Official SealSan Joaquin County Human Resources Division


#0822-RS3415-AC
Supplemental Questionnaire

Last Name
First Name
1.

Please mark the box that matches the education you possess. (Check all that apply):

I possess a Master's degree in Social Work (MSW) from a recognized school of social work based on a two-year program that included supervised field placement.
I possess a Master's degree from an accredited college or university in counseling with a specialization in Marriage and Family Therapy (M.F.T.) based on a two year program with coursework sufficient to meet State standards for an M.F.T. license which included supervised field placement as part of the course. (Verification must include the possession of an M.F.T. internship number).
I possess a current M.F.T. license with the State of California.
I do not possess any of the education and/or licenses noted above.
1A.

Please note the educational institutation in which you obtained your Master's in Social Work. If you do not possess an MSW, please annotate "N/A".

1B.

Please note your M.F.T. Internship or Associate MFT number below. If you do not possess an M.F.T. Internship or Associate MFT number, please annotate "N/A".

1C.

Please provide your State of California M.F.T. license number below. If you do not possess an M.F.T. license, please annotate "N/A".

2.

Please mark the box that matches the social casework experience you possess. (Check all that apply):

I possess one (1) year of post-qualifying Master's degree paid social casework experience as a Social Worker V in San Joaquin County.
I possess at least three (3) years of paid full-time post-master's social casework experience.
I possess less than three (3) years of paid full-time post-master's social casework experience.
I do not possess any years of paid full-time post-master's social casework experience.
2A.

Provide a detailed description of the paid, full-time post-master's social casework you possess. Include in your answer: Your role and participation in court hearings and providing testimony, the clients you served, services and outreach provided, experience in home visits, crisis intervention and if you have ever been a lead or supervisor over social workers.

3.

This position requires possession of a valid California driver's license. Please provide your license number and expiration date below:

4.

This recruitment will be used to fill positions with Child Protective Services (CPS) and Adult Protective Services (APS). Please indicate your interest in referral below:

I would like to be referred for interviews in both CPS and APS.
I am only interested in being referred for interviews in CPS.
I am only interested in being referred for interviews in APS.

 

The following are for informational purposes only and will not be used to screen for the minimum qualifications.


 

Adult Protective Services provides emergency intervention to dependent adults and seniors, investigates allegations of abuse, intervenes when necessary, and provides community resources and education when needed. Do you have social casework experience working with seniors and dependent adults in the aforementioned areas? If yes, please describe in detail your social casework experience in working with older adults, dependent adults, and elder abuse. In your response, please include your job title, employer, and dates of employment.

If you do not have experience in these areas, please enter N/A for your response. 

 

Child Protective Services is the major system of intervention of child abuse and neglect in California and they investigate allegations of child abuse, including physical, emotional, and sexual abuse, and neglect. Do you have social casework experience working in a child protective setting that includes the aforementioned areas? If yes, please describe in detail your social casework experience working in a child protective setting. 

If you do not have experience in the above areas, please enter N/A for your response.