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#CBT-2922-902828
Supplemental Questionnaire

Last Name
First Name

 

2922 SENIOR MEDICAL SOCIAL WORKER (CBT-2922-902828) - SUPPLEMENTAL QUESTIONNAIRE (SQ) EXAMINATION

PLEASE READ THESE EXAMINATION INSTRUCTIONS CAREFULLY.

Section I (A-D) Minimum Qualification SQ:  To determine if you meet the minimum qualifications of the position.  It is essential that applicants provide complete information in identifying their education, experience and training. The Minimum Qualification Supplemental Questionnaire will be used to evaluate if the applicant possesses the required minimum qualifications.

Section II (1-4) SUPPLEMENTAL QUESTIONNAIRE EXAMINATION: ACCOUNTS FOR 100% OF YOUR FINAL SCORE and 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. This section of the supplemental questionnaire will be evaluated to rate your experience as it relates to the knowledge, skills, and abilities linked to the essential functions of the position. You must meet the minimum qualifications and achieve a passing score to be placed on the eligible list in rank order according to your final score. Responses are subject to verification and should be consistent with your application. All experience and education referenced in this questionnaire must also appear in the work history and education sections of you application. Suggestions:

  • When describing your examples of work, present your BEST example and be thorough Use FACTUAL data.
  • Please respond to all questions, provide complete, detailed answers and be specific when responding, as your score and rank on the eligible list will be based on the information provided.
  • Provide ALL information requested even if it may appear repetitious or redundant.
  • Do not answer "see resume", "see application" or copy and paste your resume.
  • Review 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 the EXAM (SQ) questions before the deadline; this eliminates room for errors.
  • 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.
  • Keep copies of all documents submitted, as these will not be returned.

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

*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 and certify that I have read, understood, and agreed to the above listed instructions regarding this 2922 Supplemental Questionnaire Examination.

A.

Do you possess a valid license as a Licensed Clinical Social Worker (LCSW) issued by the California Board of Behavioral Sciences, as required under Title 22, California Administrative Code, Section 70055?

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 "Employment Record" section 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 Employment Record before submitting your application

 

Yes No
B.

How much verifiable POST-MASTERS DEGREE Medical Social Worker experience in a licensed healthcare setting do you possess?

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 "Employment Record" section 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 Employment Record before submitting your application

I do not have verifiable post-Masters Medical Social Worker experience in a licensed healthcare setting
I have some experience but less than 6 months (1,000 hours) of post-Masters Medical Social Worker experience in a licensed healthcare setting
I have at least 6 months (1,000 hours) but less than 1 year (2,000 hours) of verifiable post-Masters Medical Social Worker experience in a licensed healthcare setting
I have at least 1 year (2,000 hours) but less than 2 years (4,000 hours) of verifiable post-Masters Medical Social Worker experience in a licensed healthcare setting
I have at least 2 years (4,000 hours) but less than 3 years (6,000 hours) of verifiable post-Masters Medical Social Worker experience in a licensed healthcare setting
I have 3 years (6,000 hours) or more of verifiable post-Masters Medical Social Worker experience in a licensed healthcare setting
I have post-Masters Social Worker experience but not as a Medical Social Worker
C.

In which of the following licensed healthcare settings was your post-Master Medical Social Worker experience gained?  Please check ALL that apply. 

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 "Employment Record" section 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 Employment Record before submitting your application

Licensed Hospital
Community Health Center or Facility
Licensed Home Health Agency
Licensed Mental Health Agency
Licensed Community and Ambulatory Center (meeting the regulatory requirements of the State of California)
I do not have experience in any of the above settings.
D.

How much homeless programs experience do you have?

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 "Employment Record" section 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 Employment Record before submitting your application.

I do not have any homeless programs experience
I have less than one year (less than 2,000 hours) of homeless programs experience
At least one year (minimum 2,000 hours) but less than two years (4,000 hours) of homeless programs experience
At least two years (minimum 4,000 hours) but less than three years (6,000 hours) of homeless programs experience
At least three years (minimum 6,000 hours) but less than four years (8,000 hours) of homeless programs experience
At least four years (minimum 8,000 hours) but less than five years (10,000 hours) of homeless programs experience
Five years (minimum 10,000 hours) or more of homeless programs experience
1.

Describe in detail your experience directing the work of others or a time when you took on a leadership role. In your response, be sure to also include the following:

  • Who was involved (what were the roles of those you directed or lead)
  • What skills from your professional experience and/or training helped you in your leadership role or directing the work of others.
2.

Describe your experience with assessments, recommendations, and efficacy for LPS conservatorship and medical probate within the healthcare system. Also provide a specific example and include:

  • why you did or did not recommend;
  • what your involvement was in the process; and
  • if applicable, what was your goal in seeking conservatorship?
3.

Describe your experience and/or training with Mandated Reporting. Describe in detail a specific situation, those involved, the challenges faced in filing this report, and the outcome.

4.

Describe a time in which you felt you were successful in developing or improving collaboration between your staff and another department or outside agency. What was the situation, who was involved and why did you feel you were successful? How did you measure this success? What were some of the challenges?

 

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 City and County of San Francisco.  I also understand and agree that the information provided is subject to verification.