CALIFORNIA DEPARTMENT of
Corrections and Rehabilitation

RELEASE DATE CHANGE NOTICE

INMATE NAME: GOEHLER, WILLIAM ROBERT
CDC #: K77832
FACILITY: MCSP-Facility A
HOUSING: A 002 2 - 23333001L
ASSIGNED CASE RECORDS ANALYST:REASON FOR RELEASE DATE CHANGE: S. King
ASSIGNED CORRECTIONAL COUNSELOR: B. Pham
REASON FOR RELEASE DATE CHANGE: CDCR Credits Received/Lost changed

CONTROLLING RELEASE DATE TYPE OF DATE
BEFORE: 05/05/2040 MEPD
AFTER: 04/28/2040 MEPD
CDCR CREDITS RECEIVED/LOST Work Group Duration (Days) RECD/Lost Days Reason Status Qualifier
Entry Date Effective Date Type
3/23/2020 3/17/2019 Milestone Completion Credit (MCC) 7 Self-help program Applied Course # AV10500
3/12/2018 2/18/2019 Work Group Change (done by CI's.) A1-Full Time Assignment 4051 Classification Action Pending

At this rate... my opportunities in here are ... infinite!

CDRC SOMS OTRCR122 3/24/2020 Page 1
Release Date Change Notice 3:00:00

Interested in Becoming a Certified Drug & Alcohol Counselor?

Apply now for the Offender Mentor Certification Program (OMCP)

Why Apply:
OMCP offers the education, training, and work experience necessary to secure a career as a certified alcohol and other drug (AOD) upon release from prison. While incarcerated, OMP Mentors may earn Milestone Completion Credits (MCC's), an educational merit credit (EMC), and wages varying from $0.45/hour to $2.00/hour.

Eligibility Criteria:
More than 5 years left to serve on your sentence (Lifers and LWOP's are eligible)
No pending or adjudicated-guilty serious RVR's in the last 2 to 3 years
Case by case review for administrative RVRs in the last 3 years.
No SHU terms in the last 3 years
Case by case review for SHU terms in the last 3 to 5 years
Reading level of 9.0 or above

***Note*** Space is limited. All candidates will be reviewed on a case by case basis for program eligibility based upon application packet and subsequent interviews.

Application and Selection Process:
Contact your CC I or local DRP CC III to obtain an application packet
Complete the application packet, including the 500 word essay, resume and list two staff character references
DRP CCII SOMS / ERMS review (C - File review)
Interviews with CDCR/DRP selection panel staff
Agree to and sign a CDCR OMCP Acceptance Transfer Chrono and Performance Agreement

Notes:
Chosen participants MUST sign a contract agreeing to transfer to ANY institution (as deemed appropriate by CDCR/DRP staff based on departmental needs and individual case factors) to perform duties as a Certified Drug and Alcohol Counselor.

If interested, contact your Correctional Counselor I or local DRP Correctional Counselor III.

Revised June 2020

CDCR 128-B

California Department of Corrections and Rehabilitation Offender Mentor Certification Program (OMCP)_

OMCP Acceptance and Transfer

Name: ___________________ CDCR #: _______________

The above offender has been selected to participate in CDCR's OMCP training held at:
SOL [] VSP [] CCWF [] COR [] CCI [] CMC [] LAC [].

This training is approximately 12 months in length, including an Integrated Substance Use Disorder Treatment (ISUDT) program, intense Alcohol and Other Drug (AOD) classroom instruction, closely supervised practicum, and culminating with the AOD examination. Upon successfully passing the exam, the candidate will be a registered AOD intern working towards an AOD certification to become an AOD counselor.

The selection process included OMCP application review, a 500 word essay, personal interview/assessment, and Central File review. Selecction staff assured this inmate met the eligibility criteria for participation in the OMCP training program established by CDCR Division of Rehabilitative Programs (DRP) and indicated below:

Has more than 5 years left to serve, has a Test of Adult Basic Education (TABE) score of 9.0, does not have any pending or adjudicated serious Rule Violation Reports (RVRs) within the last 24 months (24 to 36 months case-by-case), does not have any Security Housing Unit (SHU) terms within the last 36 months (36 to 60 months case-by-case), may be validated as a STG-I or STG-II member or associate, posses an active or potential felony hold, and have received an administrative RVR within the last 36 months on a case-by-case basis.

The above offender acknowledges and agrees to transfer to any institution or facility deemed appropriate by CDCR, based on both program and institutional needs, to perform the duties of an OMCP Mentor. Transfer may include a work override to a higher level prison, if deemed necessary.

It was explained during the interview that failing the final AOD exam may result in removal from the OMCP. It was also explained that upon successful completion of the AOD exam, refusing to transfer to a CDCR determined OMCP assignment location will result in removal from the OMCP.

__________________________________________ ________________________
CDCR DRP CCIII Printed Name & Signature Date

__________________________________________ ________________________
OMCP Candidate Date

CDCR 128-B GENERAL CHRONO

Revised 1-27-2020

CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
OFFENDER MENTOR CERTIFICATION PROGRAM (OMCP) - PERFORMANCE AGREEMENT

OMCP Candidate Name:________________________ Date:_______________

Candidates selected to participate in the CDCR Offender Mentor Certification Program (OMCP) will receive comprehensive alcohol and other drug counselor certification training. OMCP Mentors are required to model the highest level of personal integrity, professional ethics, good judgment, and constant accountability.

OMCP Mentor Job Description/Responsibilities:

1. Assist in the delivery of CDCR DRP ISUDT programming at various institutions by co-facilitating groups, providing program orientations and appropriate presentations under the supervision of contract staff.
2. Follow all ISUDT contract staff supervisor instructions to properly deliver rehabilitative treatment services.
3. Maintain a professional relationship with all supervisors (custody and contractor), staff, and inmates without bias, discrimination, exploitation, or influence.
4. Respect and protect the dignity and welfare of others by conforming to the high moral and ethical standards of your responsibility and certification requirements.
5. Report unlawful and unethical conduct to the appropriate authority; cooperate with investigations and maintain the trust of staff at all times.
6. Maintain personal integrity and sobriety; "Reasonable Suspicion Urinalysis Testing" may be performed if deemed necessary.
7. Demonstrate leadership, teamwork and initiative as a positive role model by reporting to work each day on time, contributing to a safe therapeutic community work environment.
8. Assist staff and fellow OMCP Mentors in supporting positive secure living environment and maintain confidentiality and compassion for inmates during "non-paid" activities. Provide accurate information and education to support their recovery from addiction.
9. Uphold a healthy personal and professional level of conduct to remain effective in your position, asking for help when needed. Understand the limitations of your knowledge, training and position as an OMCP Mentor.
10. Continue your success, growth, and development through education, patience, persistence and dedication.
11. Turn in a signed, completed OMCP Verification of Hours Timesheet to the contract staff supervisor on a timely basis and retain all original timesheets.

You may be assigned additional duties at the discretion of the contract staff supervisor. You will not be asked to participate in the preparation or handling of any documents which are classified as confidential. Your performance will be evaluated regularly throughout your service as a Mentor. You are responsible for notifying your contract staff supervisor and CC III immediately should you receive any duty limitations (CDCR Form 128C or CDCR Form 1845) from the Medical Department. If you have any questions regarding your job duties or expectations, seek clarification form your contract staff supervisor and Correctional Counselor (CC) III.

Revised 3.2020.

CDCR OMCP PERFORMANCE AGREEMENT (Continued) Page 2

Expected Behavior Standards:

1. Adhere to all laws, rules and regulations of CDCR and the ISUDT Provider.
2. Uphold all aspects of the Certifying Organizations Code of Ethics and Scope of Practice.
3. Maintain strict confidentiality and positive professional relationships with all colleagues, including contract and custody staff and fellow OMCP Mentors.
4. Apply yourself diligently to learning all material presented, including completion of homework and other assignments.
5. Work to create friendships with fellow OMCP Mentors to support each other in their roles as co-facilitators, and gaining self-awareness.
6. Create a positive community for inmates interested in learning and making positive changes in their lives.
7. Represent the OMCP by: maintaining a positive attitude and demeanor, dressing appropriately in clean and neat clothing, and practicing good personal hygiene.
8. Understand the limits of practice, and ask for guidance when unsure of how to deal with situations that arise.

Failure or Refusal to Meet Expected Behavior Standards:

Failure to comply with the requirements of this assignment and/or the California Code of Regulations (CCR), Title 15, will result in appropriate disciplinary action. If found guilty of a rule violation defined in CCR Title 15, or pattern of rule violations, you may be dismissed as an OMCP Mentor. If it's determined you are engaged in an inappropriate relationship (sexual or not) with another inmate, or violate confidentiality, this may result in a dismissal form the OMCP Mentor assignment. Reassignment is at the discretion of the CDCR and on a case-by-case basis.

I have read and received a copy of this signed job description and fully understand my duties and responsibilities.

Inmate's Printed Name:__________________________ Date: ____________

Inmate's Signature: ____________________________ CDCR #: ____________

Local CC III Printed Name: _____________________ Date: ____________

Local CCIII Signature: __________________________

Distribution: Original: CCIII
Copy: ISUDT Program Director
Copy: Inmate
Copy: DRP Program Analyst

Revised 3.2020

CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
OFFENDER MENTOR CERTIFICATION PROGRAM (OMCP) - APPLICATION

Applicant Name (please print): ______________________ CDCR #: ____________

Present Job Assignment: _______________________ City/County of Commitment: ________

EPRD/MEPD: _____________________ Housing: _______________________

Describe your involvement in self-help or volunteer programs: ___________________________________

Have you been a Co-Facilitator or Teacher's Assistant? Yes / No

If yes, describe your experience as a Mentor, Big Brother, Co-facilitator, Teacher, Teacher's Assistant, Sponsor: __________________

Have you ever had problems with drugs and/or alcohol? Yes / No

If yes, describe your history of problems with drugs and or alcohol use: _____________________

Do you have public speaking experience? Yes / No

If yes, describe any public speaking experience you have had: _______________________

What significant positive changes have you applied in your life? (please be specific) _________________

List three reasons you are interested in participating in the OMCP? ____________________

Selected candidates complete the first part of training (approximately one year) at one of the training institutions. Training includes completion of an accelerated Integrated Substance Use Disorder Treatment (ISUDT) Program, Alcohol and Other Drug (AOD) education, practicum, and sitting for an AOD exam. After successfully passing the exam, OMCP Mentors are transferred back to their home institution, or to an institution chosen by CDCR, to work as a co-facilitator to complete the required internship hours to become a certified AOD counselor.

OMCP Applications must include an updated resume, two (2_ character references from staff, any certificates earned and a 500-word essay answering the following:
"How do I maintain my recovery AND what can I offer others to sustain their recovery?"
For more information on OMCP,
contact your institution's DRP Correctional Counselor (CC_) III or your assigned CC I.
If you need more space to answer the above questions, please include additional pages as necessary.

Revised 1-27-2020.

CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
OFFENDER MENTOR CERTIFICATION (OMCP) PROGRAM
APPLICATION - CANDIDATE RESUME

OMCP Applicant Name: __________________ Date: ________________

Permanent Address: ____________________________

My Objective in applying for the OMCP: ______________________

Work Experience:

Education:

Certificates or Accreditations:

Staff Character References:
1. Name: __________________ Title: _____________________
Contact Information: ___________________
How do you know this person? ________________
2. Name: __________________ Title: _____________________
Contact Information: ___________________
How do you know this person? ________________

Revised 1/27/2020

CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
OFFENDER MENTOR CERTIFICATION PROGRAM (OMCP)
APPLICATION - WRITTEN ESSAY

Use the space below for your 500 word essay describing:
How do you maintain your recovery and what can you offer others to sustain their recovery from problems with drugs or alcohol?

OMCP Applicant Name: __________________

_____________________________________________________________

Revised 1/27/2020

Inmate Name: __________________ CDCR#: ___________________ Date: ___________

OMCP INTERVIEW QUESTIONS

1. Why do you want to become and OMCP Mentor?

2. What is your experience with substance use disorders or other addictive behaviors (violence, gambling, etc.)? Are you in recovery yourself? How long?

3. What education, experience, or personal characteristics do you have that make you a good candidate for the OMCP position?

4. Please explain your correct commitment offense and the circumstances that led up to it. How do you feel you can use this experience to help others?

5. As an OMCP Mentor, you may find yourself in sensitive or uncomfortable situations. What would you do if you observed another inmate participating in illegal or inappropriate activity? What would you do if you observed free staff doing something illegal?

6. If you are accepted into the OMCP, are you willing to transfer to any institution based on program needs? While working towards your Alcohol and Other Drug certification, you won't be allowed to participate in voluntary and self-help programs during your work hours. Are you okay with that?

7. Do you have any questions for the panel/me, or is there anything else you would like to add?

Revised 2/11/2020