Caseworker Interview Assessment Form Page 3
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10Calculate Total Score
Part A Score: _____ X .75 = Total Competency Score __________________
Part B Score: _____ X .25 = Total Functional/Tech Skills Score_______
Total Score: competencies and skills combined: ______________________________________
Part C: Possible Disqualifiers
An applicant receiving an acceptable score in Parts A and B, above, may be disqualified based on
demonstrating poor writing ability as determined by the writing exercise. An applicant may also be
disqualified from further consideration based on observations or other information shared during the
interview such as using profanity, speaking about youth using derogatory terms or having poor hygiene. In
such case, the interview panelists must state the specific reasons in the “Other” box below.
Writing Ability: (Based on Writing Exercise)
Other: (Must be specific)
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