Cal. Code Regs. Tit. 16, § 1833 - Supervised Experience: Required Documentation

(a) When a written oversight agreement is required by section 4980.43.4 of the Code, the agreement shall contain the following provisions and shall be executed as described below.

(1) The written oversight agreement shall be executed and signed prior to commencement of supervision.

(2) The agreement shall contain a statement from the supervisor agreeing to ensure that the extent, kind, and quality of counseling performed by the supervisee is consistent with the supervisee's training, education, and experience, and is appropriate in extent, kind, and quality.

(3) The agreement shall contain an acknowledgment by the supervisee's employer that the employer:

(A) Is aware of the licensing requirements that must be met by the supervisee and that the employer agrees not to interfere with the supervisor's legal and ethical obligations to ensure compliance with those requirements;

(B) Agrees to provide the supervisor access to clinical records of the clients counseled by the supervisee; and

(C) Is aware that the supervisor will be providing clinical guidance and direction to the supervisee in order to ensure compliance with the standards of practice of the profession, which include legal requirements and professional codes of ethics, and agrees not to interfere with this process.

(4) The supervisor shall provide the signed agreement to the supervisee upon completion or termination of supervision. The supervisee shall submit the agreement to the board upon application for licensure.

(b) Supervisors shall complete and submit a self-assessment report pertaining to the licensee's qualifications to be a supervisor, as specified in section 1833.1.

(c)

(1) Except as specified in subsection (c)(2), within 60 days of the commencement of any supervision, the supervisor and supervisee shall sign a supervision agreement, as specified in subsection (c)(3), under penalty of perjury. The original signed supervisory agreement shall be retained by the supervisee and submitted to the board with the supervisee's application for licensure.

(2) A supervisor and a supervisee who are in a supervisory relationship that existed prior to January 1, 2022 shall complete a supervisory plan as required by subsection (c)(3)(F), but are not required to complete a supervision agreement. The supervisee shall instead submit the previously required signed supervisor responsibility statement with the application for licensure.

(3) The supervision agreement shall include all of the following:

(A) The licensee's qualifications to be a supervisor as specified in section 1833.1 and in section 4980.03 of the Code.

(B) The supervisor affirms an understanding of the requirements pertaining to registration of the supervisee, acceptable supervision practices, work settings, supervisee employment, and oversight of supervisees as specified in sections 4980.43, 4980.43.1, 4980.43.2, 4980.43.3, and 4980.43.4 of the Code.

(C) The supervisor affirms an understanding of the requirements pertaining to direct supervisor contact as specified in section 4980.43.2 of the Code.

(D) The supervisor affirms an understanding of the supervision documentation required by this section and the board's right to audit a supervisor's compliance with the requirements in this article and in the Code.

(E) The supervisee affirms an understanding of all of the following:

1. Requirements pertaining to registration as an associate as specified in section 4980.43 of the Code.

2. The supervisee's supervisor must hold a current and active California license that is not under suspension or probation while supervising in order for hours to count toward licensure as specified in section 1833.1 and in section 4980.03 of the Code.

3. Requirements pertaining to documentation of completed supervised experience as specified in this section.

4. Prohibited practices pertaining to employment and supervisory relationships as specified in section 4980.43.3 of the Code.

5. The age limit pertaining to experience hours as specified in section 4980.43 of the Code.

(F) A supervisory plan that describes the goals and objectives of supervision and whereby the supervisor affirms an understanding of the responsibilities pertaining to monitoring and evaluating the supervisee as specified in section 1833.1 and in section 4980.43.1 of the Code. This plan shall be developed collaboratively by the supervisor and supervisee.

(d) Supervisees shall maintain a weekly log of all hours of experience gained toward licensure. The log of hours shall be signed by the supervisor on a weekly basis. The supervisee shall retain the signed logs until such time as the supervisee is licensed by the board. The board shall have the right to require an applicant for licensure to submit all or such portions of the logs as it deems necessary to verify hours of experience. The log shall include all of the following:

(1) The name and address of the supervisee's work setting.

(2) Hours of experience gained per category as listed in sections 4980.43(c)(8), 4980.43(c)(10), and 4980.43.2(b) of the Code per week.

(3) Total hours gained per week and in each category overall.

(e) Completed hours of experience shall be documented at the completion or termination of supervision. Such documentation shall be submitted to the board by the supervisee upon application for licensure and shall include all of the following:

(1) The supervisor's telephone number and license information.

(2) The supervisee's employer's name, address, and telephone number.

(3) Whether the supervisee's work setting complies with sections 4980.43.3 and 4980.43.4 of the Code.

(4) If the supervisee was an associate at the time the experience was gained, documentation of employment or volunteer status, as specified in section 4980.43.3 of the Code.

(5) The applicant's accumulated hours of experience broken down by category as set forth in subsection (d)(2).

(6) The amount and type of supervision provided to the applicant.

(7) The dates during which the experience was gained.

(8) The supervisor's signature under penalty of perjury.

Notes

Cal. Code Regs. Tit. 16, § 1833

1. Amendment filed 8-20-76; effective thirtieth day thereafter (Register 76, No. 34). For prior history, see Register 75, No. 39.
2. Amendment filed 10-5-78; effective thirtieth day thereafter (Register 78,No. 40).
3. New subsection (g) filed 1-24-80; effective thirtieth day thereafter (Register 80, No. 4).
4. Amendment filed 9-15-83; effective thirtieth day thereafter (Register 83, No. 38).
5. Amendment filed 3-19-85; effective thirtieth day thereafter (Register 85, No. 12).
6. Amendment of subsections (a)-(e) filed 2-5-90; operative 2-5-90 (Register 90, No. 8).
7. Repealer of form and new form filed 12-24-92; operative 1-25-93 (Register 93, No. 1).
8. Amendment of section, including repealer and new form, filed 10-31-97; operative 1-1-98 (Register 97, No. 44).
9. The Board of Behavioral Sciences has discovered that the word "hours" was mistakenly duplicated in subsection (c)(2) (filed with the Secretary of State on 10-31-97). However, the duplication was not printed in Barclays Official California Code of Regulations. This action is a change without regulatory effect amending subsection (c)(2) (to remove the duplication from the regulation as filed with the Secretary of State) filed 12-29-97 pursuant to section 100, title 1, California Code of Regulations (Register 98, No. 1).
10. Change without regulatory effect amending form filed 4-19-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 17).
11. Change without regulatory effect amending subsections (b) and (c)(1) filed 4-25-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 17).
12. Change without regulatory effect amending subsections (b) and (c)(1) filed 10-18-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 42).
13. Repealer of subsections (a)(4)-(5), subsection renumbering, amendment of subsections (c), (c)(2) and (e), repealer and new Form 1800 37A-524 and new Form 1800 37A-524a filed 7-15-2013; operative 10-1-2013 (Register 2013, No. 29).
14. Change without regulatory effect amending section and NOTE filed 8-29-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 35).
15. Amendment of section heading, section and NOTE filed 9-27-2021; operative 1-1-2022 (Register 2021, No. 40). Transmission deadline specified in Government Code section 11346.4(b) extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60 calendar days pursuant to Executive Order N-71-20. Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60 calendar days pursuant to Executive Order N-71-20.

Note: Authority cited: Sections 4980.35, 4980.60 and 4990.20, Business and Professions Code. Reference: Sections 4980.03, 4980.35, 4980.40, 4980.42, 4980.43, 4980.43.4 and 4980.44, Business and Professions Code.

1. Amendment filed 8-20-76; effective thirtieth day thereafter (Register 76, No. 34). For prior history, see Register 75, No. 39.
2. Amendment filed 10-5-78; effective thirtieth day thereafter (Register 78,No. 40).
3. New subsection (g) filed 1-24-80; effective thirtieth day thereafter (Register 80, No. 4).
4. Amendment filed 9-15-83; effective thirtieth day thereafter (Register 83, No. 38).
5. Amendment filed 3-19-85; effective thirtieth day thereafter (Register 85, No. 12).
6. Amendment of subsections (a)-(e) filed 2-5-90; operative 2-5-90 (Register 90, No. 8).
7. Repealer of form and new form filed 12-24-92; operative 1-25-93 (Register 93, No. 1).
8. Amendment of section, including repealer and new form, filed 10-31-97; operative 1-1-98 (Register 97, No. 44).
9. The Board of Behavioral Sciences has discovered that the word "hours" was mistakenly duplicated in subsection (c)(2) (filed with the Secretary of State on 10-31-97). However, the duplication was not printed in Barclays Official California Code of Regulations. This action is a change without regulatory effect amending subsection (c)(2) (to remove the duplication from the regulation as filed with the Secretary of State) filed 12-29-97 pursuant to section 100, title 1, California Code of Regulations (Register 98, No. 1).
10. Change without regulatory effect amending form filed 4-19-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 17).
11. Change without regulatory effect amending subsections (b) and (c)(1) filed 4-25-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 17).
12. Change without regulatory effect amending subsections (b) and (c)(1) filed 10-18-2005 pursuant to section 100, title 1, California Code of Regulations (Register 2005, No. 42).
13. Repealer of subsections (a)(4)-(5), subsection renumbering, amendment of subsections (c), (c)(2) and (e), repealer and new Form 1800 37A-524 and new Form 1800 37A-524a filed 7-15-2013; operative 10-1-2013 (Register 2013, No. 29).
14. Change without regulatory effect amending section and Note filed 8-29-2018 pursuant to section 100, title 1, California Code of Regulations (Register 2018, No. 35).
15. Amendment of section heading, section and Note filed 9-27-2021; operative 1/1/2022 (Register 2021, No. 40). Transmission deadline specified in Government Code section 11346.4(b) extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60 calendar days pursuant to Executive Order N-71-20. Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60 calendar days pursuant to Executive Order N-71-20.