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Placer County Human Resources Department
#2017-14463-03


Supplemental Questionnaire

Last Name First Name
 

 

CLIENT SERVICES PRACTITIONER - I

Supplemental Questionnaire



 

The following supplemental questionnaire is the examination for this recruitment and will be used to determine your examination score.  Note: The supplemental questionnaire and the application are administered as two separate documents.  The supplemental questionnaire is the only item used to determine your examination score which will, in turn, determine your ranking and placement on the eligible list. 

By continuing in this examination process, you are certifying that all information provided in the supplemental questionnaire is true to the best of your knowledge.


 

I have read and understood the above information.


 

SECTION I - MQ SCREENING (NOT SCORED)

This section will not be scored but may assist with determining how the applicant reports meeting the minimum qualifications for this classification. 


1.

Do you possess a Master's degree from an accredited college or university with major course work in social work, psychology or counseling, which meets the eligibility requirements for licensure a Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT) or Licensed Professional Clinical Counselor (LPCC) by the State Board of Behavioral Science Examiners? (Note: Possession of a license is not mandatory to be qualified for this recruitment; however, a Master’s degree in social work, psychology or counseling must be obtained by date of appointment.)

Yes No
1a.

If you answered no, when do you anticipate receiving the required degree?


 

SECTION II - SPECIALIZED SKILLS, EXPERIENCE, AND/OR LICENSURE (NOT SCORED)

Please note that indicating "No" to any questions in this section does not exclude you from participation in this recruitment. Note: Applicants indicating "Yes" to being bilingual may be required to demonstrate their proficiency via participating in a Placer County administered Language Skills Examination as part of the selection process. Upon successful completion of a foreign language proficiency exam, an additional 5% bilingual pay will be paid to employees who use a second language on a regular basis in the normal course of business.



 

Bilingual


1.

Are you English/Spanish Bilingual?

Yes No
2.

Are you English/Russian Bilingual?

Yes No

 

Native American


3.

Are you interested in working with Native American families as part of a Native Service Team?

Yes No
4.

What special skills, education, or experience do you have working with Native Families?

5.

What experience do you have working with community partners and/or cultural brokers?


 

Lived Experience


6.

Do you possess lived experience receiving mental health services for self and/or a family member? Note: If you check “Yes” and are selected for an interview, you may be asked to provide a description of such lived experience relevant to the program assignment, absent any confidential medical information.

Yes No

 

License/Certification


7.

Do you possess licensure as a Licensed Clinical Social Worker (LCSW) or Licensed Marriage Family Therapist (LMFT) by the State of California Board of Behavioral Science Examiners? Note: Possession of a license is not mandatory to be qualified for this recruitment.

Yes No
7a.

If you answered yes, please provide your California Board of Behavioral Science license number(s).

8.

If you do not possess the above license(s), are you currently registered by the California Board of Behavioral Sciences as a Marriage and Family Therapist Intern (MFTI) or Associate Clinical Social Worker (ACSW)? Note: Registration is not mandatory to be qualified for this recruitment.

Yes No
8a.

If you answered yes, please provide your California Board of Behavioral Sciences registration number(s).


 

SECTION III - TRAINING AND EXPERIENCE EXAMINATION (SCORED)



 

This section of the supplemental questionnaire will serve as the examination for this recruitment and will be scored using a pre-determined formula, based on applicants’ checked responses.  Scores from this evaluation will determine applicant ranking and placement on the eligible list.

Instructions: For each item, please select the option that best corresponds with your relevant training and/or experience.


1.

I have worked and/or completed an internship as part of my educational program in the following areas:

Counseling
Adult protective services
Child protective services
Children's mental health
Medical social work
Family services
Community organization
Social research
Substance use disorders
Severely & persistently mentally ill
Forensic mental illness
Other related areas
2.

Knowledge of child welfare laws:

I possess none or a very little amount of this knowledge.
I possess this knowledge, but have not applied it in a job/internship setting.
I have applied this knowledge under close supervision.
I have applied this knowledge independently under normal supervision.
I have used this knowledge to train or provide consultation to others.
3.

Knowledge of Adult Protective Services laws:

I possess none or a very little amount of this knowledge.
I possess this knowledge, but have not applied it in a job/internship setting.
I have applied this knowledge under close supervision.
I have applied this knowledge independently under normal supervision.
I have used this knowledge to train or provide consultation to others.
4.

Conducting home, site, or field visits with clients and/or transporting clients in a service provider or public agency role:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
5.

Participating in or conducting comprehensive individual and/or family psychosocial assessments for problem identification and diagnosis:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
6.

Developing and administering long and short term treatment plans, with the goal of improving or restoring individual or family functioning:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
7.

Relating effectively and positively while providing professional services to clients in circumstances in which their physical or emotional welfare is involved, including cases of neglect, emotional/behavioral problems, physical/mental disabilities:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
8.

Performing case management duties including treatment plan monitoring, advocacy, referral and linkage to other needed services, and crisis interventions:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
9.

Creating and maintaining casework records and documents such as progress notes, treatment plans and case histories:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.
10.

Working with individuals who have severe and persistent mental illness or are emotionally disturbed:

I have none or a very little amount of experience performing this task.
I have been trained on how to complete this task but have not done so in a job setting.
I have experience performing this task under close supervision.
I have experience performing this task under normal supervision
I have experience performing this task and have trained and/or provided consultation to others.

 

SECTION IV – ADDITIONAL TRAINING AND EXPERIENCE (NOT SCORED)


1.

Based on your selections in Section III, please describe any additional experience and training related to questions 1-10.  Your response to this section will not be scored, but may be used by the hiring department for the purposes of screening and identifying which applicants to invite to the hiring interview.


 

SECTION V – SERVICE ASSIGNMENT PREFERENCE (NOT SCORED)



 

Responses for Section V may be used as selection criteria for specific assignments.

Client Services Practitioners perform a broad spectrum of duties ranging from providing direct services/case management support to those faced with difficult situations, emotional stresses, or significant change in their lives to clinically diagnosing emotional, behavioral or mental health disorders in individuals.  Not only do Client Services Practitioners assist individuals to cope with the situation at hand, they advocate for them and seek out valuable resources and other means of support for the affected person(s).

Client Services Practitioner assignments within Placer County vary in terms of the nature of professional services provided and the population served.


 

Please select the service areas in which you possess interest and/or experience in:

Professional Services

Direct/Case Management Services: Direct/Case Management service assignments have a strong focus on client and system strengths and the development of self-care skills that go beyond the disease and symptom focus of a diagnosis. The overall focus of direct services and case worker assignments is built on the bio-psychosocial model which uses a person-in environment perspective to assess strengths and challenges within a systems framework and may incorporate therapy, public or private organizations, case management, administration, and more. Many times work will involve counseling/therapy and helping clients with whatever issues they may be having. This can range from working with individuals to secure a new job, to coordinating rehabilitation programs, and more. Typically, these assignments do not require licensure.
Clinical/Therapeutic Services: Clinical/Therapeutic Service assignments address individual and family problems such as serious illness, substance abuse, and domestic conflict. The majority of work will be done in a clinical setting and typically encompasses psychotherapy, formal counseling, skill development, psycho-educational, and more. Some clinical/therapy assignments may require licensure.
 

Service Focus

Child Welfare Services
Mental Health
Substance Use Disorders
Homeless Services
Employment
Older Adult Services
Public Health
Whole Person Care (physical health, behavioral health, and social services)
Emergency After Hours/Child Protective Services Response
Co-Occurring Diagnosis
Criminogenic/Forensic
Perinatal
Wraparound (Children Services)
Adoptions/Permanency (Children Services)
 

Age of Population Served

Children/Adolescent
Transition Age Youth (17 years to 23 years of age)
Adult
Older Adult (65 and over)

 

Thank you for completing the examination portion of the application process. We encourage applicants to review their answers for accuracy prior to submitting.

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 Be sure to select the "Submit" button once the application has been completed. You will receive an email confirmation that the application has been submitted. A notice of your status will be sent to you after the posted final filing date.