26%
BHWD (MIP) Organizational Capacity Pre/Post Evaluation Survey
Questions marked with a
*
are required
The purpose of this survey is to assess your organization's strengths regarding the implementation of the Mentored Internship Program (MIP) and identify areas where training and technical assistance (TTA) could enhance your MIP capacity. Please note that one survey must be completed for
each
awarded application.
Organization Information
Date of survey completion
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2023
2024
What stage of the Mentored Internship Program (MIP) are you completing this survey?
Beginning of Round 2
End of Round 2
Organization Name
-- Select --
AHP (TEST)
Adventist Health Clear Lake
Aldea Inc.
AltaMed Health Services
Another Choice, Another Chance
Archway Recovery Services, Inc.
Bartz-Altadonna Community Health Center
Caminar
Casa Pacifica Centers for Children & Families
Center Point, Inc.
Children's Home of Stockton
Chinatown Service Center
Citrus Counseling Services, Inc.
CommuniCare Health Centers
Community Solutions for Children, Families and Individuals
Compatior, Inc.
Comprehensive Community Health Centers
Council on Alcoholism and Drug Abuse
Dignity Community Care dba California Hospital Medical Center
Dual Diagnosis dba Health Care Integrated Services Inc.
El Dorado County Community Health Center
El Hogar Community Services Inc.
Episcopal Community Services of San Francisco
Family Alliance for Counseling Tools & Resolution
Family Dynamics Resource Center
Florence Crittenton Services of Orange County; DBA Crittenton Services for Children & Families
Foothill Family Service
Fred Brown Recovery Services
Fresno Family Counseling Center/California State University, Fresno Foundation
Gardner Family Health Network, dba Gardner Health Services (Specialty Behavioral Health Division)
Gateways Hospital and Mental Health Center
Gateways Hospital and Mental Health Center, Conditional Release Program (CONREP)
Glenn County Behavioral Health
Grandma's House of Hope
Greater Hope Foundation for Children, Inc. (DBA: A Greater Hope)
Health Service Alliance
HealthRIGHT 360
Helpline Youth Counseling, Inc.
HEPPAC
Higher Ground Youth and Family Services
Hill Country Community Clinic
Humboldt County Department of Health and Human Services, Behavioral Health
Imperial County Behavioral Health Services
Inner-Tribal Treatment
Insights Counseling Group
Janus of Santa Cruz
Kings View
Korean Community Center of the East Bay
Korean Community Services dba KCS Health Center
La Clinica de La Raza, Inc.
LAGS Recovery Centers, Inc.
LifeLong Medical Care
Los Angeles Centers for Alcohol and Drug Abuse (L.A. CADA)
Mathiesen Memorial Health Clinic
Mendocino County Behavioral Health and Recovery Services
Merced County Behavioral Health and Recovery Services
Momentum for Health
Monterey County Health Department, Behavioral Health Bureau
Norooz Clinic Foundation
North County Health Project, Inc., d.b.a TrueCare
Open Door Community Health Centers
PathPoint
Penny Lane Centers
Petaluma Health Center
Phoenix House Orange County, Inc.
Phoenix Houses of Los Angeles, Inc.
Portia Bell Hume Behavioral Health and Training Center
Quality Group Homes DBA Quality Counseling Center
Rancho San Antonio Boys Home, Inc.
Rebekah Children's Services
Redwood Community Services Inc.
Remarkable Marriage and Family Institute dba Remarkable Services
Riverside University Health System - Behavioral Health
Sacramento Youth Center
Samuel Dixon Family Health Center, Inc.
San Diego Center for Children
San Diego Freedom Ranch, Inc.
San Mateo County Health Foundation
Seneca Family of Agencies
Sharp HealthCare Foundation on behalf of Sharp Mesa Vista Hospital
Shasta Community Health Center
Sierra Meadows Foundation
Social Model Recovery Systems, Inc.
St. John's Community Health
St. Joseph Center
Stanford Youth Solutions
STEPS Program at El Dorado Community Health Center
Sycamores
Tarzana Treatment Centers, Inc.
The AMAAD Institute
The Anti-Recidivism Coalition (ARC)
The Center for Sexuality & Gender Diversity
The DreamPower Foundation
The Guidance Center
The Happier Life Project
The Purpose of Recovery Inc
The Regents of the University of California, Davis
The Village Family Services
Tulare County Health and Human Services Agency, Mental Health Branch
United Indian Health Services
Valley Health Associates
Venice Family Clinic
Ventura County Behavioral Health Department/County of Ventura
Via Care Community Health Center
Victor Community Support Services, Inc.
Vista Hill Foundation
Vista Hill ParentCare Central
Wesley Health Centers (JWCH)
WestCoast Children's Clinic
Whole Systems Learning
Site Location Information
Site Address Line 1
Site Address Line 2
Site City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
Zipcode
Contact Information for Person Completing Survey
First Name
Last Name
Email Address
Position
Who are the target populations served by your organization?
Adult Men
Adult Women
Adults
American Indian or Alaska Native
Black or African American
Children
Families
Female Youth
Foster Youth
Hispanic or Latinx
Human Trafficking
Immigrants
Justice-Involved Persons
LGBTQIA+ Youth
LGBTQIA+ Adults
Male Youth
Older Adults
Sexually Exploited Adults
Sexually Exploited Children
Sexually Exploited Youth
Unhoused Persons
Veterans
White
Youth
Other
Please select ALL the services provided by your organization.
Peer Services
Peer Staff Supervision
Recovery Housing
Crisis Intervention
DEI/Cultural Competency
Life Skills Development
Digital Literacy
Mental Health Services
Trauma-Informed Care
Substance Use Disorder (SUD) (including alcohol) Services
Medication Assisted Treatment (MAT) Services
Recovery Planning
Justice-involved Populations/Reentry Services/Diversion Programs
Youth and/or Family Services
Anger management
Harm reduction
Other
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