CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

OFFICE OF WORKFORCE PLANNING

QUALIFICATIONS ASSESSMENT

TEACHING ASSISTANT, CORRECTIONAL FACILITY

This examination will provide you with an opportunity to demonstrate significant aspects of your qualifications for the
Teaching Assistant, Correctional Facility classification with the California Department of Corrections and
Rehabilitation (CDCR). The information you provide will be rated based on objective criteria created by Subject Matter
Experts. The rating will be used to determine your final score in this examination. If successful, your name will be
merged onto an eligible list. The list will be used by CDCR facilities statewide to fill vacant positions. A “Conditions of
Employment” form is included in this examination which will allow you to select the type of appointment you are
interested in working. It is required that you personally complete this examination accurately and without
assistance.
You will be evaluated based on your ability to follow directions and read, interpret, and respond appropriately
to the questions in this Qualifications Assessment. Candidates who fail to follow the instructions will be
eliminated from this examination.

THIS AFFIRMATION MUST BE COMPLETED.

I hereby certify that the information provided on this Qualifications Assessment Questionnaire is true and
correct to the best of my knowledge and contains no willful misrepresentations or falsifications. I also
understand that if it is later discovered that I have made any false representations, I may be removed from the
examination and/or the eligible list resulting from this examination, have adverse action taken against me
which could result in loss of state employment, and/or suffer loss of right to compete in any future state
examinations.

Name (Printed):

Address:

City/State/Zip Code:

Home Telephone Number:

Work Telephone Number:

Signature: Date:

YOUR COMPLETED QUALIFICATIONS ASSESSMENT AND EXAMINATION APPLICATION (STD. 678)

MUST INCLUDE YOUR ORIGINAL SIGNATURE. COMPLETED QUALIFICATIONS ASSESSMENTS AND
EXAMINATION APPLICATIONS MUST BE MAILED OR DELIVERED TO THE FOLLOWING LOCATION:

Mail to: or Deliver in Person to:

Department of Corrections and Rehabilitation Department of Corrections and Rehabilitation
Office of Workforce Planning 1515 S Street
P.O. Box 942883 Sacramento, CA 95811-7243
Sacramento, CA 94283-0001 Attn: Office of Workforce Planning, Room 101N
(916) 322-2545

NOTE:
 Be sure your envelope has adequate postage if submitting via mail.
 Facsimiles (FAX) will NOT be accepted under any circumstances.
 Make and keep a photocopy of the completed Qualifications Assessment for your records.

LANGUAGE, SPEECH, AND HEARING SPECIALIST - QUALIFICATIONS ASSESSMENT – Page 1

ALL RESPONSES ARE SUBJECT TO VERIFICATION
CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

GENERAL INSTRUCTIONS

This process is the entire examination for the Teaching Assistant, CF classification. Therefore, please be sure to
review and follow all instructions carefully as missing or incomplete information may result in disqualification or a
lower score.

The examination is intended to provide candidates the opportunity to demonstrate their knowledge and experience in
a variety of areas. It is not expected that you will have experience in all areas.

The following areas comprise the complete examination for the Teaching Assistant, CF classification. You must
ensure that you have reviewed each of the following areas:

 Affirmation Statement (page 1)

 General Instructions (page 2)
 Montoya Act/Felony Conviction Disclosure (page 3)
 Prior State Employment Information (page 3)
 Conditions of Employment (pages 4 - 5)
 Job Requirements (page 6)
 Instructions (page 7)
 Knowledge and Work Experience – Teaching Assistant, CF (pages 8 -14)
 Recruitment Questionnaire/Mailing Instructions (page 15)

YOUR RESPONSES ARE SUBJECT TO VERIFICATION

Please keep in mind that all information provided on this Qualifications Assessment will be subject to verification at
any time during the examination process, hiring process, and even after gaining employment. Anyone who
misrepresents his/her experience will be subject to adverse consequences, which could include the following
action(s):
 Removal from the examination process
 Removal from the certification list
 Loss of State employment
 Loss of rights to compete in any future state examinations

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

MONTOYA ACT/FELONY CONVICTION DISCLOSURE

Pursuant to the Montoya School Safety Act of 1997, all persons offered employment with the CDCR’s Division of
Juvenile Justice, Education Services Branch, shall undergo a thorough background investigation prior to appointment.
Pursuant to the Education Code Section 45122 and Penal Code Sections 677 and 1192, “No person who has been
convicted of a violent or serious felony shall be employed by a school district.”

To review the Education Code Section 45122, you can go to the following website:
http://caselaw.lp.findlaw.com/cacodes/edc/45100-45139.html

To review the Penal Code Section 667.5, subsection (c) for a listing of violent felony offenses, you can go to the
following website:
http://caselaw.lp.findlaw.com/cacodes/pen/654-678.html

To review the Penal Code Section 1192.7, subsection (c) for a listing of serious felony offenses, you can go to the
following website:
http://caselaw.lp.findlaw.com/cacodes/pen/1191-1210.5.html

Have you ever been convicted of a violent or serious felony?

□ YES

□ NO

PRIOR STATE EMPLOYMENT INFORMATION

Complete this next section ONLY if you have been previously dismissed from California State Civil Service
employment by punitive action or as a result of disciplinary proceedings. IF THIS DOES NOT APPLY TO
YOU, please skip this question.

State Personnel Board, Rule 211 provides that a dismissed state employee may only participate in State Civil
Service examinations if he/she has obtained prior consent from the State Personnel Board.

Do you have written permission from the State Personnel Board Executive Officer to take this examination?

□ YES

□ NO

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 CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

CONDITIONS OF EMPLOYMENT INFORMATION FOR

TEACHING ASSISTANT, CF

PLEASE MARK THE APPROPRIATE BOX(ES) OF YOUR CHOICE.

If you are successful in this examination, your name will be placed on an active employment list and referred to fill
vacancies Statewide according to the conditions you specify on this form.

TYPE OF APPOINTMENT YOU WILL ACCEPT

Please mark the appropriate box(es) - you may check "(A) Any" if you are willing to accept any type of employment.

 (D) Permanent Full-Time  (R) Permanent Part-Time or  (K) Limited-Term Full-Time  (A) Any
Limited-Term Part-Time
If all are marked and you receive an appointment other than permanent full-time, your name will continue to be
considered for permanent full-time positions.

 0005 ANYWHERE IN THE STATE - If this box is marked, no further selection is necessary.

NOTE: California State Prison has been abbreviated as “CSP.” Youth Correctional Facility has been abbreviated as “YCF.” Youth Correctional
Center has been abbreviated as “YCC.”
NORTHERN REGION
Amador County
 0100 Alameda County  0200 Alpine County  0300  Pine Grove Youth Conservation
Camp

 0400 Butte County  0500 Calaveras County  0600 Colusa County

Del Norte County

 0700 Contra Costa County  0800  0900 El Dorado County
 Pelican Bay State Prison

 1100 Glenn County  1200 Humboldt County  1700 Lake County

Lassen County
Marin County
 1800  California Correctional Center  2100  2300 Mendocino County
 CSP, San Quentin
 High Desert State Prison

 2500 Modoc County  2800 Napa County  2900 Nevada County

Sacramento County
 CSP, Sacramento
 3100 Placer County  3200 Plumas County  3400  Folsom Women’s Facility
 Richard A. McGee Correctional
Training Center
San Joaquin County
 California Health Care Facility
 3800 San Francisco County  3900  O.H. Close YCF  4100 San Mateo County
 N.A. Chaderjian YCF
 Northern California YCC

 4500 Shasta County  4600 Sierra County  4700 Siskiyou County

Solano County
 4800  California Medical Facility  4900 Sonoma County  5100 Sutter County
 CSP, Solano
Tuolumne County
 5200 Tehama County  5300 Trinity County  5500
 Sierra Conservation Center

 5700 Yolo County  5800 Yuba County

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 CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

CENTRAL REGION (CONTINUED ON BACK)

Kern County
 California City Correctional
Facility
Fresno County
 1000  1400 Inyo County  1500  California Correctional Institution
 Pleasant Valley State Prison
 Kern Valley State Prison
 North Kern State Prison
 Wasco State Prison
Kings County
 Avenal State Prison Madera County
 1600  CSP, Corcoran  2000  Central California Women’s Facility  2200 Mariposa County
 CA Substance Abuse Treatment  Valley State Prison
Facility

CENTRAL REGION (CONTINUED)

Monterey County
 2400 Merced County  2600 Mono County  2700  Correctional Training Facility
 Salinas Valley State Prison
San Luis Obispo County
 3500 San Benito County  4000  4300 Santa Clara County
 California Men’s Colony

 4400 Santa Cruz County  5000 Stanislaus County  5400 Tulare County

SOUTHERN REGION
Imperial County
Los Angeles County
 1300  Calipatria State Prison  1900  3000 Orange County
 CSP, Los Angeles County
 Centinela State Prison
Riverside County
San Bernardino County
 3300  California Rehabilitation Center  3600  3700
San Diego County
 California Institution for Men
 Chuckawalla Valley State Prison  RJ Donovan Correctional Facility
 California Institution for Women
 Ironwood State Prison
Ventura County
 4200 Santa Barbara County  5600
 Ventura YCF

ADDRESS OR AVAILABILITY FOR EMPLOYMENT CHANGES

After list release, please notify CDCR promptly of any address changes or availability for employment at the following
address:

California Department of Corrections and Rehabilitation

Division of Human Resources
Office of Workforce Planning
P.O. Box 942883
Sacramento, CA 94283-0001
Attn: Certification Unit

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

JOB REQUIREMENTS

The following are job requirements. Please respond to each question by marking the appropriate box.

Are you willing to abide by and adhere to safety policies and provisions (e.g., wear personal
1. alarm, carry whistle, wear protective clothing and apparatus, etc.) applicable to specific work Yes No
assignments?

2. Are you willing to comply with annual Tuberculosis screening requirements? Yes No

3. Are you willing to comply with departmental training requirements? Yes No

4. Are you willing to report dangerous situations/contraband to supervisors and/or custody staff? Yes No

Are you willing to interact with individuals (i.e., members of the public, contractor staff, and
5. Yes No
other agency personnel) from a wide range of cultural backgrounds?

6. Are you willing to work in a state correctional facility? Yes No

Are you willing to work with inmates/youthful offenders/parolees, including some who may be
7. mentally ill, developmentally disabled, potentially dangerous, infected with contagious diseases Yes No
such as Hepatitis C, HIV/AIDS, or Tuberculosis, and/or sex offenders?

8. Are you willing to work around peace officers armed with chemical agents and/or weapons? Yes No

9. Are you willing to report unethical and/or illegal behavior on the part of departmental staff? Yes No

Are you willing to treat inmates/youthful offenders in a professional, ethical, and tactful
10. Yes No
manner?

Are you willing to participate in team meetings, committees, special projects, etc. as required
11. Yes No
and/or assigned by your supervisor/manager?

Are you willing to have and maintain sufficient strength, agility, and endurance to perform
12. Yes No
during stressful situations encountered on the job?

13. Are you willing to participate in the audit and program evaluation process. Yes No

14. Are you willing to respond to changes in the work unit in a positive, professional manner. Yes No

15. Are you willing to participate in continuing education specific to your work assignment? Yes No

Are you willing to work with inmates/youthful offenders/parolees, including some who may be
16. Yes No
mentally ill, developmentally disabled, potentially dangerous, and/or sex offenders.

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

INSTRUCTIONS:

Using the rating scale(s) below, you will self-rate your knowledge and experience performing specific job-related
actions.

Respond to each of the following statements by indicating how the statement applies to you. You are required to
respond to every statement by marking one option for each of the 2 scales provided.

In responding to each statement, you may refer to your FORMAL EDUCATION, FORMAL TRAINING COURSES,
and/or WORK EXPERIENCE whether paid or not paid.

SCALE #1 - KNOWLEDGE RELATED TO PERFORMING THIS ACTION:

Extensive Knowledge
I possess an expert knowledge level to the extent that I have effectively performed tasks related to this knowledge in
the most difficult and complex situations and I have instructed others on specific aspects of this knowledge.

Moderate Knowledge
I possess an advanced knowledge level to the extent that I could effectively perform this task under the majority of
circumstances or situations encountered.

Basic Knowledge
I possess a sufficient knowledge level that would allow me to perform this task successfully in routine situations.

Limited Knowledge
I have some knowledge of how to perform this task, but I may require additional instruction to apply my knowledge
effectively.

No Knowledge
I have no knowledge of how to perform this task or what it may entail.

SCALE #2 - EXPERIENCE RELATED TO PERFORMING THIS ACTION:

3- Extensive Experience
I have performed this action regularly.

2-Moderate Experience
I have performed this action multiple times and could effectively perform this action if required.

1-Limited Experience
I have performed this action before, but would still be considered a beginner by others, and I would likely require
assistance for successful performance.

0-No Experience
I have never performed this action.

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

1. Assist the classroom teacher with classroom management.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

2. Maintain order and supervises the conduct of students.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

3. Tutor students individually and in groups.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

4. Control all classroom materials and equipment.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

5. Confer with teachers and other staff concerning educational program materials.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

6. Participate as a team member in education program evaluation.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

7. Support students in the use of educational materials and resources.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

8. Instruct students in the use of educational technologies (e.g., computer, educational software, electronic devices,
etc.)

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

9. Collaborate with the classroom teacher to provide input on student progress.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

10. Communicate effectively with students to promote positive behavior.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

11. Address student behavioral issues.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

12. Participate in educational activities (e.g., graduation ceremonies, committees, special events, etc.)

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

13. Participate as a member of multi-disciplinary teams or committees.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

14. Assist the classroom teacher with educational program and curriculum presentation to students.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

15. Compile required documents and progress reports.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

16. Operate audio-visual equipment (e.g., television/monitor, computer, interactive white board, etc.)

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

17. Prepare graphic and written teaching materials.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

18. Attend required training (e.g., legal mandates, teaching techniques, professional development etc.)

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

19. Support the process for students earning a High School Diploma/GED.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

20. Provide educational services for students restricted from attending class.

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

21. Grade student work (i.e., multiple choice, true/false, fill-in-the-blank).

Knowledge related to performing this action

☐ Extensive Knowledge
☐ Moderate Knowledge
☐ Basic Knowledge
☐ Limited Knowledge
☐ No Knowledge

Experience related to performing this action

☐ Extensive Experience
☐ Moderate Experience
☐ Limited Experience
☐ No Experience

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CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Teaching Assistant, Correctional Facility

RECRUITMENT QUESTIONNAIRE

These questions are not part of the examination. Responses are voluntary and will be used for recruitment
statistics.

HOW DID YOU HEAR ABOUT THIS EXAMINATION?

Check the appropriate box below.

☐ Newspaper/Magazine Advertisement
☐ Internet
☐ California Department of Corrections and Rehabilitation employee
☐ Recruitment Mailing
☐ College/School
☐ Job Fair/Career Fair
☐ Other: ____________________________________

THIS CONCLUDES THE QUALIFICATIONS ASSESSMENT FOR

TEACHING ASSISTANT, CF

YOUR COMPLETED QUALIFICATIONS ASSESSMENT AND EXAMINATION APPLICATION (STD. 678)

MUST INCLUDE YOUR ORIGINAL SIGNATURE. COMPLETED QUALIFICATIONS ASSESSMENTS AND
EXAMINATION APPLICATIONS MUST BE MAILED OR DELIVERED TO THE FOLLOWING LOCATION:

Mail to: or Deliver in Person to:

Department of Corrections and Rehabilitation Department of Corrections and Rehabilitation
Office of Workforce Planning 1515 S Street
P.O. Box 942883 Sacramento, CA 95811-7243
Sacramento, CA 94283-0001 Attn: Office of Workforce Planning, Room 101N
(916) 322-2545

 Be sure your envelope has adequate postage if submitting via mail.

 Facsimiles (FAX) will NOT be accepted under any circumstances.
 Make and keep a photocopy of the completed examination application (STD. 678) and Qualifications
Assessment for your records.

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