<p> University of Southern Maine School of Social Work Agency Profile for Undergraduate/Graduate Student Placements</p><p>Name of agency: Community Counseling Center Date: 1/12/10 12/27/2011</p><p>Agency address: 165 Lancaster St. Portland Maine 04101</p><p>Agency telephone number: 207.874.1030</p><p>In arranging for field placements, whom should student contact? Blanca Gurrola, LCSW interim contact or Shana Kelley-Cohen, LCSW</p><p>Name of Field Instructor: Depends on what program the intern selects</p><p>Field Instructor telephone number: same as above </p><p>Field Instructor email address: same as above</p><p>Name of agency director and/or key administrative personnel: Name Position Blanca Gurrola, LCSW Director of Clinical Programs Shana Kelley-Cohen, LCSW Program Manager for Deaf services and internship program coordinator</p><p>Agency is able to handle: BSW student__1__For Elderworks Program only MSW foundation year student__1-3 For Elderworks Program and case management only MSW concentration year student __2-3_</p><p>How many students can your agency accommodate? We are planning on having 5-6 Students </p><p>Briefly describe the basic services/programs of the agency, client population served, and the size of your staff. We are a community mental health agency that serves individuals, couples and families. We have programs that serve adults, child, youth and families and elders. We also have specialized programs serving refugee and immigrants children, youth and families, deaf And hard of hearing children, youth and families and LGBTQI youth for more information please see attached document </p><p>When (day and time) are agency staff and other important meetings held? Most meetings happen on Tuesdays and Wednesdays What characteristics or qualities would be helpful for a student to have to best utilize the placement as a learning opportunity?  Initiative,  flexibility,  quick thinking  ability to address issues as they occur.  Eager to learn  Comfortable with self  Good communication skills  Good organization skills</p><p>List the learning opportunities available for the student in your setting: All staff trainings Internship training program with 2x month seminars Peer support group Weekly supervision</p><p>Is there adequate physical space for the student(s)? Yes</p><p>Does the student need a car? No Is mileage reimbursable? No</p><p>Can your agency provide an opportunity for students to fulfill part of their required placement hours on evenings or weekends? Yes</p><p>Does your agency require any formal training for interns? Yes, orientation and participation in the inter seminar series</p><p>If yes, how many training hours are required? 2 hours a month plus three days of orientation</p><p>When is the training offered? 3rd week in September is the orientation and the seminars are arranged based on the intern’s availability </p><p>Can the training be completed online? No </p><p>Is the agency handicapped accessible? Yes </p><p>Agency Requirements:</p><p>Background check (SBI) YesX___ No___</p><p>Physical Exam Yes___ No__X_ Immunizations Yes___ No__X_ (If yes, please name immunizations required)</p><p>Other pertinent information: Open House for students interested in internships here are CCC will be held February 5th from 1:00 – 2:30 PM at 343 Forest Avenue. </p>