Please complete the following supplemental questionnaire. This questionnaire is considered an extension of your employment application and will be reviewed to help assess your qualifications. Resumes are not accepted in lieu of completing this questionnaire.
1.
PATTERN I
Do you possess at least one year of full-time paid experience as a Behavioral Health Outreach Worker Trainee with San Joaquin County?
Yes
No
If you answered yes, please identify the department/unit you worked for as a Behavioral Health Outreach Worker Trainee, dates of employment, and number of hours worked per week:
2.
PATTERN II
Please indicate if you possess at least one year of full-time paid responsible work experience in one of the following:
Note: Volunteer experience will not count towards this requirement.
Providing community based mental health services
Working with community based organizations that provide mental health related services to culturally diverse groups
Working with seriously and persistently mentally ill adults or severely mentally disabled children
None of the above
3.
FOR BOTH PATTERNS
Please indicate if you are recognized as a/an:
Designated consumer of mental health services
Immediate family member of a consumer with serious mental health needs
None of the above
3a.
If you are or have in the past been a consumer of mental health services or substance use disorder services, provide the name of the agency or provider from which you received services, and the length of time you received services. Do not disclose the medical/mental illness.
3b.
If you are an immediate family member of a consumer with serious mental health needs, or a substance use disorder please identify your relationship to the family member, the length of time your family member received services, and the name of the agency or provider from which your family member received services. Do not disclose the medical/mental illness.
Note: Immediate family member is Spouse, Child, Parent, Sibling, or Grandparent.
4.
This position requires possession of a valid California driver's license. Please provide your license number and expiration date.
San Joaquin County Human Resources Division