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 Mental Health Outreach Worker Trainee with San Joaquin County?
Yes
No
If you answered Yes, please identify the department/unit you worked for as a Mental 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
Based on your selection(s) above, please describe your one year of full-time, paid, related work experience. Include the name of your employer, dates of employment, job title, number of hours worked per week, and a detailed description of job duties performed.
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 a consumer of mental health services, provide the 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, 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.
5.
Many of the positions require working rotating shifts, which include evenings, nights, weekends, and holidays. Please indicate if you are available to work these shifts.
Yes
No
6.
Please indicate which of the following divisions in the Behavioral Health Services Department you would be willing to accept job referrals to:
NOTE: You will be refer only to the division(s) that you have selected.
ADMINISTRATION (includes Accounting, Quality Improvement, Information Systems, Medical Records, Personnel, Maintenance, Housekeeping)
CYS - Children & Youth Services
ADULTS- Outpatient Clinics
JDD - Justice Decriminalization Division
SAS - Substance Abuse Services (includes Family Ties, Recovery House, and Chemical Dependency Counseling Center)
San Joaquin County Human Resources Division