Department of Human Resources

#PBT-0932-108833
Supplemental Questionnaire

Last Name
First Name

0932 Director of Jail Health Behavioral Health Re-entry Services - PBT-0932-108833
MINIMUM QUALIFICATION SUPPLEMENTAL QUESTIONNAIRE

The purpose of this Minimum Qualification Supplemental Questionnaire (MQSQ) is to obtain specific information regarding your education, experience, and/or training in relation to the minimum qualifications for this recruitment, as stated on the announcement and will be used as a tool to screen applications for the minimum qualification requirements. This Minimum Qualification Supplemental Questionnaire (MQSQ) must be completed and submitted online with the application at the time of filing. Responses to items on on the MQSQ must be supported by the information provided on the application and is subject to verification.

Please be sure to include all relevant education and experience in the work history and education sections of the application. It is essential that you provide complete information in identifying your education, experience, and training. A resume will not substitute for a completed application. If you write "See Resume" on the application or on the below questionnaire, your application may be rejected. Resumes will not be reviewed.

Note: Falsifying one's education, training, or work experience or attempted deception on the application or Minimum Qualification Supplemental Questionnaire may result in disqualification for this and future job opportunities with the City and County of San Francisco.

VERIFICATION MAY BE REQUESTED AND REQUIRED AT ANY TIME.

Select the statement that best matches the highest level of education you have completed. Do not include courses in progress.

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

No formal college/university education

Attended some college, succesful completion of less than 30 semester units / 45 quarter units of coursework from an accredited college or university.

Attended some college, succesful completion of at least 30 semester units / 45 quarter units but less than 60 semester units / 90 quarter units of coursework from an accredited college or university.

Attended some college, successful completion of at least 60 semester units / 90 quarter units but less than 90 semester units / 135 quarter units of coursework from an accredited college or university.

Attended some college, successful completion of at least 90+ semester units / 135+ quarter units of coursework from an accredited college or university but less than a Bachelor's degree.

Bachelor's Degree from an accredited college/university

At least thirty (30) semester units or forty-five (45) quarter units towards a Master's Degree

Master's Degree from an accredited college/university

Doctorate Degree from an accredited college/university

For the education you indicated above, please identify your verifiable major program of study:

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

Verification may be required at any time.

Social Work

Counseling

Marriage and Family Therapy

Other major - similar to Social Work, Counseling

Other major - not similar to Social Work, Counseling

Not applicable, I have not completed enough courses to possess a major

Note: The major of Counseling listed above refers to Clinical Counseling

How much verifiable experience do you possess providing and overseeing behavioral health services in a correctional setting? (2000 hours = 1 year)

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

This information is subject to verification. Verification may be required at any time in the selection process.

I do not have verifiable experience providing and overseeing behavioral health services in a correctional setting

I have less than 1 year (2,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 1 year (2,000 hours) but less than 2 years (4,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 2 years (4,000 hours) but less than 3 years (6,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 3 years (6,000 hours) but less than 4 years (8,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 4 years (8,000 hours) but less than 5 years (10,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 5 years (10,000 hours) but less than 6 years (12,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 6 years (12,000 hours) but less than 7 years (14,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have at least 7 years (14,000 hours) but less than 8 years (16,000 hours) of verifiable experience providing and overseeing behavioral health services in a correctional setting

I have 8 years (16,000 hours) or more of verifiable experience providing and overseeing behavioral health services in a correctional setting

Of the experience you listed above, how much of that experience included supervising behavioral health professionals? Note: 2,000 hours of experience is equivalent to 1 year of experience.

I do not have verifiable experience supervising behavioral health professionals in a correctional setting.

I have less than 6 months of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 6 months but less than 1 year (2,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 1 year (2,000 hours) but less than 2 years (4,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 2 years (4,000 hours) but less than 3 years (6,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 3 years (6,000 hours) but less than 4 years (8,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 4 years (8,000 hours) but less than 5 years (10,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 5 years (10,000 hours) but less than 6 years (12,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 6 years (12,000 hours) but less than 7 years (14,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have at least 7 years (14,000 hours) but less than 8 years (16,000 hours) of verifiable experience supervising behavioral health professionals in a correctional setting.

I have 8 years (16,000 hours) or more of verifiable experience supervising behavioral health professionals in a correctional setting.

Do you possess one of the following licenses?

Licensed Certified Social Worker (LCSW) issued by the California Board of Behavioral Sciences; OR
Licensed Marriage and Family Therapist (LMFT) issued by by the California Board of Behavioral Sciences; OR
Licensed Professional Clinical Counselor (LPCC) issued by the California Board of Behavioral Sciences

(If yes, please be sure to indicate this information your online application)

Yes No

Do you possess a Psychologist license issued by the CA Board of Psychology?

(If yes, please indicate this information on your application)

Yes No

CERTIFICATION: By checking this box, I hereby certify that I am the author of the information supplied in this supplemental questionnaire. I understand that any false or incorrect statements may result in my disqualification or dismissal from employment with the San Francisco Department of Public Health and the City and County of San Francisco. I also understand and agree that the information provided is subject to verification.

Department of Human Resources

#PBT-0932-108833 Supplemental Questionnaire

#PBT-0932-108833
Supplemental Questionnaire