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Human Resources Department
#22-344020-01


Supplemental Questionnaire

Last Name First Name
 

 

This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and whether they will continue in the recruitment process; therefore, applicants are encouraged to answer all questions thoroughly and completely.  In your response, please include employer name and dates of employment. Omitted information will not be considered or assumed.  Applicants who have no experience in a specific area are recommended to state "no experience in this area" instead of leaving the space blank.


1

Which best describes your experience and education from an accredited college or university? 

NOTE: Depending on how you qualify, candidates must submit a copy of their college diploma (verifying the degree, date earned, and area of specialization); official/unofficial transcripts (verifying the student, institution, courses and units completed, degree conferred and degree conferral date); or a letter from their school verifying good standing in the Title IV-E program and the anticipated graduation date.

Two years of experience equivalent to the Social Worker II in Solano County
Equivalent to graduation from a four-year accredited college or university with coursework that has preferably included thirty (30) semester units in social welfare, sociology, psychology, counseling, gerontology, vocational guidance or other related behavioral science, AND Three years of experience performing professional level social work with a public social services agency or private social services provider. (Preferably including substantial experience with abused/neglected children and/or adults)
Possession of a Master's degree in Social Services (MSW) or a two year graduate level counseling degree emphasizing marriage, family and child counseling, gerontology, or clinical psychology. (Both the MSW and the two-year counseling degree must have included supervised fieldwork or an internship). This requirement may be met by a letter from an accredited college or university that states current enrollment in a Master's degree program and confirms graduation with a Master's degree in Social Services (MSW) will be conferred within three (3) months, AND Two years of experience performing social work with a public social services agency or private social services provider. (Preferably including substantial experience with abused/neglected children and/or adults). This requirement may be met by completion of a two (2) year social work internship through an accredited college or university.
None of the above
2

If you are in the process of obtaining a Master's degree in Social Work, please provide your anticipated graduation date, otherwise type in "N/A."

NOTE: As mentioned in Question 1, applicant's who have not yet obtained their MSW must submit a letter from their school)

3

Select the work experience (may include internship experience) that you have working the following. Choose all that apply.

I have no experience working within Child Welfare
I have no experience working with Adult Protective Services
Investigations and/or Emergency Response
Ongoing Programs (Court/Dependency Investigations, Family Maintenance/Family Reunification, Permanency Placement, Nonminor Dependents, Adoptions)
Specialized Programs (non-case carrying/non-investigatory) (Hotline/Intake, Resource Family Approval, Placement Support)
Foster Family Agency/In Home Support Services or Public Assistance Case Management
Determining additional Supportive Services/referrals for (older and disabled clients, CalWorks)
Other agency type where you provided case management to clients, assessing client’s functioning, developed service/case plans, etc.

 

Please indicate your level of experience with the following:


4

Write and modify Case Plans:

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
5

Experience utilizing CWS/CMS 

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
6

Conduct monthly planned compliance visits

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
7

Facilitate/lead multi-disciplinary team meetings:

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
8

Investigate abuse and neglect:

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
9

Worked with involuntary or reluctant clients:

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
10

Writings of any type that were submitted to a court setting or whose results have legal ramifications:

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
11

Conducted Social Work including field visits in risky settings to serve clients (i.e. homeless encampments, areas of high crime, jail settings, psychiatric settings):

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
12

Lead or participate in client-centered team planning meetings (i.e. Child & Family Team, Wraparound, etc.):

Novice (less than 3 years)
Experienced (3-6 years)
Proficient (greater than 6 years)
13

Which statements describes your experience conducting home visits with clients(select all that apply):

I have no experience in this area
I have conducted Foster Family Agency Social Worker Home visits
I have provided Supported Services (i.e. Therapeutic Behavioral Services, Clinical Services, 1:1 support) as part of Wraparound services to a foster child/youth and their caregiver
I have conducted County home visits for Public Health, Mental Health, In Home Support Services, Employment and Eligibility Services, Older and Disabled and/or Probation
14

Which statements reflect the area in which you have experience as a Social Worker (select all that apply):

I have no experience in this area
I have worked with children within the educational system
I have worked with children within the juvenile justice system
I have worked with children, adults or disabled adults within a mental health agency or setting
I have worked with children, adults or disabled adults within a welfare services agency
I have worked with children, adults or older disabled adults who have been victims of abuse
I have worked with adults, children, or families experiencing homelessness
I have worked with adults, or older disabled adults within In Home Support and/or Adult Protective Services
15

Some positions may require bilingual skills.  Applicants who indicate bilingual skills in their application may be required to demonstrate proficiency in speaking, reading and writing in the language indicated.

Are you proficient in speaking, reading and writing any of the following languages? (select all that apply)   

                 

Spanish
Tagalog
Vietnamese
None