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#0419-RP2515-01
Supplemental Questionnaire

Last Name
First Name

 

FOR BOTH PATTERNS


1.

Do you possess a valid California driver's license?
Yes No
2.

PATTERN I

Do you have one year of experience as a Juvenile Detention Unit Supervisor with San Joaquin County?
Yes No

3.

If you answered "yes" to Question 2, it is not necessary to answer Questions 4-6.
4.

PATTERN II - Education

Did you graduate from an accredited four-year college or university with a minimum of 18 (eighteen) units in the social or behavioral sciences?
Yes No
5.

If you answered "yes" to Question 4, list the 18 (eighteen) units in the social or behavioral sciences below.  Example: Child Psychology, 4 units.
6.

PATTERN II - Experience

Describe at least one year of your experience in a supervisory capacity in the supervision, observation and assessment of juveniles in a detention or residential treatment facility.  List the employer name, whether it was a detention or residential treatment facility, the age range of the clients served, your job title, the titles of the employees you supervised, how many employees you supervised, dates of employment, hours worked per week, and a detailed description of your duties.