USC Job Information Questionnaire

Please select the categories on this questionnaire that are directly related to the duties listed in the job description and are an “essential” function of the position as defined on the Staff Compensation web site at www.usc.edu/dept/personnel/comp . For example, while a secretarial position may involve very infrequent lifting of 20-pound storage boxes, such lifting is not an essential function generally associated with a secretarial position and should not be identified below. On the other hand, a gardener might be involved in the regular lifting of 40-pound sacks. Accordingly, you might include as an essential function of a gardener's job that he or she is required to “lift 40-pound sacks for approximately 25% of the day.”

Training Required for All Employees

Completion of University's Harassment Awareness Training

University's Orientation Training

Licenses, Certification and Training
List all licenses, permits, certificates, training, etc., REQUIRED to perform this job.

Valid State Driver's License

Commercial Driver's License

Hazardous Materials Transport Certificate

Certificate to drive vehicles that weigh over 26,000 pounds

Certificate to transport 10 or more passengers, or transport passengers for hire

Certificate to tow a trailer that weighs over 10,000 pounds

Current Defensive Driver's Certification-USC

POST (Police Officer Standards and Training) Certification

Recreational Underwater Diving Certification

Scientific Diving Certification

Private Pilot License

State Bar of license

Paralegal certificate

License to practice medicine from

Health Insurance Portability and Accountability Act (HIPPA) Education and Certificate

Laboratory Safety Orientation and Annual Safety Review

Blood Borne Pathogens Training

Human Subjects Training

Teaching certificates:

Food Service/Culinary certificates:

Other:

Comments concerning licenses and certificates, etc.:

Physical Requirements
Indicate the physical activities that are USUALLY REQUIRED to perform the ESSENTIAL functions of the position. The following physical activities required to perform the essential functions of the position include but are not limited to:

Work that involves exerting up to pounds of force to lift, carry, push or pull objects % of the day.

Work that requires climbing stairs.

Work that requires ability to make fine discriminations in sound, (e.g., making fine adjustments to audio equipment).

Work that requires standing for sustained periods of time.

Work that requires significant periods of walking.

Work that requires visual acuity for work including, but not limited to, administrative, clerical, close assembly, inspection or machine operation.

Work that requires peripheral vision to (e.g., to operate cars, trucks, forklifts or machines such as lathes, drill presses, power saws).

Comments concerning physical requirements:

Environmental Conditions and Health Hazards
Is the worker exposed to adverse environmental conditions? The worker may be subject or exposed to health hazards when performing the essential functions of the position. These include but are not limited to:

Work that is frequently performed outdoors.

Work that is subject to extreme temperatures: cold – below 32 degrees for periods of more than one hour.

Work that is subject to extreme temperatures: heat – above 100 degrees for periods of more than one hour.

Work that requires exposure to hyperbaric environments.

Work that requires exposure to hypobaric environments.

Work that requires exposure to noise levels exceeding 85dBa.

Work that requires exposure to hazardous materials (e.g., asbestos-containing materials).

Work that requires exposure to irritating fluids or solids or atmospheric conditions – air and/or skin exposure to oils, paints, solvents, chemicals, fuels, fumes, odors, dust, gases, poor ventilation, etc.

Work that requires exposure to vibration – exposure to oscillating movements of the extremities or whole body.

Work that may subject employee to radiation.

Work that requires exposure to blood born pathogens (e.g., HIV, AIDS, viruses).

Work that may require exposure to infectious agents (e.g., Hepatitis, Tuberculosis)

Other:

Comments concerning environmental conditions and health hazards:

Equipment and Machines
Indicate whether the position requires operation of equipment, machinery or devices to perform the essential functions of the position. Indicate whether the work involves exposure to operation of mechanical machinery or devices or high voltage equipment. The position may include, but is not limited to, the following:

Work that requires operation of heavy machinery.

Work that requires operation of mechanical devices.

Work that requires use of hand tools.

Work that involves exposure to operation of mechanical machinery.

Work that involves exposure to operation of mechanical devices.

Work that involves exposure to high voltage equipment.

Work that requires use of a computer keyboard for % of the day.

Work that requires operation of the following vehicle(s):

Other:

Comments concerning equipment and machines:

Equipment and computer software
List all office equipment and computer software REQUIRED to perform this job.

Telephone

Typewriter

Copier

Calculator

Fax machine

Personal computer (include monitor, keyboard and mouse)

Computer printer

Computer scanner

Microsoft Word

Microsoft Access

Microsoft Excel

Microsoft PowerPoint

Windows ( XP , NT , 2000, 98, etc.)

AIS

Other:

Schedule/Hours Requirements
Full-time staff employees of the University of Southern California are customarily expected to perform their duties at University facilities, 37 l/2 – 40 hours per week, on a schedule determined by the school or department (usually between the hours of 8:00 a.m. and 5:00 p.m. , Monday – Friday). Exceptions to this policy are noted below. List the schedule conditions that are REQUIREMENTS of the job.

Split Shift

Swing Shift

Graveyard Shift

Frequent Overtime

Weekend Assignments

On-call Duties

On-site Residence

Travel to Off-Campus meeting required

Out-of-Town travel required

Other:

Comments concerning schedule/hours:


*TO BE COMPLETED BY COMPENSATION: DEPARTMENT SIGNATURES:
Job Code:__________ Date:__________ Supervisor:______________________________
Job Title:_________________________ Dean/Director: ___________________________
Compensation Rep:_______________ Department:_____________________________
  Employee: ______________________________