Please complete the following supplemental questionnaire. This questionnaire is considered an extension of your employment application and will be reviewed to help assess your qualifications. Resumes are not accepted in lieu of completing this questionnaire.
1.
PATTERN I
Do you possess at least two years of full-time paid experience as a Substance Abuse Program Supervisor in San Joaquin County service?
Yes
No
If YES, please provide the dates of employment, number of hours worked per week, and the name(s) of the program(s) to which you were assigned.
2.
PATTERN II
Did you graduate from an accredited four year college or university with a major in psychology, social work, business or public administration, or a closely related field?
Yes
No
If YES, please provide the following information:
Name of college or university from which you graduated
Degree obtained
Major
2a.
Do you possess at least three (3) years of full-time paid counseling or case management experience?
Yes
No
If YES, please indicate if the experience was in the following area(s):
Substance Abuse Program
Social Crisis Program
Other
None of the Above
2b.
Did your experience include at least two-years of full-time paid experience as a supervisor?
Yes
No
2c.
Provide a detailed description of your counseling or case management experience in a substance abuse or social crisis program, which included two years in a supervisory capacity. Include the name of your employer, employment dates, job title, number of hours worked per week, specific duties performed and scope of responsibility.
3.
THE FOLLOWING ITEMS ARE REQUIRED FOR BOTH PATTERNS
Do you possess a current certificate as an Alcohol and Other Drug (AOD) Counselor issued by a certifying agency approved by the State of California? (NOTE: A copy of this certificate must be submitted with your employment application)
Yes
No
A copy of the required license or certificate must be submitted to Human Resources with your application. It may be submitted as an attachment to your application or sent via email to awagers@sjgov.org.
If you answered YES, please provide the type of certification you possess, name of the certifying agency, and expiration date.
If NO, possession of one of the following may substitute for the Alcohol and Other Drug (AOD) certificate only. Please indicate which license you possess. (Note: A copy of your license must be submitted with your employment application.)
Valid and current license to practice medicine issued by the Medical Board of California
Valid and current Psychologist license issued by the Board of Psychology
Valid and current Clinical Social Worker (LCSW) issued by the California Board of Behavioral Sciences
Valid and current Marriage and Family Therapist (LMFT) license issued by the California Board of Behavioral Sciences
Valid and current intern registration with the California Board of Behavioral Sciences
None of the above
3a.
This position requires possession of a valid California driver's license. Please provide your license number and expiration date.
San Joaquin County Human Resources Division