CPSS Interview Form
Applicant Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Interview
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Month
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Day
Year
Date
Person conducting the interview
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First Name
Last Name
Applicant county of residence
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Interview Questions
Position Applying for?
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CPSS
CRS Supervisor
What do you know about Peer Support?
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What thoughts do you have about Supervising a CPS? What tools training do you think you would need to do the job well? What skills?
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Please tell me about any education, training, or personal experience that is relevant to this position
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Peerstar is a recovery focused organization, how would you describe the concept of recovery to someone you were assigned to support?
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What does hope mean to you?
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What coaching or mentoring experience have you had? What skills do you have that will help you mentor CPS staff well?
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Can you tell me about a time where you had to support someone that was struggling with tasks/responsibilities?
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As a peer support supervisor, you are not responsible for disciplining staff. How would you handle a situation in which one of your staff members are not meeting the expectations of their job description?
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Have you ever completed assessments or recovery/service plans with clients? If so, what did you feel was the most difficult part and what did you do to complete the task? If not, what are your concerns about doing so?
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What do you do to take care of yourself and nurture your own well-being?
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What would you say about your dependability?
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What challenges do you think you may encounter with this position?
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All of our documentation is completed on an iPad, how much experience do you have using an iPad or similar types of devices?
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If I talked to your previous supervisor, what they say are your 3 strengths and 3 things you could be improving?
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What questions do you have about Peer Support or this position?
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How many hours are you interested in working?
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What counties/areas are you interested in working?
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Is there any specific issues/diagnosis too avoid when staffing?
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What times are you available to work (day, evening, weekends)?
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Have you ever been convicted of a crime (felony or misdemeanor)? ***IF YES, applicant will need to submit 2 letters of recommendation and an explanation of charges with in 7 DAYS of the interview***DO NOT ASK THIS QUESTION IF APPLICANT RESIDES IN PHILADELPHIA OR PITTSBURGH***
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Yes
No
N/A
Have you ever been excluded from participation in Medicare, Medicaid, or the Pennsylvania Medical Assistance Programs?
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Yes
No
Have you served in the military?
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Yes
No
Minimum Qualifications
Does the applicant have a MS/MA degree in a clinical field?
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Yes
No
N/A
Does the applicant have a BS/BA degree AND at least 2 years of obvious experience OR does the applicant have 4 years of obvious experience?
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Yes
No
N/A
Does the applicant have an Associates degree with 3 years mental health direct service experience?
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Yes
No
N/A
***IF EXPEREIENCE IS NOT OBVIOUS, CHECK WITH HR DIRECTOR BEFORE ANY OFFER CAN BE MADE***
Is the applicant an effective communicator?
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Yes
No
Do you have adequate transportation and/or valid driver's license?
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Yes
No
Date applicant is available to start training
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-
Month
-
Day
Year
Date
Do you want to hire this applicant?
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Yes
No
Unsure
Please check all items that have been verified
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Driver's license
Social Security Card
Degree
None
Submit
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