City Hall, 9 Glen Street
Glen Cove, NY11542 /
Job Survey Classification Questionnaire
GCCS-22 (5/09)
The Glen Cove Civil Service Commission is tasked with periodically reviewing the positions under its jurisdiction to ensure proper classification. This form is used to gather information about the positions from the current incumbents of the positions. Classification decisions based on completion of this form will not adversely affect the employment of permanent competitive-class employees.
This survey will help the Commission determine how this position fits within the overall classification plan. The classification plan is the organization of all positions within an agency. Within the classification plan, similar positions are grouped together within the same title and promotional fields are identified.
Classification Survey InformationClassification Survey:
Position Incumbent:
Current Classification:
Jurisdictional Class:
Employment Status:
Status Date on File:
Your assistance in completing this form is appreciated as you are best qualified to describe the important role you play in service to Glen Cove’s residents. Please take care while filling out this form so the person that reviews the form can obtain a clear and complete understanding of your job.
Thank you for assisting the Commission in its classification responsibilities.
Sincerely,
John Charon
Civil Service Secretary
Survey Completion DatesDate Issued:
Deadline for Employee Completion:
Deadline for Supervisor Review:
Deadline for Agency Review and Return to Commission:
Employment Information
Work Location (Building, Room Number, etc.):
Work Phone Number:
How many hours do you work in a typical week?
What are your normal hours of work? / From: / AM
PM / To: / AM
PM
What is your salary?
How long have you worked in your current title?
The Job Classification Questionnaire begins on the following page. Please read these important…
INSTRUCTIONS AND SUGGESTIONS
Remember that the questions asked are about your job and not about you as an individual. This survey is not concerned with how well you perform your work or how well qualified you are. Your own statement of your work is wanted not the ideas of others about your work. Use your own words in describing your position. Describe the duties of your position only, not the function of your unit or department.
Additionally, take some time to think about the structure of your unit or division. Identify who is your immediate supervisor and those who you immediately supervise. This will assist you in answering some of the questions on the questionnaire.
Upon completion of the questionnaire, retain a copy for your records, if you so desire, then forward the original, completed, signed questionnaire to your immediate supervisor. The information prepared and provided by you will not be altered in any fashion by your supervisors. Your immediate supervisor will complete the questionnaire and forward it to the department or division head for further comment. Once both your immediate supervisor and the department or division head have finalized the questionnaires, they will be forwarded to the Commission Office.
Section 1. DESCRIPTION OF WORK ACTIVITIES
Please describe fully the work you do. List all the major duties and responsibilities of your job. Also, give your best estimate of the percent of time spent performing each duty or responsibility. Attach additional pages as necessary.
% of Time / Duties and ResponsibilitiesA.
B.
C.
D.
E.
F.
G.
Section 2. DESCRIPTION OF USE OF MACHINES, TOOLS AND EQUIPMENT
Please list the machines, tools and equipment you use in this position and estimate the percentage of work time you spend using them. Attach additional pages as necessary.
% of Time / Machine, Tool or Piece of EquipmentSection 3. REPORTING REQUIREMENTS AND COMPLEXITY
Please list any reports in which you participate indicating the level of complexity, how often the report is made and your role in making the report. A simple report would require a person to fill in a form based on readily available information like date, time and work location - while a complex report may require substantial research and the compiling of information. Your role may be filling out the form, researching readily available records, complex research, compiling information, printing and collating, etc. Attach additional pages if necessary.
Complexity / FrequencyReport Name: / Simple / Daily
Moderate / Weekly
Your Role: / Complex / Monthly
Annually
Report Name: / Simple / Daily
Moderate / Weekly
Your Role: / Complex / Monthly
Annually
Report Name: / Simple / Daily
Moderate / Weekly
Your Role: / Complex / Monthly
Annually
Report Name: / Simple / Daily
Moderate / Weekly
Your Role: / Complex / Monthly
Annually
Section 4. WORKPLACE SAFETY
The Civil Service Commission appreciates the importance of a safe work environment and good safety practices. Furthermore, workplace safety is an important part of any job assessment. The Commission joins with appointing authorities in supporting a safe work environment.
A. Describe how any of your work activities described above give you concern for your safety:B. Please describe any concernsyou have about workplace violence regarding your work location or job responsibilities:
C. Please list any hazardous chemicals you have encountered while performing the above tasks:
D. Please describe any personal protective equipment (PPE) you use to reduce the risk of injury:
E. Please describe any workplace safety training you have receive while in this position (include workplace wellness programs):
Section 5. TRAINING CONSIDERATIONS
A. Please describe any training you have received while in this position (include seminars, conferences or any other formal training):B. Please describe any training that you received prior to being hired for this position that you have applied in the performance of the above duties:
C. To which position(s) would you feel qualified for promotion to solely on your experience in this position (if any):
D. What training would you like to receive to help you qualify for any promotions listed above:
Section 6. SUPERVISORY RESPONSIBILITY
Supervision involves responsibility for subordinate employees – including assigning their work, assuring their safety and reviewing/evaluating their work performance.
- What level below best describes your supervisory responsibility? (Check one)
I am the lead worker in my unit.
I supervise a single unit of employees.
I supervise two or more units, each unit having an individual supervisor.
I supervise a major division of an agency or department.
I supervise an entire agency or department.
I supervise more than one agency or department.
B. If applicable, please list the names and titles of employees you directly supervise. That is, all employees for which you are the immediate supervisor. This includes only those employees who report to you for work assignments and whose work performance you review and evaluate.
Name / Title
C. What is the total number of employees for whom you are responsible, either directly or indirectly, through supervisors reporting to you?
D. Name of your immediate supervisor:
Section 7. MINIMUM QUALIFICATIONS
EducationA. What do you think should be the education requirement for your job? (Check one)
Requires no specific formal education.
Requires a high school or general equivalency diploma (GED) or completion of an equivalent technical/vocational program.
Requires college study or post high school education.
If so, how many years (circle one)? / 1 2 3 4 5
Requires a master’s degree (M.S., M.A., M.B.A., M.P.A., etc.)
Requires an advanced graduate degree (Ph.d., Psy.d., Ed.d., M.D., etc.)
B. What field of study or vocational/technical specialization, if any, is required for your job?
C. What, if any, special license or certification is required?
Experience
How much previous work experience do you think is necessary to perform your job? Please indicate the amount and type of experience needed.
Section 8. ADDITIONAL INFORMATION ABOUT YOUR JOB
Is there anything about your job that has not been covered in this questionnaire? Use the space below to tell us anything else you feel we should know about your job. Remember, we will be using the information from this questionnaire to better classify your position. Please be sure you have given us a complete description of your duties and responsibilities. Attach additional pages as necessary.
Additional CommentsEmployee's Signature
/Date
This is the end of the employee section of the questionnaire. Thank you again for you assistance in completing this form. Please, pass the completed and signed form to your supervisor. You may keep a copy for your records.
INSTRUCTIONS TO THE IMMEDIATE SUPERVISOR
Each employee shall fill out a questionnaire for their job and present the completed questionnaire to their immediate superior for review and comments. Employee and supervisor should exercise care in the complete and accurate recording of information. Any comments on this part of the Job Classification Questionnaire will be made only by the immediate supervisor who has direct responsibility over the subordinate's work. Supervisors should also complete a questionnaire for any recently vacated or currently vacant position.
Please review the responses provided in this questionnaire as they relate to the duties and responsibilities of the position. If you have any comments or additions to the information provided, please feel free to indicate them below. Do not change or alter any of the statements made by the employee. Attach additional pages as necessary.
Immediate Supervisors CommentsImmediate Supervisor's Signature
/Date
Immediate Supervisor's Title
INSTRUCTIONS TO THE DEPARTMENT / AGENCY HEAD
In order for an accurate classification to take place, please do not alter or change the employees or supervisors statements. However, it is required that you comment on the accuracy of the statements made by your subordinates. Moreover, include your opinion on whether it is a good description of the position or if any important details have been omitted. Inform us if there is an inaccurate perception of a position, or if the duties of the position have been misstated. Include a general evaluation and refer to any specific items of concern. Attach additional pages as necessary.
Department / Agency Head's Comments