Free State of Arizona - Arizona

STATE OF ARIZONA POSITION DESCRIPTION QUESTIONNAIRE
JOB CODE

POSITION NUMBER

OFFICIAL CLASSIFICATION TITLE

WORKING TITLE

AGENCY

DIVISION/SECTION

ADDRESS (PHYSICAL WORK LOCATION)

PHONE

SUPERVISOR'S NAME

TITLE

EMAIL

PHONE

REQUEST TO

Establish New Position Update PDQ

Review/Reclass Position

Change Position Status

Other: ___________________________________________

EMPLOYEE INITIATED: SEE PERSONNEL RULE R2-5-301.G. IF YES, EMPLOYEE SHOULD SUBMIT THROUGH AGENCY MANAGEMENT. FOR ASSISTANCE, EMPLOYEE SHOULD CONTACT THEIR AGENCY HUMAN RESOURCES OFFICE.

Yes

No

SUPERVISE

MANAGE

Yes No

(If yes, please complete the section below.)

Yes No

(If yes, please complete the section below.)

Number of Direct Reports: ___________ Work Assignment Disciplinary Actions Work Review Hiring

Number of Indirect Reports: _______________ Performance Appraisal Leave Requests

Other: ________________________________

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1.

JUSTIFICATION STATEMENT: EXPLAIN THE EVENTS/CHANGES THAT MADE THIS REQUEST NECESSARY, INCLUDING JUSTIFICATION FOR EXEMPT, UNCOVERED POSITION REQUESTS.

2.

JOB SUMMARY: EXPLAIN THE PURPOSE OF THIS POSITION.

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3.

MAJOR RESPONSIBILITIES: USE ACTION VERBS TO STATE THE PRIMARY FUNCTIONS FOR WHICH THIS POSITION IS ACCOUNTABLE, AND EXPLAIN WHAT THIS POSITION DOES AND WHY.

Primary Responsibilities (in increments of no less than 5%)

Percent Time Spent (%)

1.

2.

3.

4.

5.

6.

7.

8.

Attach additional sheets as needed

Must total 100%
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4.

DECISION MAKING AUTHORITY: CHECK THE ONE BOX THAT BEST DESCRIBES THIS POSITION'S INVOLVEMENT IN THE DECISION MAKING PROCESS.

Follows written and verbal instructions Follows established guidelines Interprets policies and procedures Participates in the establishment of guidelines and policies Acts as final authority to implement guidelines and policies Other: ______________________________________________________________________________

5.

PROBLEM SOLVING: CHECK THE ONE BOX THAT BEST DESCRIBES THE TYPE OF PROBLEM-SOLVING SITUATIONS REQUIRED OF THIS POSITION.

Identical or similar situations following established routines/instructions Diverse procedures in differing situations; some research within area of expertise is required Variable situations requiring analytical, interpretive, evaluative, and/or constructive thinking within broadly defined policies and objectives 6.
KNOWLEDGE, SKILLS, ABILITIES (KSAS): EXPLAIN THE KNOWLEDGE, SKILLS, AND ABILITIES AN EMPLOYEE IN THIS POSITION MUST HAVE IN ORDER TO PERFORM WORK SATISFACTORILY. KNOWLEDGE IS THE UNDERSTANDING OF A SUBJECT THROUGH EXPERIENCE OR EDUCATION; ALWAYS COGNITIVE.

SKILLS ARE LEARNED AND GET BETTER WITH PRACTICE; THEY ARE EITHER COGNITIVE OR PSYCHOMOTOR.

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ABILITIES ARE NATURAL, CONTRIBUTE TO SKILLS, AND ARE PERCEPTUAL, MOTOR, OR A COMBINATION; THEY ARE EITHER COGNITIVE OR PSYCHOMOTOR.

7.

LICENSES/CERTIFICATIONS: LIST ANY LICENSES, CERTIFICATIONS, DEGREES, OR CREDENTIALS THAT ARE REQUIRED BY LAW FOR THIS POSITION.

8.

SELECTIVE PREFERENCES: LIST ANY PREFERRED (NOT REQUIRED) QUALIFICATIONS THAT THE IDEAL CANDIDATE WOULD PORTRAY.

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9.

ESSENTIAL JOB FUNCTIONS: LIST ALL PHYSICAL, MENTAL, AND ENVIRONMENTAL REQUIREMENTS FOR THIS POSITION BY CHECKING EACH BOX THAT APPLIES. FOR EACH REQUIREMENT, INDICATE THE FREQUENCY WHICH IS REQUIRED IN THIS POSITION. UNDER APPLICABLE MAJOR FUNCTIONS, IDENTIFY THE CORRESPONDING PRIMARY RESPONSIBILITY (FROM PG.3).

C = CONTINUOUSLY (>66%); F = FREQUENTLY (34-66%); O = OCCASIONALLY (10-33%); R = RARELY (<10%); N/A = NOT APPLICABLE

Physical Demands Balancing Climbing Crawling Fine Dexterity Foot Controls Hearing Kneeling/Crouching/Bending Manual Dexterity Lifting/Carrying # of pounds _________________
*Lifting/Carrying 25 lbs or more will require a physical exam.

Frequency

Applicable Major Functions

Span of Lift: Floor to Waist Floor to Shoulder Waist to Shoulder Other:

Pushing/Pulling # of pounds _________________
*Pushing/Pulling 25 lbs or more will require a physical exam.

Reaching Sitting Standing Talking Twisting Upper Extremity Repetitive Motion Seeing Walking/Running Short Distances Walking/Running Long Distances Length of distance ____________ Length of distance ____________

Other _____________________________________________________ Applicable Major Functions

Mental Demands Analysis/Reasoning Communications Skills (as distinguished from talking) Math/Mental Computation Reading Sustained Mental Activity (e.g., auditing, grant writing, composing reports, problem solving) Writing Other _____________________________________________________

Frequency

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Environmental Demands Asbestos Dust Frequent Task Changes High Volume Public Contact Loud Noise Physical Danger Tedious/Exacting Work Temperature Extremes Toxic Substances (e.g., solvents, degreasers, herbicides, pesticides, asbestos,
printer toner, etc.)

Frequency

Applicable Major Functions

TO THE EMPLOYEE: THIS SECTION IS TO BE SIGNED BY THE INCUMBENT.

I have reviewed the contents of the questionnaire, and it accurately describes my job.

_______________________________________________________________________________________ Print Name Sign Date

TO THE SUPERVISOR: PLEASE PROVIDE ANY ADDITIONAL INFORMATION THAT YOU BELIEVE WILL CONTRIBUTE TO A CLEARER UNDERSTANDING OF THE DUTIES PERFORMED BY THIS POSITION. USE ADDITIONAL PAPER IF NEEDED.

Comments:

_______________________________________________________________________________________ Print Name Sign Date

TO THE AGENCY DIRECTOR OR THE AUTHORIZED REPRESENTATIVE OF THE AGENCY DIRECTOR:

I have reviewed the contents of the questionnaire, and it accurately describes this position.

_______________________________________________________________________________________ Print Name Sign Date

** Please attach an organization chart clearly identifying each position's official classification title, position number, class code, and grade. Include at least two levels of supervision above this position, this position's co-workers, and if applicable, subordinates. If requesting a reclassification, two (2) organization charts (current and proposed) must be attached.
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