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Placer County Human Resources Department
#2022-14464-01


Supplemental Questionnaire

Last Name First Name
 

 

Client Services Practitioner - II

(Clinician/Social Worker)

Supplemental Questionnaire

2022-14464-01

This is the supplemental questionnaire for the classification Client Services Practitioner - II. Sections I, II, and III are not scored but will be available to hiring authorities for interview and selection determination. Section IV 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 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.


 

I have read and understood the above information.


 

PART I - MINIMUM QUALIFICATIONS (NOT SCORED)

This section will not be scored but may assist with determining how the applicant reports meeting the minimum qualifications for this classification. 


1.

Do you possess two years of responsible casework or clinical experience performing duties similar to a Client Services Practitioner I with Placer County?

Yes No
 

If you answered yes, please describe your experience below.

2.

Do you possess a master's degree from an accredited college or university with major course work in social work, psychology or counseling, which meets the eligibility requirements for licensure a Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT) or Licensed Professional Clinical Counselor (LPCC) by the State Board of Behavioral Science Examiners? Note: Possession of a license is not mandatory to be qualified for this recruitment.

Yes, degree obtained in California
Yes, degree obtained outside of California
No
 

If you received your degree outside of California, please list the state/country in which you received your degree.  If you do not have a master's degree in the specified areas above, please enter "N/A."


 

PART II - DIVISION/ASSIGNMENT PREFERENCE (NOT SCORED)

Please mark "Yes" or "No" to specify the program(s) in Health and Human Services division(s) you are interested in being assigned to:



 

ADULT SYSTEM OF CARE (ASOC):


1.

Adult Protective Services (APS) - A 24-hour program mandated by the State that investigates allegations of harm to seniors and dependent adults who are reported to be endangered by physical, sexual, and financial abuse, isolation, neglect or self-neglect.

Yes No
2.

Mental Health Services - ASOC partners with other agencies to provide a variety of needs-based services including: assessments, mental health clinical and support services, mental health crisis response, housing assistance, peer support, and psychiatric medication services. Supervisory specialty areas include crisis services, housing, and consumer development.

Yes No
3.

Substance Use Services - ASOC offers screening clinics in-person and via telehealth, performing American Society of Addiction Medicine (ASAM) screenings and providing recommendations for clinically indicated levels of care.  In addition to substance use treatment recommendations and linkage, general case management support is provided to address a variety of needs including housing, medical care, and mental health.

Yes No
4.

Enhanced Care Management - Intensive case management for individuals experiencing homelessness and/or serious mental illness or substance use disorders to help coordinate their health care and other needed services.

Yes No

 

CHILDREN'S SYSTEM OF CARE (CSOC):


5.

Child Welfare Services - Investigations and services to children who are at risk or have suffered from abuse or neglect, and their families. This includes intake, ongoing services, approval of caretakers for youth, and support/coaching for families in crisis.

Yes No
6.

Mental Health Services - Programs to provide intensive in-home support services to families in Placer County where children are at risk of out-of-home placement or have been put in placement and cannot return home successfully without extra support. Family Support Counselors ensure that families receive needed and required services.

Yes No
7.

Please check the boxes that correspond with the population(s) you are interested in being assigned to:

Children / Adolescent
Transition Age Youth
Adult
Older Adult

 

PART III - SPECIALIZED SKILLS, EXPERIENCE, AND/OR LICENSURE (NOT SCORED)

Please note that indicating "No" to any questions in this section does not exclude you from participation in this recruitment.

Note: Applicants indicating "Yes" to being bilingual may be required to demonstrate their proficiency via participating in a Placer County administered Language Skills Examination as part of the selection process. Upon successful completion of a foreign language proficiency exam, an additional 5% bilingual pay will be paid to employees who use a second language on a regular basis in the normal course of business.



 

BILINGUAL:


1.

Are you fluent in any languages other than English?

Yes No
 

If you selected yes above, please list the language(s) you are fluent in below. If you are not fluent in any other languages, please enter "N/A."


 

NATIVE AMERICAN:


2.

Are you interested in working with Native American families as part of a Native Service Team?

Yes No
3.

What special skills, education, or experience do you have working with Native Families? If you do not have experience, please enter "No experience."

4.

What experience do you have working with community partners and/or cultural brokers? If you do not have experience, please enter "No experience."


 

LICENSE/REGISTRATION:


5.

Are you a Licensed Clinical Social Worker (LCSW), Licensed Marriage Family Therapist (LMFT), or Licensed Professional Clinical Counselor (LPCC) by the State of California Board of Behavioral Science Examiners? Note: Possession of a license is not mandatory to be qualified for this recruitment.

Yes
No
No, but I am licensed in another state
 

If you answered yes, please provide your California Board of Behavioral Science license number.

6.

If you do not possess California licensure, are you currently registered by the California Board of Behavioral Sciences as an Associate Marriage and Family Therapist (AMFT), Associate Clinical Social Worker (ACSW), or Associate Professional Clinical Counselor (APCC)? Note: Registration is not mandatory to be qualified for this recruitment.

Yes
No
No, but I am registered in another state
 

If you answered yes, please provide your California Board of Behavioral Science registration number.


 

PART IV - TRAINING AND EXPERIENCE EXAMINATION (SCORED)

This section of the supplemental questionnaire will serve as the examination for this recruitment and will be scored using a pre-determined formula, based on applicants’ checked responses.  Scores from this evaluation will determine applicant ranking and placement on the eligible list.

Instructions: For each item, please select the option that best corresponds with your relevant training and/or experience. Please thoroughly and accurately complete all text boxes. Responses may be used as a non-scored writing sample for the hiring authority.


1.

Describe your experience with crisis intervention and conflict resolution practices including managing of assaultive behavior, and principles of social work related to child protective services and adult services, risk and safety assessments.

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. If you do not have any experience, please enter "no experience."

2.

Describe your experience preparing relevant correspondence and reports, including for court documents.

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. If you do not have any experience, please enter "no experience."

3.

Describe your experience participating in or conducting comprehensive individual and/or family psychosocial assessments for problem identification and diagnosis.

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.
4.

Describe your experience developing, administering, and reviewing long and short term treatment plans, with the goal of improving or restoring individual or family functioning.

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. If you do not have any experience, please enter "no experience."

5.

Describe your experience performing case management duties including treatment plan monitoring, advocacy, referral and linkage to other needed services, and crisis intervention.

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.
6.

Describe your experience evaluating client needs relative to appropriate program referrals.

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.
7.

Describe your experience establishing and maintaining casework records and documents in accordance with departmental and statutory regulations and procedures.

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.
8.

Describe your experience developing, maintaining and participating in an inter-agency and community networking/referral system.

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. If you do not have any experience, please enter "no experience."

9.

Describe your experience utilizing pertinent federal, state and local statutes and regulations governing public health and welfare services in your daily work.

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. If you do not have any experience, please enter "no experience."


 

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