The City of South San Francisco
Office of the City Clerk
400 Grand Avenue
South San Francisco, CA 94080
(650) 877-8518 (fax) (650) 829-6641
CALIFORNIA
Application for Boards and Commissions
APPLYING FOR (more than one may be checked)
Bicycle and Conference Center Conference Center Conference Center Pedestrian Advisory Authority Business Authority Community Authority Hotel Committee (BPAC) Representative Representative Representative Cultural Arts Equity and Public Housing
Housing Authority
Commission Safety Commission Authority Tenant Commission Library Measure W Citizens' Parking Place
• Board Parks & Recreation
- Oversight Committee Commission Commission
Personnel Planning SSF General Plan 2040 Traffic Safety Board Commission Community Advisory Commission
Committee
Youth
Commission
Are you interested in participating in the Citizen's Academy? Yes 1 NO
PERSONAL INFORMATION
Rey, Jamie M
Name (last, first, middle)
SSF, CA 94080
Address (number owest and anartmant numbas
Telephone number Cell phone/alternative contact number E-mail address If you selected more than one Board/Commission/Committee of interest, please rank your preferences here, starting with your first choice.
How many years have you been a resident of South San Francisco? 34 Have you attended any meetings of the commission/board for which you are applying? Yes WI No L If yes, which one(s)? 8/18
Are you a resident of South San Francisco? Yes Le
If no, are you employed in South San Francisco? Yes
Number of hours employed in South San Francisco:
Housing Authority Tenant Commission
Are you a resident of the Housing Authority? Yes • No D Youth Commission - (Ages 14 to 22)
If not a resident of South San Francisco, are you a student of SSFUSD? Yes No DI Current school:
Conference Center Authority Hotel Representative
Which hotel within the City of South San Francisco are you representing? South San Francisco General Plan 2040 Community Advisory Committee What is your District of Residency?
Click here to locate your District.
Why do you want to be a member of a Board/Commission/Committee? What do you feel you could contribute? A younger perspective also one of a person of color.
What qualifies you for this appointment? Being an appreciatior of culture and art and a lifelong resident of SSF What is your vision for growth in South San Francisco? Being a place where we can honor the cultures that have built tl Having a center gathering/meeting place, and allowing artist to have space to create and share their work Are you currently receiving any form of compensation from the City for work performed? Yes No M If yes, please explain: _
Do you have any relatives serving on Council, Commissions, Boards, and Committees or otherwise employed by the City of South San Francisco? Yes L No L If yes,
Name Position Relationship
EDUCATION - Please include additional information on separate sheet.
Saint Ignatius College Prep, SF, High School Diploma
Name and location of college/university/technical or trade school Degrees received University of San Francisco, SF, BSN
California State University, Fullerton, MSN
Name and location of college/university/technical or trade school Degrees received What community activities are you presently involved in, or have been in the past? Measure W
MISCELLANEOUS - Please include additional information on separate sheet or attach resume.
Military Service: Dates and branch
WORK EXPERIENCE - Please include additional information on separate sheet or attach resume.
March 2011- Jan 2019 Cedars Sinai Medical Center, Staff Nurse Dates employed Employer Position
Duties
Nov 2019- present UCSF, Staff Nurse
Dates employed Employer Position
Duties
I certify that, to the best of my knowledge, all statements in this application are complete and true. I agree and understand that any mis- statement of material fact will cause me to forfeit all rights to appointment to a Commission, Board, or Committee with the City of South San Francisco.
09/08/22
Signature Date
The interest of the City is served best by actual and regular participation by Board and Commission members. Thus, upon the second absence trom a regular meeting within any rolling twelve-month period, a member shall receive a written communication from the Mayor requesting that the member respond to the Mayor with an explanation for said absences within one week of the member's receipt of the written communication. The Mayor shall report to the City Council the reasons provided for the member's absences. If the City Council determines that the absences occurred for legitimate reasons, the City Council may excuse both or one of the absences. Members are also encouraged to give advanced notice of their absence from meetings.
Applications are accepted on a continuous basis and will remain valid 1 year from the date of submission. If you are selected to serve on a Board or Commission, you may be required to file an Annual Statement of Economic Interest (FPPC Form 700) and bi-annual Ethics Training (AB1234).
PRINT AND MAIL TO:
CITY OF SOUTH SAN FRANCISCO
Office of the City Clerk
400 Grand Avenue, South San Francisco, CA 9408(
For more information, call (650) 877-8518
For official use only Accepted Not Accepted
Dai09/0/2022
Jamie Marie Rey, MSN, BSN, RNC
EMPLOYMENT:
Birth Center: Labor& Delivery, Maternal Fetal Care Unit- Staff II nurse November 2019- present University of California, San Francisco, CA
Labor and Delivery/Maternal Fetal Critical Care Unit-Staff Nurse III Cedars-Sinai Medical Center, Los Angeles, CA September 2012- January 2019 Adjunct Professor August 2019
University of San Francisco, San Francisco, CA
Postpartum Mother-Baby Staff Nurse II
Cedars-Sinai Medical Center, Los Angeles, CA March 2011- September 2012 Hospital Administrative Assistant
Seton Medical Center Foundation, Daly City, CA Dec 2009- February 2011 District School Nurse
Mountain View School District, Mountain View, CA Sept 2010- November 2010
EDUCATION
Rutgers University January 2020-present
Women's Women's Global Health Leadership Program
California State University, Fullerton August 2015- August 2018 Masters of Science in Nursing
University of San Francisco, San Francisco, CA Aug 2006 - May 2010 Bachelor of Science in Nursing
Saint Ignatius College Preparatory, San Francisco, CA Aug 2002 - May 2006 High School Diploma
AWARDS, POSTERS, ABSTRACTS & HONORS
Daisy Award Nominee June 2021, Sept 2021
Dorskind Women's Health Excellence Award Nominee
Cedars Sinai Medical Center May 2018
Circle of Friends, Cedars Sinai Medical Center 2015, 2016 Rock & Roll Hall of Fame, Cedars Sinai Medical Center July 2013 Team Spirit Award, Cedars Sinai MEdical Center May 2012 "Becoming Human" Theory Paper Contributor
Anne Klevay, RN & Mary DeNatale March 2012
Rutger's International Technology Conference
Best Poster Award: "Design Implementation of H1N1 video" October 2009/March 2010 University of San Francisco School of Nursing: Dean's Honor Roll Sept 2006-May 2008 ACADEMIC and PROFESSIONAL AFFILIATIONS
Saint Ignatius College Preparatory Alumni Board Member August 2021-Present Saint Ignatius College Prep Alumni Association June 2006- Present California Nurse-Midwife Association, Student Rep Aug 2017-May 2018 Sigma Theta Tau International Honor Society of Nursing November 2011- 2016 Tri-Gamma Nursing Sorority, Sept 2006-May 2010
President 2009-2010
Vice President 2008-2009
Order of Omega National Honor Society September 2009
Saint Ignatius Student Body President Sept 2005- May 2006
COMMITTEES
Sunshine Committee, UCSF Nov 2020- present
RN-MD Collaborative, UCSF Nov 2021-present
Journal Club, UCSF April 2022- present
Peer Mentor, UCSF July 2022- present
Community Service Committee (L&D) October 2012- 2019
RR Committee: Retention and Recognition (L&D) September 2012-2019 RRR: Recruitment, Retention, & Recognition Task Force March 2011-2019 Breastfeeding Task Force March 2011- September 2012
SPECIAL PROJECTS
Cervical Exam (UCSF) July 2021 - ongoing
Aromatherapy (UCSF) June 2022- ongoing
RN-MD Resident buddy July 2021, July 2022
OB Resident Simulation Drills (Cedars) 2016-2019
Skin-to-Skin, Champion (Cedars) 2015-2019
Aromatherapy, Champion (Cedars) 2015-2019
Employee Survey Ambassador May 2013, May 2012
Employee Resource Handbook (L&D) July 2013
Volte Ambassador May 2012
Infant Education Task Force (Postpartum) January 2012- September 2012 Compilation Admission Packet (Postpartum) October 2011-September 2012 Community Service
Second Harvest Senior Brown Box Program Now 2019- present Covid Vaccine Clinic, SF Moscone Center Feb- May 2021
Project Learn Belize Nursing Immersion May 2010
Guatemala Service Nursing Immersion January 2010
LECTURES AND PRESENTATIONS
Cervical Checks, Staff (UCSF) August 2021
Cedar Sinai Medical Center
"Skin-to-Skin in the OR" March 2018
"Aromatherapy, Essential Oils In Labor" March 2016, March 2019 Rutger's International Technology Conference March 2010 Best Poster Award: "Design & Implementation of H1N1 Video" Resurrection Catholic Elementary School, Sunnyvale October 2009 "Personal Health Portfolio"
San Jose Unified School District October 2009
"What is the flu?" "H1N1"
PROFESSIONAL DEVELOPMENT
Triage Nurse Trained (UCSF) March 2022- present
Scrub Nurse Trained (UCSF) Nov 2021- present
Yoga Teacher Training, Wanderlust, 200 hours 2017
Customization of Care (L&D) 2015-2019
Committee Service Committee (L&D) 2012-2019
RR Committee: Retention and Recognition (L&D) 2012-2019 Unit Preceptor: Travelers, New Hires, New Grads 2015-2019 Flu Ambassador 2017-2018
RRR: Recruitment, Retention, & Recognition Task Force 2011-2012 Breastfeeding Task Force 2012-2019
LICENSURE/CREDENTIALS
California State RN Licensure: 778845- expires 6/30/2024 Basic Life Support healthcare Provider (BLS), State of California- expires 12/2022 Advance Cardiovascular Life Support Provider (ACLS)- Certificate expires 12/2022 Neonatal Resuscitation Provider (NRP) - expires 8/2023
Inpatient Obstetric Nursing RNC-OB - expires 6/16/2025
Maternal Newborn Nursing RNC-MNN - expires 9/15/2023
Women's Health Care Nurse Practitioner WHNP-BC - expires 9/15/2023 Women's Health Nurse Practitioner #95010555 expires: 6/30/2024 WHNP DEA: #95010555 expires: 6/30/2024
Certified Nurse Midwife Licensure: #235990 expires: 6/30/2024 CNM DEA: #235990 expires: 6/30/2024
Hospital Fire and Life Safety- expire 4/2019
Wanderlust Yoga Teacher Certification: 5/21/17
REFERENCES: Available upon request