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Human Capital Management
#171002-H20A-58


Supplemental Questionnaire

Last Name First Name
 

 

Please make sure that you attach all requested documents to your application, if requested.  Resumes should be attached to the "Resume" tab and any other requested documents to the "Other" tab.



 

OK Department of Human Services (DHS) requires that the following questions be answered before continuing with the application.


1.

Do you have legal status to work in the United States?

Yes No
2.

Have you had a protective order entered against you pursuant to the Oklahoma
Protection from Domestic Abuse Act or a similar statute of another state? 

If yes, provide the name of the court and court number in the text area:

If no, please enter No in the text area:            

3.

DHS policy does not allow some family members to be employed within the same supervisory group or unit. Please list the names of all of your relatives now employed by DHS:

If no, please enter No in the text area:

4.

Have you ever been terminated or resigned from employment in lieu of being terminated?  
If yes, explain circumstances:      

If no, please enter No in the text area:

 

Do you have any of the following?

a bachelor's degree
four (4) years of professional level social work
a combination of college coursework AND professional level social work experience that totals four (4) years
none of the above

 
STOP! You have completed the required screening questions for this Job Family.  Please verify you meet the education and experience requirements listed in the job bulletin before completing the following supplemental questionnaire. The questions below will be used for scoring in lieu of a written exam.

1.

What experience do you have arranging referrals and collaborations with social service agencies for individuals in need?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

2.

What experience do you have in assessing the needs of individuals and determining eligibility for specific programs?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

3.

What experience do you have in developing a plan for individuals to eliminate barriers to successful and independent living?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

4.

What experience do you have in caseload principles and practices and ensuring compliance with federal and state regulations, or organizational policies and procedures?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

5.

What experience do you have in coordinating or consulting with team members to develop and execute shared goals?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

6.

What is your highest level of experience regarding managing caseloads?

I have trained other professionals to manage a caseload and coordinate service delivery.
I have effectively managed a caseload and coordinated service delivery with others.
I have effectively managed a caseload.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

7.

What is your experience documenting your ongoing work activities?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

8.

What experience do you have conducting interviews?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some education/training on it.
I have no experience with this task.
 

Please list the school or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.