Job Questionnaire

Identification

Name(s):           Title:          

Reports to:           Title:          

Department:           Date Completed:          

Approval Signatures (typed names will suffice)

Employee:      

Immediate Manager:          

Overall Job Purpose

Briefly summarize in one or two sentences the overall purpose of this job. What is it expected to
accomplish?
        

Specific Accountabilities
Consider the major results for which this job is accountable (typically jobs can be described in 3 to 6 major
accountabilities). Describe each accountability by a phrase at the top of each box and indicate the
appropriate percentage of the time over the course of a year that is dedicated to this
accountability.

Accountability A:                   %

        

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Accountability B:                   %

        

Accountability C:                   %

        

Accountability D:                   %

        

Accountability E:                   %

        

Accountability F:                   %

        

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Knowledge and Skill
1a) Describe the overall knowledge or skill required for your job, however acquired, e.g., skill gained
through formal education, or on the job experience, or specialized skills and training etc. Consider
knowledge/understanding of:
 Office routines, methods, procedures
 Specialized skills, use of specialized equipment
 Procedures, methods, processes, systems, programs
 Technical/professional/scientific theory/principles etc.
       

1b) Describe the responsibilities/duties for which the overall knowledge and skill described in 1a) are
required.
       

Working Relationships
2a) Describe the various working relationships required in job including:
 Titles of jobs that report directly to your job
 Titles/groups of jobs that report indirectly (i.e., through a subordinate supervisor) to your job
 Other titles/groups that receive functional guidance/advice of a specialized nature from your job
and describe the guidance/advice.
       

2b) Describe the typical types of interactions, either internal or external, that are required of your job.
Indicate with whom the interactions occur and the purpose or nature of the interactions. Do not
consider one-time or infrequent examples.

       

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Problem Solving/Challenges
3a) Describe the types of support that are available to help you to problem solve, e.g., guidelines,
procedures, policies, guidance from supervisors/peers etc.
       

3b) Describe the typical most difficult or challenging situations that your job is expected to handle and
describe how they are resolved.

       

Impact of Recommendations, Decision Making and Actions Taken:

4a) Indicate the one statement below that best describes your job’s impact on the results to the
organization.

Provides information, assistance or service in support of others – i.e., to collect, or process

information or data; or for use by other jobs.
Interprets, advises or provides other supporting services for use by others in achieving
results. – i.e., providing advice and counsel, where decisions are likely to be made by virtue
of that advice/counsel.
Controls significant activities and resources which produce the results and must answer for
the results – e.g., control of budgets, client service delivery objectives.

4 b) List examples of recommendations/decisions you make on a regular basis on your own without
reference to your supervisor, e.g., work priorities, assign work schedules to others.

Recommendations / Decisions
       

4 c) List examples of recommendations/decisions about which you are required to seek consultation
with, or approval from your supervisor, e.g. changes in procedures, capital expenditures, etc.
Recommendations / Decisions
       

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Dimensions
5. If applicable, state the measures for which your job is accountable, e.g. total number of employees
supervised stated as full-time equivalents; operating and/or capital budget amounts, revenue
generation responsibility etc.

Quantitative Data
Number of Staff Supervised: Directly     Indirectly     Total      
       
Financial Responsibilities:
Annual revenue generation: $         
Annual operating budget responsibility: $         

Other Quantitative Information (Please Specify):

       

Working Conditions
Please tick the appropriate box describing the conditions under which the job is performed. Take into
consideration the intensity, duration, and frequency.
6. Physical Effort

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A. Minimal Work activities involve alternating positions of light physical activities (sitting,

standing, walking, bending, lifting light weight animate/inanimate objects, intermittent

periods of keyboarding etc.), which cause little physical effort. Majority of time is spent in

a comfortable position with frequent opportunity to move about at will. Activities require a

variety of easy muscle movements.

B. Moderate Work activities require intermediate periods of moderate physical effort, e.g.,

sitting in one place, standing, walking, sustained keyboarding, working in awkward or

constrained physical positions or confined/restricted spaces for up to 50% of the work day,

regularly climbing ladders, or regularly lifting medium weight animate/inanimate objects.

Activities typically require a variety of muscle movements with frequent requirement for

speed and coordination.

C. Considerable Work activities require frequent, lengthy periods of heavy physical effort,

e.g., sitting in one place, standing, walking, sustained keyboarding, working in awkward or

constrained physical positions or confined/restricted spaces for 51% to 80% of the work

day, regularly lifting/carrying large, or awkward heavy weight animate/inanimate objects.

Activities typically require a high level of speed and coordination.

D. Extreme Work activities involve almost continuous and lengthy durations of heavy

physical activity, e.g., lifting heavy weight animate/inanimate objects, standing, walking,

sustained keyboarding, working in awkward or constrained physical positions over 80%

of the work day. Activities typically require a high level of speed and coordination for

most of the work time.

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7. Physical Environment

A. Minimal physical Works in an environment with occasional exposure to mild

unpleasant or disagreeable conditions, e.g., negligible conditions of dust, dirt, noxious

odours, noise etc. and/or a remote possibility of risk of accident or health hazards.

B. Moderate physical or moderate hazardous Works in an environment with frequent

exposure to unpleasant or disagreeable conditions, e.g., minor conditions of dust, dirt,

noise, noxious odours, inclement weather, grease/oil, garbage, behaviourally difficult

clients and/or occasional exposure to health or accident hazards that may result in lost-

time accidents or injuries that cause discomfort for a short period of time.

C. Extreme physical or substantial hazardous Works in an environment with almost

continuous exposure to unpleasant or disagreeable conditions, e.g., extreme conditions of

dust, dirt, fumes, heat, cold, temperature extremes, exposure to violence and/or regular

exposure to health or accident hazards of a serious nature which may result in

partial/permanent disability, or serious injuries that extend beyond the day of occurrence,

requires medical attention and involves lost time.

D. Extreme hazardous Works in an environment with almost continuous exposure to

health or accident hazards of an extreme nature which may result in disabilities or

death.

8. Sensory Attention

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A. Limited Work activities involve occasional periods of low intensity concentration

requiring little demand on sensory effort. Requires normal use of sensory

attention/concentration, e.g., collecting routine information, filing, basic word

processing of routine documents, inputting straightforward data (no formatting or

creation of formulas), monitoring machines/video display terminals, attending to phone

conversations and/or routing demands for information, low intensity smelling/tasting

during food/beverage preparation, where there is a basic need for

presentation/palatability. If sensory activities are interrupted, the job incumbent

generally picks up where the task flow was interrupted with no need for backtracking.

The need for detailed or precise work is low.

B. Moderate Work activities involve need to concentrate on a variety of sensory inputs for

intermediate durations at a time requiring close attention several times daily, e.g.,

advanced work processing or graphical layout, creation of spreadsheets including new

formula, data entry or attending to single or simultaneous tasks where accuracy of

details is important, repairing/tuning tools/equipment/instruments where the need for

precision is moderate; taking/transcribing minutes of meetings, moderate intensity

smelling/tasking during food/beverage preparation where there is an advanced need for

presentation/palatability etc. If sensory activities are interrupted, time is required to

backtrack to resume activities, involving lost time. The need for detailed or precise

work is moderate.

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 C. Considerable Work activities involve a frequent need to concentrate on a variety of

sensory inputs for lengthy durations at a time requiring diligence and attention to interpret

effectively, e.g., graphic design, analyzing/auditing data/information, software/hardware

programming, technical troubleshooting, repairing tools/equipment/instruments that are

detailed requiring an exacting need for precision; writing complex reports, intense

listening, e.g., when facilitating meetings, conducting interview, crisis intervention. If

sensory activities are interrupted, considerable time in backtracking is required to resume

activities. The need for detailed or precise work is high.

D. Extreme Work activities involve an almost continuous need for a high degree of

concentration to focus simultaneously on several events or changing factors,

coordinating the “messages” and reacting, or the need for detailed sensory

concentration is essential to interpret fine nuances of detail, which leave no room for

error, e.g., surgical procedures. Sensory activities should not be interrupted as there is

no opportunity to backtrack. The need for detailed or precise work is extreme.

9. Mental Stress

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A. Minimal Work activities are performed in an environment with very little exposure to

any factor that would produce mental stress, e.g., few deadlines, limited mild,

unpleasant public or client contacts and/or little disruption of personal life because of

work schedules or need to travel.

B. Moderate Work activities are performed in an environment with occasional exposure to

one or more mental pressures. The mental stress would not be noticeably disruptive to

the work, nor would the unpleasant reaction be too strong or persistent, e.g., pressure

for deadlines, quotas or need for accuracy, unpleasant public or client contacts,

probable concern about unpleasant situations, repetitious work, and or some disruption

of personal life because of work, work schedules or need to travel.

C. Considerate Work activities are performed in an environment with frequent exposure to

mental pressure conditions where the mental stress would be noticeable, e.g., deadlines

that have aspects of conflicting and/or competing pressures, dealings with public or client

contacts who are angry, demanding, uncooperative, or emotionally disturbed, concern

about dangerous situations occurring is common and or regular disruption of personal life

because of work, work schedules or need to travel.

D. Extreme Work activities are performed in an environment with almost continuous

exposure to mental pressure conditions. Extreme mental stress is a noticeable part of

the job, e.g., conflicting demands and priorities, exposure to emotionally disturbing

experiences, confrontation, concern about danger to self or others, concern about the

probability of stressful situations which could have a serious outcome.

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Anything Else?
10. Describe any additional relevant job information that you believe has not been covered by this
questionnaire.

        

11. Manager’s Comments

        

THANK YOU FOR COMPLETING THIS JOB QUESTIONNAIRE

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