Department of Human Resources

2314 Behavioral Health Team Leader
Supplemental Questionnaire

All applicants are required to complete the Supplemental Questionnaire as part of the online application process. The questionnaire will be used to (1) assess each candidate's possession of the minimum qualifications and (2) determine each candidate's score on the Training and Experience Evaluation as described on the examination announcement.

Responses to supplemental questionnaire items must be supported by the information provided in the body of your application (i.e. education and training/employment record section) in order to receive appropriate credit, and are subject to verification. Verification of experience, licensure, and possession of valid certifications/certificates may be collected at any time during or after the selection process.

Resumes are NOT to be used or reviewed to determine whether you meet the minimum qualifications or to determine your score/rank. A resume should NOT be submitted to substitute for a complete application. If you write "See Resume" on the application or on the Supplemental Questionnaire, your application may be rejected. Verification of experience, licensure, and possession of valid certifications/registrations may be collected at any time.

If you experience technical difficulties, make note of any error messages and contact the Analyst prior to the filing deadline.

PART ONE: EXPERIENCE AND LICENSES

This section of the Supplemental Questionnaire will be used to determine if you meet the minimum qualifications of a 2314 Behavioral Health Team Leader.

INSTRUCTIONS: For Questions 1 and 2, please answer by choosing the best response that matches your experience and licenses.

Do you possess a valid permanent or temporary (including an interim permit) Licensed Vocational Nurse (LVN) or Licensed Psychiatric Technician (PT) License issued by the State of California?

As a reminder, all licenses, certifications and registrations must be listed in the "Professional Licenses , Certification or Registrations" section of your application in order to be considered in review of Minimum Qualifications. If you do not include the licenses, certifications and registrations in your application, you will not receive credit for this experience. If you are copying from an old application, please take the time to update the appropriate sections before submitting your application.

How much verifiable full-time experience do you have providing psychiatric care as a Licensed Vocational Nurse (LVN) or a Licensed Psychiatric Technician (PT) in a skilled nursing facility, psychiatric acute care setting, or related mental health setting? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the "Employment Record" section of your application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

PART TWO: TRAINING AND EXPERIENCE EVALUATION

This section of the Supplemental Questionnaire will be used to determine each candidate's score on the Training and Experience Evaluation, as described on the examination announcement.

INSTRUCTIONS: For Questions 3-8:

• Review the questions first, prepare and save your response in a word processing document, and then paste them into the online Supplemental Questionnaire.
• Be concise, but thorough. Ensure that you address all parts of the question. Your written communication skills we be evaluated based on your responses.
• Ensure that your responses are sufficiently detailed to assist in evaluating your knowledge, skills and abilities.
• Provide your best or highest examples of work.
• Answer all questions independently (e.g., do not reference your responses in prior questions). Provide all information requested even if they appear redundant. Do not write "See Application" or "See Resume" as a response.
• If you do not have experience that related to the question(s) below, please enter "N/A" as your response.

Which of the following valid American Heart Association Cardiopulmonary Resuscitation (CPR) Certificates do you possess?

As a reminder, all licenses, certifications and registrations must be listed in the "Professional Licenses, Certifications and Registrations" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide your name and the expiration date for each of the American Heart Association CPR Certificates you selected in Question 3a. If you answered "None of the above" to Question 3a, please provide an explanation.

How much verifiable full-time equivalent work experience do you have as a health care provider treating patients with Co-Occurring Disorders with Substance Abuse? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the "Employment Record" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable full-time equivalent professional work experience as indicated in Question 4a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”

Please provide a detailed description of your verifiable professional work experience as indicated in Question 4a.

In your answer, include details about your specific role, your primary duties, and your responsibilities for all positions where you gained your experience. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type "See Resume."

How much verifiable full-time equivalent work experience do you have as a team lead, supervisor, or subject matter expert consultant, which includes developing care plans, service plans, and/or treatment plans? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the "Employment Record" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable full-time equivalent professional work experience as indicated in Question 5a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”

Please provide a detailed description of your verifiable professional work experience as indicated in Question 5a.

In your answer, include details about your specific role, your primary duties, and your responsibilities for all positions where you gained your experience. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type "See Resume."

How much verifiable full-time experience do you have treating patients who have psychotic disorders (schizophrenia, schizo-affective disorder, bipolar disorder with psychotic features, etc.)? (Full-time experience is equivalent to 40 hours per week.)

As a reminder, all experience must be listed in the "Employment Record" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable full-time equivalent professional work experience as indicated in Question 6a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”

Please provide a detailed description of your verifiable professional work experience as indicated in Question 6a.

In your answer, include details about your specific role, your primary duties, and your responsibilities for all positions where you gained your experience. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type "See Resume."

Please select the populations you have worked with as a provider of mental health services for at least 6 months (equivalent to 1,000 hours).

As a reminder, all experience must be listed in the "Employment Record" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable full-time equivalent professional work experience as indicated in Question 7a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”

Which of the following Certifications do you possess?

As a reminder, all licenses, certifications and registrations must be listed in the "Professional Licenses, Certifications and Registrations" section of your application in order to receive credit. If you are copying an old application, please take the time to update the appropriate sections before submitting your application.

Please provide your Certification number, your name as it appears on your Certification, and the expiration date, if any, for each of the Certifications you selected in Question 8a. If you selected "None of the above" in Question 8A., please type "N/A".