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Placer County Human Resources Department
#2021-13621-03


Supplemental Questionnaire

Last Name First Name
 

 

Health and Human Services Program Supervisor

(Adult System of Care)

 Supplemental Questionnaire

2021-13621-03

This is the supplemental questionnaire for the classification of Health and Human Services Program Supervisor. Part I will not be scored or used for determining minimum qualifications but is provided for the applicant to review prior to completing the questionnaire. Part II will not be scored but will be available to hiring authorities for interview and selection determination. Part III will be scored based on your checked responses. 

Narratives provided by applicants describing training and/or experience will not be scored but will be available to the hiring authority.

By continuing in this examination process, you are certifying that all information provided in the supplemental questionnaire is true to the best of your knowledge. If selected for an interview, you may be required to display and respond to questions to validate your responses to this exam.

NOTE: Resumes, letters, and other materials will not be evaluated or considered as responses to the items in this supplemental questionnaire. In addition, responses to this questionnaire will not be used for determining minimum qualifications for this position.


 

I have read and understood the above information.


 

PART I: MINIMUM QUALIFICATIONS SCREENING (NOT SCORED)

This section will not be scored but may assist the applicant with determining how he/she meets the minimum qualifications for this position.


1.

Do you possess four years of increasingly responsible experience in providing professional and/or clinical client services with at least two years of the qualifying experience at the journey level or higher?

Yes No
2.

Do you possess the equivalent to a bachelor's degree from an accredited college or university?  

Yes No

 

PART II: SPECIALIZED SKILLS AND PROGRAM PREFERENCE (NOT SCORED)

This section may be used for screening purposes by hiring divisions and will not be scored.


1.

Do you possess a master's degree from an accredited college or university with major course work in social work, psychology or counseling?

Yes No
2.

Do you possess a Professional Clinical License or are a Registered Associate? (e.g., LCSW, LMFT, LPCC)

Yes No
 

If you selected yes, please list your license(s) below.

3.

Please select all programs you are interested in:

Adult Protective Services
Mental Health Clinic Services
Mental Health Crisis Services
Enhanced Care Management
Forensics/Long Term Care
Full Service Partnership- Co-occurring
Full Service Partnership- Homeless
Housing
In Home Supportive Services
Public Administrator
Public Guardian
Quality Management
Substance Use Services

 

PART III: TRAINING & EXPERIENCE EXAMINATION QUESTIONS (SCORED)

This section of the supplemental questionnaire is the Civil Service examination for this position. This supplemental questionnaire will be scored based on your checked responses below. Narratives provided by applicants describing training and/or experience will not be scored, but will be available to the hiring authority and may be utilized for interview and selection determination. Scores received from this section will determine applicant ranking and placement on the eligible list.

For the items in this section, please indicate your level of experience and then provide a brief but detailed description of your related experience in the space provided. Please note references to "Experience" is defined as paid employment or internships, with amount of time calculated on a full-time basis (ie. 40 hours/week).

Resumes, letters, and other materials will not be evaluated nor considered as responses to the items in this supplemental questionnaire. In addition, responses to this questionnaire will not be used for determining minimum qualifications for this position.


1.

Describe your experience providing professional and/or clinical services in support of a client services program.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

2.

Describe your experience representing departments and/or assigned programs to other organizations, community groups, special interest groups, schools, businesses, clients and/or the general public. 

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

3.

Describe your experience acting as a primary resource to staff, clients and/or the public. 

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

4.

Describe your experience planning, assigning and reviewing the work of staff. 

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

5.

Describe your experience managing performance via daily feedback, performance evaluations, verbal and written documented counseling, performance improvement plans, and/or written reprimand.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

6.

Describe your experience ensuring compliance with a quality improvement/assurance program for behavioral health or social services programs and monitoring adherence to federal, state and local regulations.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below. In your response, include your strategies for keeping current on changing policies and implementing necessary changes related to program operations.

7.

Describe your experience recommending improvements and modifications to your assigned program or work unit.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

8.

Describe your experience participating in the development and implementation of assigned program's policies, practice guidelines, goals, and objectives.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

9.

Describe your experience maintaining a variety of records and documentation and preparing reports on program operations and activities.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

10.
Describe your experience establishing and maintaining effective working relationships with contracted providers while performing required quality assurance tasks and responsibilities.
I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.

11.

Describe your experience working with older adults and people with disabilities.

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision.
I have experience performing this task and have trained and/or provided consultation to others.
 

If you indicated experience, please describe below.


 

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