Comprehensive Community Support Services Certification Application Guide Page 1Guide Page 2Guide Page 3Guide Page 4Guide Page 5Guide Page 6Agency InformationPolicies and Procedures - 1Policies and Procedures - 2Policies and Procedures - 3Policies and Procedures - 4Attestation0% Complete1 of 12 Guide When to Submit the Application: Agencies/Organization who want to provide Comprehensive Community Support Services CCSS and have never applied before Agencies/Organizations who are opening a new location (requires separate application) After completion of the required training related to providing clinical supervision of non-clinical staff Supporting Documentation to Gather: CCSS Clinical Supervisor: Copy of License Evidence of 1 year of Supervisory Experience Board-approved Clinical Supervisor Designation Letter/Verification Attestation of Training Related to Providing Clinical Supervision of Non-Clinical Staff Copy of CCSS Training Certificate Resumé (detailing one or more years of supervisory experience) CCSS Program Supervisor (if this is a different person than the Clinical Supervisor, these will be required): Copy of Bachelor's Degree in a human services field from an accredited university Resumé (detailing four years relevant experience in the delivery of case management or CCSS with the target population, and one year demonstrated supervisory experience) Copy of CCSS Training Certificate If you have hired CSWs/CPSWs, you will be required to state their names and upload the following documents (*IMPORTANT NOTE: These documents must be combined into a single PDF before uploading): For CSWs, you will be required to upload proof of education (degree or diploma earned), an initial CCSS training certificate of completion, and a resume detailing months and years of experience. For CPSWs, you will be required to upload proof of CPSW credentials and the initial CCSS training certificate of completion. If you are human, leave this field blank. Next Start Over (Warning! This completely erases all data you have entered into this form)
