Section 1869 - Supervised Experience: Required Documentation(a) When a written oversight agreement is required by section 4996.23.3 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 the 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 1870.(c)(1) Except as provided 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 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 1870 and in section 4996.20 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 4996.18, 4996.23, 4996.23.2, and 4996.23.3 of the Code.(C) The supervisor affirms an understanding of the requirements pertaining to direct supervisor contact as specified in section 4996.23.1 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 specified 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 4996.18 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 1870 and in section 4996.20 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 4996.23.2 of the Code.5. The age limit pertaining to experience hours as specified in section 4996.23 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 1870 and in section 4996.20 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 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 4996.23(d)(2), 4996.23(d)(3), and 4996.23.1(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 section 4996.23.2 of the Code.(4) Documentation of employment or volunteer status, as specified in section 4996.23.2 of the Code.(5) The applicant's accumulated hours of experience broken down by category as specified 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.Cal. Code Regs. Tit. 16, § 1869
1. New section 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: Section 4990.20, Business and Professions Code. Reference: Sections 4996.18, 4996.20, 4996.23, 4996.23.1, 4996.23.2 and 4996.23.3, Business and Professions Code.
1. New section 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.