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Candidate Reference Evaluation Form

The reference form for candidate Steven M Tyler indicates he is currently employed as an RN Sub-acute at Saratoga Pediatric Subacute since April 2023. His supervisor, Sam Stukov, rates his performance positively across various attributes, including clinical care, communication, and professionalism. The reference confirms a willingness to rehire him, with the evaluation completed by Pankaj Patel on August 30, 2023.

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Pankaj Patel
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6 views1 page

Candidate Reference Evaluation Form

The reference form for candidate Steven M Tyler indicates he is currently employed as an RN Sub-acute at Saratoga Pediatric Subacute since April 2023. His supervisor, Sam Stukov, rates his performance positively across various attributes, including clinical care, communication, and professionalism. The reference confirms a willingness to rehire him, with the evaluation completed by Pankaj Patel on August 30, 2023.

Uploaded by

Pankaj Patel
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

CANDIDATE APPLICATION

Reference Form
CANDIDATE NAME Steven M Tyler

FACILITY INFORMATION
Facility Name Saratoga Pediatric Subacute
City/State Saratoga, CA
Reference Name Sam Stukov
Title Supervisor
APPLICATION INFORMATION
Position(s) Held RN Sub-acute
Travel Assignment Yes

Employment Dates April 2023 to Present

Average Patient Ratio NA

# Of Beds in Facility 36

Would you rehire? yes

PERFORMANCE AND ATTRIBUTES


/ / /
Experience scale: 1 – N/A 2 – Below Standard 3 – Meets Standard 4 - Above Standard
1 2 3 4
✔ Provides competent clinical care following facility policies and procedures
✔ Communicates effectively w/ patients, families and staff
✔ Completes accurate documentation of patient care
✔ Ability to communicate with staff
✔ Attendance and punctuality
✔ Flexibility and adaptability
✔ Overall professionalism

ADDITIONAL COMMENTS

Reference Completed By: Pankaj Patel

Evaluation Date: 30 August 2023

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