801 capitol mall sacramento, california 95814 - state personnel board

CALIFORNIA STATE PERSONNEL BOARD801 Capitol Mall • Sacramento, California 95814

DATE: April 7, 2000

TO: ALL STATE AGENCIES AND EMPLOYEE ORGANIZATIONSDISABLED PROGRAM COORDINATORSEDD JOB SERVICE OFFICESEEO OFFICERSPERSONNEL OFFICERS

SUBJECT: Nontesting Classifications

This memorandum refers to recently enacted legislation effective January 1, 2000, whichrequires priority consideration for any person receiving public assistance under theCalWORKs program for any specified seasonal or entry level nontesting class vacancy.Since 1983, Government Code Sections 19063 through 19063.8 have required that priorityconsideration for seasonal jobs be given to qualified persons receiving public assistance.Senate Bill 1073 (Chapter 310, Statutes of 1999) adds all entry level nontestingclassifications to those for which priority consideration must be given. This memorandumprovides state agencies with guidance on the specified seasonal and entry level nontestingclassifications affected and the process established to assist state agencies to comply withthis legislation.

Attached you will find copies of Government Code Sections 19063 through 19063.8 asamended by Senate Bill 1073 (Attachment A), the list of seasonal and entry levelnontesting classifications for which CalWORKs recipients are to be given priority hiringconsideration, and the revised forms to be used for record keeping and auditdocumentation purposes.

GENERAL PROGRAM REQUIREMENTS

Effective January 1, 2000, any person receiving state public assistance under theCalWORKs program who meets the minimum qualifications for any specified seasonal oran entry level nontesting class shall be given priority consideration. For purposes of thisarticle, priority consideration means that each state agency is required to hire qualified andinterested job applicants who are receiving assistance under the CalWORKs program,before hiring any other applicant when filling vacant positions in the classes listed onAttachment B. If a state agency does not select a public assistance recipient to fill anopening, it shall document in its employment records the reasons why the publicassistance recipient was not selected.

Government Code Section 19063 through 19063.8 Implementation

PROCEDURES

Obtaining CalWORKs Referrals

To obtain CalWORKs referrals, a state agency must list each vacancy with theEmployment Development Department (EDD) Job Service Office closest to the work site.Attachment C is a current listing of EDD Job Service Offices, however state agencies areencouraged to check with EDD for any changes in office locations.

Participation in a seasonal or entry level nontesting class vacancy by a public assistancerecipient shall be voluntary only and in no event shall any person be subject to sanctions,through loss of benefits or eligibility, for not applying for, accepting, or continuing in sucha position. Job announcements posted for vacancies covered by this program mustexplain the voluntary nature of the application to work in a seasonal or entry levelnontesting class opening, the class title, job requirements, amount of pay, estimatednumber of hours, duration, work location and the job qualifications. All notices shall alsoinform public assistance recipients that they will have priority in being hired for jobs inthese openings as provided in Section 19063.

State agencies may establish qualified hiring pools of CalWORKs recipients, which willbe used to fill several vacancies. Hiring pools can significantly reduce the time necessaryto recruit, interview and select employees for these classes. Public assistance recipientswho apply for openings under this article shall be required to undergo the sameemployment process used by state agencies to select any other person for appointment to aposition in such a class. When a vacancy needs to be filled, and a hiring pool exists, thenew employee can quickly be selected from the available names contained in the pool.

While the majority of applicants will be through referrals from local EDD Job ServicesOffices, some CalWORKs recipients may contact hiring agencies directly. Theseapplicants must also be given hiring priority under the program. Written verification mustbe obtained through the county Social Services Department for any non-EDD referredapplicant who indicates that they are receiving CalWORKs benefits.

Exceptions & Waiver

Qualified and interested CalWORKs recipients must be hired before any other applicantexcept in the following circumstances:

1. A State agency is not precluded from hiring any person appointed during theprior 12 months in the same nontesting class.

2. Any seasonal or entry level nontesting classification specifically designed tosupport a program to train students, as determined by the board, to the extentthat they are authorized as of the effective date of this article, shall be exemptfrom this article. However, state agencies shall be encouraged by the SPB toincrease their efforts to recruit disadvantaged youth or students for these jobs.

Government Code Section 19063 through 19063.8 Implementation

3. Upon prior approval of the Governor, the provisions of the article may bewaived in order to address an emergency, which threatens the public health orsafety, the State’s natural resources, or the economy. If an emergency waiveris granted, notification including reasons for the waiver shall be forwarded tothe Joint Legislative Budget Committee within five working days. Requestsfor a Governor’s waiver in order to address an emergency as outlined in theexception criteria should be submitted in writing to:

Department of Personnel AdministrationAttn: S.R.O.A. Coordinator 1515 S StreetSacramento, CA 95814

Documentation Requirements

The law requires state agencies to document in its employment records the reasons whythe public assistance recipient was not selected. The following process will be used togather this information:

A. Each PAR document which records an appointment to any of the designatedclasses, must indicate under Item 957, Other Eligibility Substantiation, whetherthe appointment was a CalWORKs applicant, a returning CalWORKsemployee, a returning employee, or a non-CalWORKs applicant. A revision tothe PAM will be issued by the State Controller’s Office to incorporate the lawchanges.

B. Departments are required to maintain written documentation regarding allappointments to specified nontesting seasonal and entry level classifications.This documentation should be compiled on the Report of Appointment toNontesting Classification Subject to Government Code Section 19063, Form100-264 (Attachment D). This documentation must be maintained by thehiring department for a period of three years after the appointment date foraudit purposes. A copy of these forms can be downloaded from the SPB website at www.spb.ca.gov.

If you have any questions regarding this program you may contact Kris Sullivan orJennifer Roche, Personnel Resources & Innovations Division, Policy Review andConsultation Services, at (916) 653-0818, CALNET 8-453–0818 or TDD (916) 653-1498.

LAURA M. AGUILERA, ChiefPersonnel Resources and Innovations Division

Attachments

Attachment A

GOVERNMENT CODESECTION 19063-19063.8

SEC.5. Section 19063 of the Government Code is amended to read:

19063. (a) Any person receiving state public assistance under the CalWORKs program (Article3.2 (commencing with Section 11320) of Chapter 2 of Part 3 of Division 9 of the Welfare andInstitutions Code) who meets the minimum qualifications for any civil service position describedby the State Personnel Board as a seasonal or an entry level nontesting class that does not requirean examination shall be given priority consideration. "Priority consideration" means, for thepurposes of this article, that after consideration has been made for all conditions described in thissection, the state agency involved shall hire all qualified job applicants who are receiving statepublic assistance before hiring any other applicant. The board shall review all nontesting classesand determine those that are subject to this article. (b) Public assistance recipients who apply for openings under this article shall be required toundergo the same employment process used by state agencies to select any other person forappointment to a position in such a class. If a state agency does not select a public assistancerecipient to fill an opening, it shall document in its employment records the reasons why thepublic assistance recipient was not selected and any other information determined to benecessary by the board. (c) The employment of public assistance recipients shall be consistent with the goalsestablished by each agency under Section 19790. (d) This section shall not preclude a state agency from hiring any person appointed during theprior 12 months in the class for which the vacancy exists.

SEC. 6. Section 19063.1 of the Government Code is amended to read:

19063.1. Each state agency that intends to establish qualified hiring pools, as defined by theState Personnel Board, for seasonal or entry level nontesting class employment shall notify theEmployment Development Department or its delegate in the area where the openings areexpected to occur at least 45 calendar days prior to the establishment of the pool. The stateagency shall request referrals of public assistance recipients and at the same time shall providenecessary job-related information.


19063.2. Each state agency that has an open seasonal or entry level nontesting class position, butdoes not have a qualified hiring pool, shall notify the Employment Development Department orits delegate in the area where the job is located of the opening no later than five working daysafter the vacancy occurs. The state agency shall request referrals of public assistance recipientsand at the same time shall provide necessary job-related information. The agency shall provide areasonable period for referrals, but not less than 10 working days.

Attachment A

19063.3. This article may be waived by the Governor, if requested to do so by the state agencyinvolved, in order to address an emergency which threatens the public health or safety, the state'snatural resources, or the economy. If an emergency waiver is granted, notification includingreasons for the waiver shall be forwarded to the Joint Legislative Budget Committee within fiveworking days.

19063.4. If no public assistance recipient applies for a opening within the time limits establishedby this article, the state agency may fill the opening with a person not receiving publicassistance. In the event a person not receiving public assistance is hired, the state agency shallplace a certification in its employment records stating the date it contacted the EmploymentDevelopment Department or its designate, the name of the person contacted, the date the positionwas filled, and any other information determined to be necessary by the State Personnel Board.


19063.5. Notwithstanding any other provision of law, participation in a seasonal or entry levelnontesting class vacancy by a public assistance recipient shall be voluntary only, and in no eventshall any person be subject to sanctions, through loss of benefits or eligibility, for not applyingfor, accepting, or continuing in such a position. All notices shall explain the voluntary nature ofthe application to work in a seasonal or entry level nontesting class opening, the jobrequirements, the amount of pay, and the job qualifications. All notices, shall also inform publicassistance recipients that they will have priority in being hired for jobs in these openings asprovided in Section 19063.

SEC. 9. Section 19063.8 of the Government Code is amended to read: 19063.8. Any seasonal or entry level nontesting classifications specifically designed to support aprogram to train students, as determined by the board, to the extent that they are authorized asof the effective date of this article, shall be exempt from this article. However, state agenciesshall be encouraged by the board to increase their efforts to recruit disadvantaged youth orstudents for these jobs.

Attachment BSTATE CIVIL SERVICE

NON-TESTING CLASSIFICATIONSSUBJECT TO GC SECTION 19063

Rev. 4/00 -1-

Non-Testing Subject to GC19063

Class Title CurrentAdded 1/1/00

Agricultural Aide (Seasonal) XAgricultural Inspector/Technician I (Seasonal) XAgricultural Inspector/Technician II (Seasonal) XAgricultural Inspector/Technician III (Seasonal) XAgricultural Survey Interviewer I XAnimal Technician I XArcheological Aid (Seasonal) XArcheological Project Leader (Seasonal) XArcheological Specialist (Seasonal) XAssistant Exam Proctor XBackcountry Trails Camp Supv, CCC XCommunity Youth Resouce Specialist XElection Official, PERB XExam Proctor XExposition Assistant I XFire Lookout (Seasonal) XFish & Wildlife Scientific Aid XFish & Wildlife Seasonal Aid XGroup Supervisor Trainee XGuide Trainee, Historical Monument XLabor Supervisor (Casual Employment) XLaborer - Building Trades (Casual Employment) XLicense Inspector (Seasonal) XLifeguard I (Seasonal) XLifeguard II (Seasonal) XMaintenance Aid (Seasonal) XMaintenance & Service Occupational Trainee XMechanical & Technical Occupational Trainee XOffice Occupations Trainee XPark Aid (Seasonal) XPark Aid (Seasonal) (Angel Island) XPark Interpretive Specialist (Seasonal) XPool Lifeguard (Seasonal) XProcessing Fruit & Vegetable Inspector I (Seasonal) XProcessing Fruit & Vegetable Inspector II (Seasonal) XProcessing Fruit & Vegetable Inspector III (Seasonal) XScientific Aide XSeasonal Clerk XSenior Park Aid (Seasonal) XSkilled Trades Apprentice (Casual Employment) X

Attachment BSTATE CIVIL SERVICE

NON-TESTING CLASSIFICATIONSSUBJECT TO GC SECTION 19063

Rev. 4/00 -2-

Non-Testing Subject to GC19063Class Title Current 1/1/00

Skilled Trades Apprentice (Casual Employment) (Asbestos Worker Mechanic) XSkilled Trades Apprentice (Casual Employment) (Blacksmith) XSkilled Trades Apprentice (Casual Employment) (Carpenter) XSkilled Trades Apprentice (Casual Employment) (Carpet/Soft Tile Setter/Resilient Floor Covering Installer)

X

Skilled Trades Apprentice (Casual Employment) (Cement Finisher) XSkilled Trades Apprentice (Casual Employment) (Construction Equipment) XSkilled Trades Apprentice (Casual Employment) (Electrician) XSkilled Trades Apprentice (Casual Employment) (Fusion Welder) XSkilled Trades Apprentice (Casual Employment) (Glazier) XSkilled Trades Apprentice (Casual Employment) (Hodcarrier) XSkilled Trades Apprentice (Casual Employment) (Lather) XSkilled Trades Apprentice (Casual Employment) (Mason) XSkilled Trades Apprentice (Casual Employment) (Metal Trades) XSkilled Trades Apprentice (Casual Employment) (Millwright) XSkilled Trades Apprentice (Casual Employment) (Operating Engineer) XSkilled Trades Apprentice (Casual Employment) (Painter) XSkilled Trades Apprentice (Casual Employment) (Plasterer) XSkilled Trades Apprentice (Casual Employment) (Plumber) XSkilled Trades Apprentice (Casual Employment) (Reinforcing Steel) XSkilled Trades Apprentice (Casual Employment) (Roofer) XSkilled Trades Apprentice (Casual Employment) (Sheet Metal) XSkilled Trades Apprentice (Casual Employment) (Shipwright) XSkilled Trades Apprentice (Casual Employment) (Steamfitter) XSkilled Trades Apprentice (Casual Employment) (Structural Steel) XSkilled Trades Apprentice (Casual Employment) (Tile Setter) XSkilled Trades Apprentice (Casual Employment) (Welder) XSnow Gauger XState Fair Worker (Casual Employment) (Various) XSurvey Interviewer XTemporary Clerk X

Attachment C

Page 1 March 31, 2000

EMPLOYMENT DEVELOPMENT DEPARTMENTJOB SERVICE LOCATIONS BY COUNTY

ALAMEDA COUNTY

Fremont39155 Liberty Street, B200510.794.3753510.794.2400 Fax

Hayward22225 Foothill Boulevard510.887.4660510.783.2556 Fax

Oakland675 Hegenberger Road510.563.5283510.563.5347 Fax

BUTTE COUNTY

Chico CommunityEmployment Center2445 Carmichael Drive530.895.4634530.895.6488 Fax

Oroville2185 Baldwin Avenue530.538.7301530.534.1167

CALAVERAS COUNTY

Angels Camp571 Stanislaus Avenue209.736.9693209.736.4064 Fax

COLUSA COUNTY

Colusa146 Market Street530.458.7642530.458.7918 Fax

CONTRA COSTA COUNTY

Antioch218 I Street925.777.2109925.756.1758 Fax

Brentwood120 Oak Street925.777.2109925.756.1758 Fax

Pleasant Hill363 Civic Drive925.602.1563925.602.1540 Fax

Richmond330 – 25th Street510.970.7379510.970.7372 Fax

DEL NORTE COUNTY

Crescent City245 Price Mall707.464.2112707.464.5695 Fax

EL DORADO COUNTY

Meyers3141 U.S. Highway 50, Suite B530.573.2330530.573.2320 Fax

Placerville4535 Missouri Flat Road, Suite101530.642.5516530.642.5523 Fax

South Lake Tahoe3141 U.S. Highway 50, Suite B530.573.6740530.573.6735 Fax

FRESNO COUNTY

Fresno – North1455 E. Shaw Avenue559.244.7676559.244.7686 Fax

Fresno – West2555 S. Elm Avenue559.455.6747559.455.5850 Fax

Huron36612 Central Avenue559.945.5002559.945.2995 Fax

Mendota660 Tule Street559.655.3711559.655.3453 Fax

Sanger1939 Academy Avenue559.875.1736559.875.7585 Fax

HUMBOLDT COUNTY

Eureka409 K Street707.445.6531707.444.2222 24-Hour Job Line707.445.6781 Fax

IMPERIAL COUNTY

Calexico601 South Imperial Avenue760.339.2709760.339.2740 Fax

El Centro1550 W. Main Street760.339.2709760.339.2740 Fax

INYO COUNTY

Bishop873 N. Main Street760.873.7185760.873.6902 Fax

Attachment C


KERN COUNTY

Bakersfield1924 Q Street661.395.2804661.322.4334 Fax

Bakersfield5121 Stockdale Highway, Suite100661.336.6700661.336.2750 Fax

Delano800 11th Avenue661.721.3411661.725.4364 Fax

Lamont10215 Stobaugh Street661.336.6789661.336.6817 Fax

Ridgecrest540 Perdew Street, Suite C760.446.5373760.446.5108 Fax

KINGS COUNTY

Hanford124 N. Irwin Street559.585.3540559.584.3763 Fax

LAKE COUNTY

Clearlake7105 S. Civic Center Drive,Suite 420707.994.6711707.263.7637 Fax

Lakeport991 Parallel Drive707.262.3105707.263.7637 Fax

LASSEN COUNTY

Susanville2545 Main Street530.251.2854530.257.9710 Fax

LOS ANGELES COUNTY

Canoga Park21010 Vanowen Street818.596.4200818.596.4228 Fax

Carson1 Civic Plaza, Suite 500323.290.5280323.290.5110

Chatsworth One-Stop20500 Nordoff Street818.596.4200818.596.4228 Fax

City of Commerce1231 S. Gerhart626.350.6509626.459.4371 Fax

Compton1940 N. Bullis Road310.223.1200310.604.1441 Fax

Compton700 N. Bullis Road310.605.3050310.605.3067 Fax

El Monte10404 E. Valley Boulevard626.350.6509626.459.4371 Fax

Gardena16801 S. Western Avenue, SuiteA310.217.9579310.217.6146 Fax

Glendale1255 S. Central Avenue818.596.4200818.596.4228 Fax

Huntington Park2677 Zoe Street323.290.5280323.290.5110 Fax

Inglewood110 S. La Brea Avenue, Room503323.290.5280323.290.5110 Fax

Inglewood2930 W. Imperial Highway#515323.290.5280323.290.5110 Fax

Lancaster1420 West Avenue I661.945.8131661.945.5767 Fax

Long Beach3447 Atlantic Avenue562.570.3658562.570.3790 Fax

Los Angeles-Crenshaw5401 S. Crenshaw Boulevard323.290.5280323.290.5110 Fax

Los Angeles-South Central12700 S. Avalon Boulevard323.290.5280323.290.5110 Fax

Los Angeles Metropolitan158 W. 14th Street626.350.6509626.459.4371 Fax

Los Angeles3921 Selig Place323.290.5280323.290.5110 Fax

Norwalk12715 S. Pioneer Boulevard626.350.6509626.459.4371 Fax

Pasadena1207 E. Green Street626.350.6509626.459.4371 Fax

Pomona150 E. Arrow Highway626.350.6509626.459.4371 Fax

Attachment C


San Fernando1250 San Fernando Road818.596.4200818.596.4228 Fax

San Pedro1851 N. Gaffey Street323.290.5280323.290.5110 Fax

Santa Clarita21515 Soledad Canyon Road,Suite 121818.596.4200818.596.4228 Fax

Santa Monica932 Broadway323.290.5280323.290.5110 Fax

Sun Valley One-Stop9024 Laurel Canyon Boulevard818.596.4200818.596.4228 Fax

Torrance1220 Engracia Avenue323.290.5280323.290.5110 Fax

Watts/Southeast10950 S. Central Avenue323.290.5280323.290.5110 Fax

West Covina933 S. Glendora Avenue626.350.6509626.459.4371 Fax

Whittier9825 S. Painter Avenue626.350.6509626.459.4371 Fax

MADERA COUNTY

Madera114 South A Street559.675.5264559.673.1789 Fax

MARIN COUNTY

San Rafael3301 Kerner Boulevard415.257.3660415.454.2699 Fax

MENDOCINO COUNTY

Fort Bragg310 E. Redwood Avenue707.964.3295707.964.2109 Fax

Ukiah631 South Orchard707.463.5710707.463.4795 Fax

Willits1155 South Main Street707.459.3885707.459.7050 Fax

MERCED COUNTY

Los Banos1075 H Street209.826.0420209.826.4068 Fax

Merced1205 West 18th Street209.726.5404209.726.5444

MODOC COUNTY

Alturas802 N. East Street530.233.4133530.233.7716 Fax

MONTEREY COUNTY

Greenfield690 Walnut Avenue831.674.4065831.674.4050 Fax

Monterey Peninsula480 Webster Street831.649.2925831.649.2828 Fax

Salinas730 La Guardia Street831.796.3696831.796.3650 Fax

NEVADA COUNTY

Nevada City117 New Mohawk Road, Suite D530.470.1902530.470.1906 Fax

Truckee10075 Levon Avenue, Suite 206530.582.7332530.582.7335 Fax

ORANGE COUNTY

Anaheim2450 E. Lincoln Avenue714.518.2323714.518.2393 Fax

Costa Mesa1675 Scenic Avenue, Suite 100714.518.2323714.518.2394 Fax

Garden Grove11277 Garden Grove Blvd.,Suite 101C714.518.2323715.518.2394 Fax

Mission Viejo23456 Madero Street #150714.518.2323714.518.2392 Fax

Santa Ana1000 E. Santa Ana Blvd., Suite103714.518.2323714.518.2394 Fax

PLACER COUNTY

Roseville1800 Sierra Gardens Dr., Suite100916.774.4045916.786.6177 Fax

Attachment C


PLUMAS COUNTY

Quincy1905 E. Main Street530.283.6852530.283.4317

RIVERSIDE COUNTY

Blythe1277 W. Hobson Way760.922.3173760.342.7590

Corona237 W. River Road909.340.4060909.734.5783 Fax

Hemet151 N. Lyon Avenue909.765.0731909.652.9841 Fax

Indio47110 Calhoun Street760.922.3173760.342.7590 Fax

Palm Springs1111 E. Tahquitz Canyon Way,Suite C760.568.4551760.327.3984 Fax

Riverside1161 Spruce Street909.955.2200909.955.2220 Fax

Temecula27447 Enterprise Circle West909.600.6000909.600.6035 Fax

SACRAMENTO COUNTY

Sacramento-Midtown2901 50th Street916.227.0301916.227.0208 Fax

SAN BERNARDINOCOUNTY

Barstow2700 Barstow Road760.252.2878760.252.7547 Fax

San Bernardino646 N. Sierra Way909.888.8385909.798.6857 Fax

Fontana17590 Foothill Boulevard909.350.2083909.350.8942 Fax

Ontario2314 S. Mountain Avenue, Suite A909.458.1650909.460.7659 Fax

Redlands814 W. Colton Avenue909.798.0683909.798.6857 Fax

Victorville15419 Cholame760.241.1647760.241.2468 Fax

SAN BENITO COUNTY

Hollister1111 San Felipe Road, Suite 107831.638.3311831.637.0478 Fax

SAN DIEGO COUNTY

Chula Vista1111 Bay Boulevard619.424.1112619.424.1144 Fax

El Cajon924 E. Main Street619.689.6227619.689.6231 Fax

Escondido1935 E. Valley Parkway619.689.6227619.689.6231 Fax

Oceanside2027 E. Mission Avenue, Suite E619.689.6227619.689.6231 FAX

San Diego6145 Imperial Avenue619.689.6227619.689.6231 Fax

SAN FRANCISCO COUNTY

San Francisco3120 Mission Street415.749.7500415.749.7477 Fax

SAN JOAQUIN COUNTY

Lodi631 E. Oak Street209.333.6904209.941.1935 Fax

Manteca1783 W. Yosemite Avenue209.825.1360209.941.1935 Fax

Stockton135 W. Fremont Street209.948.7862209.941.1935 Fax

Tracy213 West 11th Street209.833.1020209.833.1027 Fax

SAN LUIS OBISPOCOUNTY

Paso Robles2800 Buena Vista Dr., Bldg.4000805.238.4847805.238.5067 Fax

Attachment C


San Luis Obispo4111 Broad Street, #A805.788.2697805.549.9974 Fax

SAN MATEO COUNTY

South San Francisco230 S. Spruce Avenue650.737.2605650.737.9379 Fax

Santa Barbara County130 E. Ortega Street805.568.1280805.568.1316 Fax

Santa Maria304 W. Carmen Lane805.349.8123805.922.4912 Fax

SANTA CLARA COUNTY

Campbell2450 S. Bascom Avenue408.369.3604408.369.3680 Fax

Sunnyvale420 S. Pastoria Avenue408.774.2374408.732.8526 Fax

SANTA CRUZ COUNTY

Capitola2045 40th Avenue, Suite B831.464.5627831.462.4369 Fax

Watsonville18 W. Beach Street831.464.6283831.763.8706 Fax

SHASTA COUNTY

Redding1325 Pine Street530.225.2284530.225.2206 Fax

SISKIYOU COUNTY

Weed310 Boles Street530.938.3231530.938.1366 Fax

SOLANO COUNTY

Suisun320 Campus Lane707.863.3570707.864.3216 Fax

Vallejo1440 Marin Street707.649.4706707.645.9856 Fax

SONOMA COUNTY

Petaluma680 Sonoma Mountain Parkway707.778.2440707.778.2439 Fax

Santa Rosa606 Healdsburg Avenue707.576.2360707.576.2859 Fax

STANISLAUS COUNTY

Modesto629 12th Street209.576.6005209.576.6197 Fax

Oakdale1405 West F Street, Suite J209.848.4241209.848.4235 Fax

Turlock125 N. Broadway209.669.2950209.669.2965 Fax

TRINITY COUNTY

Weaverville1248 Main Street530.623.2342630.623.5276 Fax

TULARE COUNTY

Porterville61 N. Second Street559.788.6452559.788.6485 Fax

Visalia2370 W. Whitendale559.636.7350559.739.0633 Fax

TUOLUMNE COUNTY

Sonora19890 Cedar Road, North, Suite B209.536.2971209.536.2977 Fax

VENTURA COUNTY

Oxnard635 S. Ventura Road805.382.8614805.382.8701

Simi Valley980 enchanted Way, Suite 105805.582.8714805.522.8328 Fax

YOLO COUNTY

West Sacramento500 A Jefferson Boulevard,Suite 110916.375.6288916.375.6310 Fax

Woodland825 East Street, Bldg. C530.668.3111530.668.3153

YUBA COUNTY

Marysville1204 E Street530.741.4151530.743.7058 Fax

State Personnel BoardForm 100-264 (4/00)

REPORT OF APPOINTMENT TO NON-TESTING CLASSIFICATIONSUBJECT TO GOVERNMENT CODE 19063

1. Department:

5. Location (City) of Position Filled:

4. Non-Testing Classification of Hire:

2. Institution, Hospital or Facility (if applicable):

7. Name of Person Hired:

COMPLETED FORMS MUST BE RETAINED FOR SPB AUDIT PURPOSES FOR THREE (3) YEARSAFTER THE APPOINTMENT DATE FOR WHICH IT WAS COMPLETED.

Name & Title of Person Completing Form (Date)(Telephone Number)

New Hire:

Rehire of Former Non-Testing Employee, in sameclassification, within 12 months of last date worked:

9. Appointment Type:

6. Effective Date of Hire:

(Date Last Worked)

a. Is the person hired a CALWORKs recipeint (or were they at thetime job was offerred)?

b. Was this hire made from an established employment pool?

c. Was this hire made under the provisions of a waiver in order toaddress an emergency as described in Section 19063.3 of thisAct?

Yes (Go to Section II)No (Answer Question b.)

Yes (Notify the Joint Legislative Budget Committeewithin five days of date of hire of the circumstancesjustifying the need for the waiver and attach DPA waiverapproval.)No (Completed Form 264 - Side 2)

Yes (Completed Form 264 - Side 2 & Go to Section II)

No (Answer Question c.)

I. Position & Appointment Information

3. Position Number:

8. Social Security Number:

II. Documentation & Certification

The provisions of Government Code Section (GCS) 19063 require that all appointments to nontesting, seasonal or entry-level posi-tions be documented to ensure that public assistance recipients under CALWORKs are provided with priority consideration.

I hereby certify, by signature below, that all requirements of GCS 19063 were applied to this hire and that required documentation, asapplicable, is maintained on file.

State Personnel BoardForm 100-264 - Side 2

DOCUMENTATION FOR ESTABLISHMENT OF HIRING POOLAND APPOINTMENT TO NONTESTING, SEASONAL & ENTRY-LEVEL

CLASSIFICATIONS SUBJECT TO GOVERNMENT CODE 19063

Department:

Non-Testing Classificationfor Appointment/Hiring Pool:

Work Location (City) forPosition/Hiring Pool:

Location of Employment Development Department(EDD) One-Stop/Job Service Office Contacted:

Date EDD Contacted: Date Listed on CalJOBS: Final Date for AcceptingApplications:

Institution, Hospital orFacility (if applicable):

Number ofPositions:

Estimated Hoursper Month:

For Hiring Pools (if applicable):

# of CALWORKS Applicants Referred byEDD:

# of CALWORKS ApplicantsDirectly Replied:

# of non-CALWORKSApplicants Directly Replied:

HIRING POOL OR APPOINTMENT APPLICANT DOCUMENTATION

Name of Applicant Placed inPool or Hired

(Yes-Give Date or No)

CALWORKSAppplicant(Yes or No)

IF CALWORKs Applicant Not Placed in Pool/Hired, Specify Reason:Did NotAppear

Does notMeetMQs

WaivedJob Offer

Other (Specify)

COMPLETED FORMS MUST BE RETAINED FOR SPB AUDIT PURPOSES FOR THREE (3) YEARSAFTER THE APPOINTMENT DATE FOR WHICH IT WAS COMPLETED.

Name & Title of PersonCompleting Form:

Date:TelephoneNumber:

New Pool Merge With Existing PoolDate Pool Established:

801 capitol mall sacramento, california 95814 - state personnel board

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