Official SealHuman Resource Services Department


#20-6640-01
Supplemental Questionnaire

Last Name
First Name
 

Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants. 

Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position.  Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process.  A resume will not be accepted as a substitute for properly completed responses.

Information provided in your responses to the supplemental questionnaire regarding your employment experiences must also be detailed in the Work Experience section of the application for this recruitment.  Please be sure to list all employers and required information, on your application, especially if you are referencing those employers in your responses to the supplemental questions.

The supplemental questions were designed to elicit your experience as it relates to the current recruitment in order to identify the best qualified candidates for this position.  Only the best and most suitably qualified candidates will be invited to participate in the oral interviews. 

By selecting yes below, you certify your understanding that all applicants who meet minimum qualifications are not guaranteed to move forward in the process.  Do you understand the above statement?

Yes No
1.

Please describe your experience providing rehabilitation counseling services to the disabled or individuals in substance abuse recovery within a criminal justice or comparable detention setting. In your response, be sure to include the name of your employer, the duration of your employment, your title, role and level of responsibility.

2.

The position in the Vocational Services Program has been designated with additional job-related requirements. Please describe your experience providing rehabilitation counseling services to the disabled or individuals in substance abuse recovery as a vocational counselor, vocational case manager, or serving in an employment related position which is comparable.   In your response, be sure to include the name of your employer, the duration of your employment, your title, role and level of responsibility.

3.

This position requires applicants to possess a valid California Motor Vehicle Operator's license. In the space provided below, please provide your license class, number, and expiration date.

4.

In compliance with the Administrative Simplification provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), employees in this classification are required to possess a National Provider Identifier (NPI) number prior to their first day on the job. Can you meet this criteria?

Yes No