yelling, Biting, Scratching, Eloping, Self- injurious behaviors?)
A. Yes
12. Explain your work experience with the following behaviors. (Hitting, Kicking, Yelling, Biting, Scratching, Eloping, Self- injurious behaviors?)
I had a family member that got frustrated and decided to start throwing objects across the room. After a while of the family member going through the tantrum. I reassured that the person was calm, asked what frustrated them, and I informed them that instead of throwing stuff that they can ask for help. I then helped the person clean up all of the objects that were thrown across the room
13. Are you N-CPI trained?
B. No
16. We provide services in the following regions within LAUSD (West LA, East LA, Central LA, South, Northeast, Southeast). Do you agree to commute to all regions within LAUSD?
A. Yes
17. Regions (preferred to work in) *
West LA
East LA
Central LA
Availability:
18. Monday: Times that I am available to work *
7:30 AM and 3:30 PM
19. Tuesday: Times that I am available to work *
7:30 AM and 3:30 PM
20. Wednesday: Times that I am available to work *
7:30 AM and 3:30 PM
21. Thursday: Times that I am available to work *
7:30 AM and 3:30 PM
22. Friday: Times that I am available to work *
7:30 AM and 3:30 PM
23. Print Full Name: *
Tatiana Frances James branch
Form Status: Approve

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Date 2024-08-14
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