The purpose of this Supplemental Questionnaire is to assist with evaluating possession of the required Minimum Qualifications, Special Conditions, and Conditions of Employment for the DPH BHS 2576 Supervising Clinical Psychologist positions.
IMPORTANT NOTE: Attaching a resume does not substitute for submitting a completed application. Your application’s Education, Professional Licenses, Certifications, or Registrations, and Employment Record sections should clearly demonstrate how you satisfy this position’s Minimum Qualifications. Do NOTtype “see resume” or leave the above-mentioned application sections blank.
It is suggested that you allow ample time to submit your application and Supplemental Questionnaire responses before the filing deadline. If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with and supported by the information on your application (i.e. Professional Licenses, Certifications, or Registrations & Employment Record sections) and are subject to verification at any time.
As a reminder, all qualifying licensure, registration, certification, and experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the licensure, registration, certification, and experience you are about to describe in the applicable sections of your application, you will not receive credit. If you are copying an old application, please take the time to update applicable sections before submitting your application.
1.
Do you have a valid Psychologist license issued by the California Board of Psychology?
Yes
No
2.
How much full-time experience do you have as a practicing Clinical Psychologist?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have some, but less than one (1) year of this experience
I have at least one (1) year, but less than two (2) years of this experience
I have at least two (2) years, but less than three (3) years of this experience
I have at least three (3) years, but less than four (4) years of this experience
I have at least four (4) years, but less than five (5) years of this experience
I have five (5) years or more of this experience
I don't have any of this experience
3.
SPECIAL CONDITION FOR CHILDREN, YOUTH AND FAMILIES SYSTEM OF CARE
How much full-time clinical experience do you have working with children?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have experience working with children, but it was not clinicial
I have some, but less than one (1) year of this experience
I have at least one (1) year, but less than two (2) years of this experience
I have at least two (2) years, but less than three (3) years of this experience
I have at least three (3) years, but less than four (4) years of this experience
I have at least four (4) years, but less than five (5) years of this experience
I have five (5) years or more of this experience
I don't have any of this experience
4.
CONDITION OF EMPLOYMENT FOR COMPREHENSIVE CRISIS SERVICES
Do you have the ability to: work directly with high-risk clients in the field, responding to potentially dangerous, crisis situations (including shootings and homicides) throughout San Francisco AND perform crisis assessments/interventions in the field/office/ER, including mental status examinations, interpretation of psychiatric symptoms, interface with collateral parties, completion of 5150 application, transport of client, and linkage to appropriate services?
Yes
No
CERTIFICATION: I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.
Department of Human Resources