Interview Questionnaire - Care Roles v.3.0

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Interview Start

• Time of commencement of interview :

  Date

Personal Details

• Gender

  Male

  Female

  Other

• Surname

• First Name & Middle Name

• Date of Birth:

  Date

Contact Details

• Address:

• Postcode:

• Home Phone Number:

• Mobile Phone Number:

• Email:

Job Applied For

• Role being interviewed for:

  Select Care Worker Care Worker - Residential Support Worker Senior Carer Senior - Residential Field Care Supervisor Other

  • Care Worker
  • Care Worker - Residential
  • Support Worker
  • Senior Carer
  • Senior - Residential
  • Field Care Supervisor
  • Other

• Details:

• 'Driver' or 'Walker'?

  Driver

  Walker

  N / A

• Full Driving Licence?

  Yes

  No

• Use of a vehicle for work?

  Yes

  No

Appearance

• General appearance and hygiene of acceptable level?

  Yes

  No

• Hair neat and groomed ?

  Yes

  No

  N/A

• Clean shaven or facial hair (if any) of neat appearance ?

  Yes

  No

  N/A

• Clothing worn of suitable standard for interview ?

  Yes

  No

  N/A

• Were any tattoos visible at time of the interview unacceptable?

  No

  Yes

  N/A

• Will it be covered when in uniform?

  Yes

  No

  N/A

• Was any body jewellery worn at the time of interview unacceptable?

  No

  Yes

  N/A

• Will it be covered when in uniform?

  Yes

  No

  N/A

• Overall score for appearance and presentation at interview (10 highest)

• General Comments

Background Knowledge

• Do they currently work for the company?

  Yes

  No

  N/A

• What is their current job role?

  Select Care Worker Care Worker - Residential Support Worker Senior Carer Senior - Residential Field Care Supervisor Other

  • Care Worker
  • Care Worker - Residential
  • Support Worker
  • Senior Carer
  • Senior - Residential
  • Field Care Supervisor
  • Other

• Do they know anyone that works for the company

  Yes

  No

  N/A

• Details:

• What do you know about the company & the services we provide? (Rate Knowledge)

  Excellent

  Good

  Poor

  None

• What knowledge do they have about the role they have applied for? (Rate their knowledge)

  Excellent

  Good

  Poor

  None

• Where did they hear about the vacancy?

Basic skills

• Handwriting? (Check Application Form)

  Excellent

  Good

  Poor

  None

• Spoken English?

  Excellent

  Good

  Poor

  None

• Do they have a maths qualification?

  Yes

  No

• Do they have an English qualification?

  Yes

  No

• Do they have any learning disabilities? i.e dyslexia

  No

  Yes

  N/A

• Details:

• Rate their relevant basic skills (10 highest)

• General Comments

Education/Training

• Do they hold any certificates relevant to the position they are applying for?

  Yes

  No

  N/A

• Details:

• Rate their Qualifications and Training in relation to the role applied for (10 highest)

• General Comments

Work History and Experience

• Have they worked in the care industry previously?

  Yes

  No

• Details: (Company and Responsibities)

• Are they currently employed ?

  No

  Yes

• Notice Period?

• Have they previously worked as a Lone Worker?

  Yes

  No

• Will they be required to undertake Supervisions or Management tasks?

  No

  Yes

  N/A

• Do they have any supervision or management training ?

  Yes

  No

  N/A

• Details:

• General Comments

Further Training

• What areas do they believe they could do with further training or experience in to make them a better potential employee?

• Rate their suitability based on their answers above (10 highest)

• General Comments

What are they looking for ?

• What are their goals for the next 6 to 12 months ?

• What are their goals for the next 2 to 5 years ?

• Rate their suitability based on their answers above (10 highest)

• General Comments

Questions

• What qualities do they believe a good worker in the role applied for must have?

• Why do they feel that they have these qualities?

• What is the greatest achievement in their personal life to date?

• Describe a difficult decision you had to make in your work life and how you made it?

• What is the greatest achievement in their work life to date?

• If you they were to be offered a position - what would they be most apprehensive about?

• Rate their suitability based on their answers above (10 highest)

• General Comments

Personality

• What was their personality during interview?

  Select Cheerful Talkative Polite Relaxed Shy Quiet Nervous Very Nervous Knowall Rude

  • Cheerful
  • Talkative
  • Polite
  • Relaxed
  • Shy
  • Quiet
  • Nervous
  • Very Nervous
  • Knowall
  • Rude

• General Comments

Applicant Questions

• Do you have any questions regarding this interview, the role or the company in general ?

• General Comments

Final Question

• Why do you feel we should employ you? What makes you the person we want to employ in preference to the next applicant ?

• Rate their answer above (10 highest)

• General Comments

Recommendation and Job Offer

• Overall, are they suitable for the position ?

  No

  Yes

• Reasons?

• Authorisation required to offer job?

  Required

  Not Required

• Authorising Person:

  Sign

• Was the job offer made at the interview?

  Yes

  No

• Reason for not making offer:

• Was the offer Accepted?

  Yes

  No

• Photocopy Certificates if applicable

• DBS Check information

• Reference Details

• Photocopy of Driving Licence

• Photocopy of Valid Insurance Certificate

• Photo for ID Card

  Media

• Details why offer not accepted:

Interview Conclusion

• Time of conclusion of interview :

  Date

• Any Further Information required?

• Pass all details to HR for processing

• Interviewer Signature:

  Sign