St Judes Nursing Home
REFERENCE REQUEST IN CONFIDENCE
The person named below has applied for work for St Judes and given your
name as a referee. Please complete and return this form by the following ASAP
date:
Full name of Maria Apetri Post for which they Health Care Assistant
applicant have applied
For how long and in what capacity do you know them (eg I am writing as a member of staff who has known
a member of staff, a patient/client/customer or a friend) Maria since 2017.
Part A. EMPLOYER REFEREES ONLY
Period of service From 2017 To 2024
Salary or 3650 RON per Reason Maria’s reason for leaving is the reunification
Hourly Rate month for leaving with her family in the UK.
Main Duties Brief description of their main duties with you
As an employee in the internal medicine department, Maria had to care for the sick. She would wash
them, feed them, help them move around, take the patients in other departments of the hospital for
further investigations, dress them. She would also disinfect the ward with all it’s surfaces change the
bedsheets.
Training/Development Brief details of any training/development whilst employed with you
Maria has been thoroughly instructed in all the procedures necessary for her role in the Internal
Medicine department that have already been mentioned above. Her work was important for the obtaining
of funds for the hospital form ANMCS in 2022, as well.
Sickness absence Number of days in last 2 10 Number of occasions in last 2
years 2 years
Disciplinary/other warnings Are there any on file or are they subject to any such action?
If YES, please give brief details:
Would you re-employ them? (Please one box) YES NO
If NO, please say why
Part B. ALL REFEREES
From your work/other knowledge of them, please the appropriate box for the following
Excellent Good Fair Poor
Time keeping and attendance
Reliability and honesty
Performance as an individual
Performance as part of a team
If you have ticked ’Poor’ or are unable to respond, please say why:
Please comment on their working relationships with a) customers/clients and (where applicable) clients’ families b)
work colleagues and/or friends
Maria communicated well with the clients and their families and has shown great teamwork in relationship with her
colleagues.
Based on the information provided, please give your opinion on their suitability for the post
I believe Maria Apetri would be suitable for this post as she is patient, hard-working, and possesses good
communication skills especially with elderly people.
Please add any further information, including what you believe to be their a) strengths and major achievements b)
weaknesses or development needs.
Regarding her strengths, I can safely say she is involved and caring, and managed to quickly adapt to the
standards and procedures of our ward.
One weakness: she can be quite selfish at times.
Under the Rehabilitation of Offenders Act (Exemptions Order) 1975, all posts in the Foundation are exempt from
Section 4(2) of the Rehabilitation of Offenders Act 1974. It is therefore in order to reveal any information
concerning convictions that would otherwise be considered as ‘spent’. Please provide on a separate sheet any
relevant information you may have in this respect.
Signed …… Hanganu Elena Gabriela …………………………………………. Date: 10 of April 2024
………………………………….
Name, Position and Address : Hanganu Elena Gabriela, Chief Doctor of the Internal Medicine Department,
Of “Sf Dimitrie” hospital on Bulevardul Ștefan cel Mare nr.35, Târgu Neamț, postal code:615200 .
The information provided on this form is supplied in confidence and will not be disclosed to the person to whom it
relates without the express consent of the person organisation or agent providing the reference.