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#18-000383-0003
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Please explain in detail, your experience in matching youth resource parents and/or seeking specialized placements of fostering and/or adoption. Please include the name of your employer, job title, job duties, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A.

 

2.

Please explain in detail, your experience in a child welfare program or public or private Child Welfare agency. Please include the name of your employer, job title, job duties, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A.

 

3.

Please explain in detail, your experience and knowledge of Maryland's Child Welfare System and/or direct experience in working in Resource Homes within a Local Department of Social Services. Please include the name of your employer, job title, job duties, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A.

 

4.

Please explain in detail, your experience with CIS (Client Information System) and MD CHESSIE (Maryland Children's Electronic Social Services Information Exchange System) appropriate to represent SSA (Social Service Administration) and child welfare on matters related to designing, building, and testing of the automated system. Please include the name of your employer, job title, job duties, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A.


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