Official SealHuman Resource Services Department


#23-6531-01
Supplemental Questionnaire

Last Name
First Name
1.

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. They must be appropriately completed to be fully considered for the next phase in the selection process. Your responses will also be evaluated and used in the selection process to identify the best-qualified applicants. 

Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and 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 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 related to the current recruitment 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
2.

Possession of a valid clinical license from one of the applicable licensing authorities: California Board of Behavioral Sciences, California Board of Psychology, or California Board of Nursing, is preferred, but not required.  If you possess a license, please provide the following information in the space below:

  • License Title
  • Licensing Authority
  • License Effective Date
  • License Expiration Date
3.

Please describe your post-license professional experience as a clinical supervisor coordinating the day-to-day operations and staff coverage of a mental health/behavioral health clinic/program, providing psychiatric, substance abuse, crisis, clinical, and case management services, and supervising behavioral health clinicians and other health care professionals.  In your response, include the organization where you worked, duration of the experience (employment dates), your title, your role and description of primary related responsibilities, the number of staff, and titles of those you supervised. 

4.

Describe your experience providing leadership to a multidisciplinary team of behavioral health professionals within a high-volume clinic and/or program providing services to clients with serious behavioral health issues.  Include any specific experience you have working with a large intensive caseload and/or working within a justice mental health setting such as a detention center, court, or with justice involved clients.

5.

Please tell us what you consider to be the most important characteristics or principles that a clinical and/or program manager working in a behavioral health care crisis or justice system should possess to be successful.  Describe a situation in which you have demonstrated those characteristics or principles.

 

Collaborating with internal staff and external partners is an integral part of the manager position. Please describe your experience establishing and maintaining effective work relationships.


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