Official SealDepartment of Human Resources


#CBT-2305-107840
Supplemental Questionnaire

Last Name
First Name

 

2305 PSYCHIATRIC TECHNICIAN

   SUPPLEMENTAL QUESTIONNAIRE EXAMINATION

PLEASE READ THE FOLLOWING EXAM INSTRUCTIONS CAREFULLY AS THEY CONTAIN INFORMATION THAT MAY AFFECT YOUR EXAMINATION SCORE AND RANK ON THE ELIGIBLE LIST

The 2305 Psychiatric Technician examination will consist solely of this Supplemental Questionnaire. The quality of your responses will account for 100% of the total weight of your final score.  Candidates will be placed on the eligible list in rank order according to their final score.  A passing score must be achieved in order to be placed on the eligible list.

The purpose of this Supplemental Questionnaire is 1) to determine if you meet the Minimum Qualifications for class 2305 Psychiatric Technician; AND 2) to determine knowledge, skills and abilities in job related areas identified as critical for satisfactory performance in this position (please refer to the job announcement for a more detailed description of these knowledge, skills, and abilities).

PART ONE: LICENSE AND CERTIFICATION QUALIFICATIONS

INSTRUCTIONS FOR QUESTION A AND B: Question A will be used to assess possession of the required license for this position.  Question B will be used to assess possession of the required CPR certificate, which is a condition of employment for this position. Please answer by choosing the best response that matches your license and certification qualifications.  

 *If you have technical difficulties, make note of any error messages and contact the analyst BEFORE the filing deadline. 


 

By checking this box, I acknowledge that I have read, understood, and agreed to the listed instructions for Part one (as described above) and Part Two (as described below) regarding the Supplemental Questionnaire Examination.

 

A.  Do you possess a valid PSYCHIATRIC TECHNICIAN LICENSE issued by the California Board of Vocational Nursing and Psychiatric Technicians?

 

Yes No
 

Please provide the following information about your valid California Psychiatric Technician LIcense issued by the California Board of Vocational Nursing and Psychiatric Technicians:

  1. License Number
  2. Issue Date (MM/DD/YYYY)
  3. Expiration Date (MM/DD/YYYY)
  4. Your Name as it appears on your license

If you do not possess a Psychiatric Technician License, please type N/A.

 

B.   Which of the following valid American Heart Association Cardiopulmonary Resuscitation (CPR) certificates do you possess? (check all that apply)

 

Basic Life Support (BLS) for Healthcare Providers
Pediatric Advanced Life Support (PALS)
Advanced Cardiovascular Life Support (ACLS)
None of the above
 

For each of the American Heart Association CPR certificates you selected above, please provide the following:

  • Your name as it appears on the certificate
  • expiration date

If you answered "None of the above," please type "N/A"


 

PART TWO: SUPPLEMENTAL QUESTIONNAIRE EXAMINATION

INSTRUCTIONS FOR QUESTIONS #1 - #4 

Questions 1 through 4 will be assessed and scored by an expert review panel. Your application or additional documents (e.g. resumes, cover letters, letters of reference, etc.) will NOT be considered during the scoring process. The supplemental questionnaire will account for 100% of the total weight of candidates' final score.

It is suggested that you:

  • When describing your examples of work, present your BEST examples.
  • Review the questions, prepare and save your responses in a word processing document, and then paste them into the online Supplemental Questionnaire.
  • Allow yourself enough time to complete these exam (Supplemental Questionnaire) questions before the deadline; this eliminates room for errors.
  • Be concise, yet thorough and use FACTUAL data.
  • Provide all information requested even if it may appear repetitious or redundant. Answer all questions independently (e.g., do not reference your responses in prior questions).
  • Ensure that your responses are detailed to assist in evaluating your knowledge, skills, and abilities.
  • Please note: All experience, license, and education referenced in this questionnaire must also appear in the work history, license, and/or education sections of your application.
  • Keep copies of all documents submitted, as these will not be returned.

DON'TS: DO NOT leave questions unanswered. If a question does not relate to you, write in the most closely related answer possible. DO NOT provide incomplete answers, blank or inconsistent information. DO NOT plagiarize, copy others' answers, or falsify information. Do not write "See Application" or "See Resume" as a response or copy and paste resume.

Once you click on the submit button, your application and examination are subject for review. Responses cannot be changed or edited after submission.


1.

Describe in detail a time when you have had to provide or participate in a therapeutic technique such as crisis intervention or group therapy. Make sure to include:

  • Your role and responsibility
  • The therapeutic technique and why it was chosen
  • The outcome for the patient

Reminder: Make sure your response are sufficiently detailed to assist in evaluating your knowledge, skills, and abilities.

 

Please provide the following information for the experience you provided above:

  • Name of the employer, setting, or school where this experience was obtained
  • Dates of experience (eg. MM/YYYY - MM/YYYY)
  • Contact information of supervisor, program director, teacher, or other person who can verify you performed specific activities or that your position/education required you to perform such activities.

Note: Do not copy and paste resume or do not type "See Resume" or "See Attachment."

2.

Please provide an example of a challenging patient you successfully assisted who was recently placed on anti-psychotic medications and/or psychotropic drugs and complained of side effects. In your response, be sure to answer the following questions:

  1. What medication(s) was in use, the side effect(s) present and what issue or issues did you address?
  2. What specifically did you do to assist the patient and when did you do it?
  3. What was the outcome for the patient?

Reminder: Make sure your responses are sufficiently detailed to assist in evaluating your knowledge, skills, and abilities.

 

Please provide the following information for the experience you provided above:

  • Name of the employer, setting, or school where this experience was obtained
  • Dates of experience (eg. MM/YYYY - MM/YYYY)
  • Contact information of supervisor, program director, teacher, or other person who can verify you performed specific activities or that your position/education required you to perform such activities.

Note: Do not copy and paste resume or do not type "See Resume" or "See Attachment."

3.

Describe a time when you facilitated patient recovery which specifically included medication(s).

  • What considerations did you make?
  • What were the medications and why?
  • What was the outcome for the patient?

Reminder: Make sure your responses are sufficiently detailed to assist in evaluating your knowledge, skills, and abilities.

 

Please provide the following information for the experience you provided above:

  • Name of the employer, setting, or school where this experience was obtained
  • Dates of experience (eg. MM/YYYY - MM/YYYY)
  • Contact information of supervisor, program director, teacher, or other person who can verify you performed specific activities or that your position/education required you to perform such activities.

Note: Do not copy and paste resume or do not type "See Resume" or "See Attachment."

4.

This position often works with patients who have psychotic and non-psychotic disorders and requires the ability to understand the needs of each patient population. Please describe an experience in which you effectively provided care to patients with psychotic signs and symptoms, and an experience with patients with Borderline Personality Disorder. 

Please include in your response:

  • The challenges you faced working with each of these populations and how your knowledge of the disorder helped you address the challenges.
  • Your experience implementing at least two interventions you utilized for patients with each of these diagnoses and the outcome of each intervention utilized.

Reminder: Make sure your responses are sufficiently detailed to assist in evaluating your knowledge, skills, and abilities.

 

Please provide the following information for the experience you provided above:

  • Name of the employer, setting, or school where this experience was obtained
  • Dates of experience (eg. MM/YYYY - MM/YYYY)
  • Contact information of supervisor, program director, teacher, or other person who can verify you performed specific activities or that your position/education required you to perform such activities.

Note: Do not copy and paste resume or do not type "See Resume" or "See Attachment."

 

CERTIFICATION: I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.