Cities Index.
CPRC Applications

Mayor's Nominating and Screening Committee
March 7, 2023

Document
CPRC Applications
Meeting
March 7, 2023
Body
Mayor's Nominating and Screening Committee
Pages
7
Original file
5.4 MB
Text extracted from the city's file for reading and search. Open the original on riversideca.legistar1.com. That file is the official record.

Submit Date: Jan 28, 2023
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 2

Which Boards would you like to apply for?
Community Police Review Commission: Submitted
Board of Ethics: Submitted
Planning Commission: Submitted
Ms./Mr.

Mr.

Business Address
Business Phone
Length of residence in City of Riverside
9 Are you a registered voter of the City of Riverside?

Yes

No
Justin
I
Ramirez
Riverside
CA
U.S. Army
Counterintelligence Special
Agent
Justin I Ramirez

Page 1 of 5 ends

Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

I want to serve so that I'm better engaged in my community and the city I live in.

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

I have experience in working with local city government with code enforcement, planning and law enforcement.

EDUCATIONAL BACKGROUND:

Associates Degree in Counterintelligence Studies. Currently working on my Bachelors Degree at UC Riverside.

OCCUPATIONAL EXPERIENCE:

Worked in the Military and City Government for the past 11 years.

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

California Association of Code Enforcement Officers

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

American Legion and Veterans of Foreign Wars
Justin I Ramirez Page 2 of 5

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Justin I Ramirez

Page 3 of 5 ends

Upload a Resume
Additional document(s)
Additional document(s)
Question applies to Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor? Yes No
Question applies to Community Police Review Commission
Do you have basic computer skills?
Yes No
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? Web Site
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
Justin_Ramirez_Resume_JAN_23.docx
Justin I Ramirez Page 4 of 5
Justin Ignacio Ramirez III

PROFESSIONAL SUMMARY
Demonstrated unique skill set and expertise in the field of Counterintelligence, Program Protection and Site Security. Over 12 years working with the U.S. Army and City Government has gained me a wealth of knowledge for making key decisions on how to safeguard our Nation’s Classified Materials.

PROFESSIONAL EXPERIENCE
October 2018 – Present (Reserves)
U.S. Army Reserves – A CO 314th MI BN Bell, CA
Military Intelligence – Counterintelligence Special Agent o Deployed to Kuwait, Iraq and Syria in April 2022 to February 2023 in support of Combined Joint Task Force Operation Inherent Resolve in the continued effort to defeat Terrorism in order to set conditions for long-term security in the Middle East. o Investigations of: National Security Crimes, Defection of Military personnel and DA Civilians overseas, security violations, AWOL/Deserters and Suicides involving someone with access to Classified Material
o Operations: Counterintelligence (CI) Special Operations/National Foreign CI Program, Offensive CI Programs, CI Support to Force Protection and Participate in Human Intelligence Operations
o Collection: Intelligence collection related to Foreign Intelligence Service activities, intelligence collection related to National Security Crimes, write Intelligence Information Reports and Intelligence Debriefings
o Analysis and Production: CI analysis focusing on Foreign Intelligence, Insider Threat, CI Threat and Vulnerability Assessments, CI Studies of Foreign Intelligence Entities and Insider Threats
o Interpret and implement Security Classification Guidance o Ensure all classified materials are marked and controlled in accordance with Department of Defense Guidelines
o Conduct Counterintelligence Threat Vulnerability and Assessments to help Commanders make informed decisions on overall Base Security
o Conduct Threat Awareness and Reporting Program Briefs o Department of Defense Top Secret Security Clearance (TS-SCI) with active CI Polygraph March 2018 – Present
City of Highland – Highland, CA
Code Compliance Officer
o Issue liens, warrants or notices to abate on properties considered a public nuisance o Ensure that Commercial, Residential and Business Licenses are current with all business/properties throughout the City
o Investigate cases for nuisance abatement and code violations; perform citywide surveillance, enforcing compliance with city ordinances
o Coordinate with local Law Enforcement to investigate cases of vagrancy, squatting and trespassing when dealing with the homeless
o Prepare detailed case notes and work with the City Attorney’s Office regarding legal issues on cases that may appear in court
February 2017 – March 2018
1 City of Moreno Valley Code & Neighborhood Services – Moreno Valley, CA Code Compliance Officer
o Investigate cases for nuisance abatement and code violations; perform citywide surveillance, enforcing compliance with city ordinances
o Issue citations for parking violations as needed
o Removing signs from the public right-of-way
o Identifying locations of abandoned shopping carts and debris throughout the City o Assisting in the identification of specific violations as assigned by Code Compliance Supervisor
o Help to preserve the community, enhance property values and improve the overall quality of life throughout the City of Moreno V alley
o Educating the public on City Standards and Code Regulations February 2012 – September 2018 (Reserves)
California Army National Guard – B CO 1-185 IN Riverside, CA Infantrymen/ Specialist/E-4
o Serve as a Fire Team Leader with responsibility of 3 subordinate Soldiers o Perform monthly inventories on sensitive items of all assigned equipment o Trained in close quarters combat and to engage and close in with the enemy with hand to hand combat or various weapons systems
o Operate, maintain, and clean assigned various weapons platforms o Sexual Harassment/Assault Response and Prevention Coordinator and Victims Advocate for my unit
o Risk Management and Safety Management Coordinator for my Troop Company o Deployed to Germany in April 2016 for participation in Saber Junction 16-04 Mission between U.S. Military and Multinational European Military’s o Deployed to the Philippines in April 2013 for participation in Balikatan 2013 Mission between U.S. Military and Philippines Military
o Awarded the Army Achievement Medal during deployment in the Philippines May 2013– February 2017 (Active Duty)
U.S Army V eterans Honors Program – Riverside National Cemetery, CA U.S. Army Honor Guard Team Member
o Active Duty Operational Support with the CA Army National Guard-Honor Guard Team 4 (Riverside National Cemetery) and Team 7 (SF Bay Area)
o Perform Military Funeral Honors for U.S. Army V eterans o Level II Army Honor Guard Instructor Certified
o Southern CA Army Honor Guard Training NCOIC
o In charge of over 15 M-day (part time) subordinate soldiers o Training and mentoring of soldiers to be in compliance of Honor Guard Principles and Standard Operating Procedures
o Folding and presentation of the U.S. Flag to the next of kin, pall bearing and escorting of Veteran remains, playing of taps and firing of rifle volleys o Coordinate and schedule Military Funeral Honors with the funeral home and family members o Performed over 1,800 U.S. Army Honor Guard Services
o Awarded the Honor Guard Tab and Honor Guard Badge
November 2006 – February 2012
Neiman Marcus – S.F. Bay Area
Loss Prevention Investigator
o Monitor company assets and property via CCTV
o Detain and interview shoplifter's
2 o Conduct awareness meetings with associates regarding profit protection and risk management strategies
o Entrusted with keys & alarm codes to close and open the store o Identify and investigate fraudulent activity involving credit cards and checks o Detain and interview suspects involved in identity theft and credit fraud o Conduct audits on all registers and precious jewelry, monitor and neutralize internal shortage o Head of the safety committee to ensure OSHA standards were kept o Conduct OSHA safety standards classes to all employees

EDUCATION
2023 Cochise College – Sierra Vista, AZ
Associates Degree in Counterintelligence Studies
2006 Mt. Pleasant High School – San Jose, CA
High School Diploma

QUALIFICATIONS
o Department of Defense Top Secret Security Clearance – Sensitive Compartmented Information (TS-SCI) with active CI Polygraph
o Proficient in Microsoft Office and Outlook
o Bi-Lingual in basic Spanish
o U.S. Army Risk Management Basic Course
o U.S. Army Injury Prevention through Leadership Course o U.S. Army Commanders Safety Course
o U.S. Army Sexual Harassment/Assault Response & Prevention (SHARP) Course o U.S. Army SHARP Coordinator and Victims Advocate Course o U.S. Army Structured Self Development Level 1
o U.S. Department of Defense Anti-Terrorism Level 1 Awareness Training o U.S. Department of Defense Information Assurance Awareness Training o U.S. Department of Defense Information and Security Prevention Course 3 Submit Date: Jan 05, 2019
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 2

Which Boards would you like to apply for?
Community Police Review Commission: Submitted
Ms./Mr.

Mr.

Business Address
Business Phone
Length of residence in City of Riverside
30 Are you a registered voter of the City of Riverside?

Yes

No
Derek
L.

Thesier
Riverside
CA
City of Banning
Detective
Derek L. Thesier

Page 1 of 5 ends

Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

To help create a balanced representation of City Interests.

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

I am a 17 year Veteran of Law Enforcement.

EDUCATIONAL BACKGROUND:

Some College, with additional Law Enforcement training and certification.

OCCUPATIONAL EXPERIENCE:
17 years of Law Enforcement experience with specialized training in the enforcement of City, State and Federal Laws. Specialized training in the feild of Firearms instruction and traing, the use of less Leathal weapon systems, training in the identification and recognition of drug use and abuse. Several specialized positions and training over my time as a Police Officer.

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

BPOA Vice President, Homicide Investigators Association Member.

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

None.

Derek L. Thesier Page 2 of 5

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Derek L. Thesier

Page 3 of 5 ends

Upload a Resume
Additional document(s)
Additional document(s)
Question applies to Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor? Yes No
Question applies to Community Police Review Commission
Do you have basic computer skills?
Yes No
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? Social Media
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
Derek L. Thesier Page 4 of 5
Submit Date: Jun 04, 2018
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 2

Which Boards would you like to apply for?
Community Police Review Commission: Submitted
Planning Commission: Submitted
Ms./Mr.

Mr.

Business Address
Business Phone
Length of residence in City of Riverside
Are you a registered voter of the City of Riverside?

Yes

No
Have you ever been convicted of a crime of moral turpitude?

Yes

No
Richard
A.

Torres
Riverside
CA
Pacific Railway
Signal Designer
Richard A. Torres

Page 1 of 5 ends

Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

EDUCATIONAL BACKGROUND:

OCCUPATIONAL EXPERIENCE:

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

Richard A. Torres Page 2 of 5

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Richard A. Torres

Page 3 of 5 ends

Upload a Resume
Additional document(s)
Additional document(s)
Question applies to Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor? Yes No
Question applies to Community Police Review Commission
Do you have basic computer skills?
Yes No
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? None Selected
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
2_-_Torres__Richard_A..pdf
Richard A. Torres Page 4 of 5

11-1-12
Planning Commission

Submit Date: Jun 01, 2018
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 2

Which Boards would you like to apply for?
Commission on Aging: Submitted
Airport Commission: Submitted
Community Police Review Commission: Submitted
Cultural Heritage Board: Submitted
Commission on Disabilities: Submitted
Human Relations Commission: Submitted
Human Resources Board: Submitted
Board of Library Trustees: Submitted
Museum of Riverside Board: Submitted
Park and Recreation Commission: Submitted
Planning Commission: Submitted
Board of Public Utilities: Submitted
Transportation Board: Submitted
Ms./Mr.

Mr.

Business Address
Business Phone
Gary
A.

Ringrose
Riverside
CA
Gary A. Ringrose

Page 1 of 6 ends

Length of residence in City of Riverside
Are you a registered voter of the City of Riverside?
Yes No
Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

EDUCATIONAL BACKGROUND:

OCCUPATIONAL EXPERIENCE:

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

Gary A. Ringrose Page 2 of 6

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Question applies to
Cultural Heritage Board
Thank you for your interest in serving on the Cultural Heritage Board.

The issues and challenges facing the Cultural Heritage Board increasingly require specialized expertise; therefore, the following special criteria guide appointments to the Board.

Please fill out supplemental
form
.

Gary A. Ringrose

Page 3 of 6 ends

Question applies to
Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to
Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor?

Yes

No
Question applies to
Community Police Review Commission
Do you have basic computer skills?

Yes

No
Question applies to
Human Relations Commission
HUMAN RELATIONS COMMISSION:

So far as is reasonably possible, the Human Relations Commission shall include representation in the fields of education, medicine, health and welfare, law, real estate, industry, business, finance, law enforcement, and labor. The diversity of the Commission is important to achieving its stated objective.

Question applies to
Human Relations Commission
Please state your field of endeavor as it applies to the Human Relations Commission:

Question applies to
Commission on Aging
COMMISSION ON AGING:

Members must be at least 55 years old and not be a paid representative of an elder service.

Question applies to
Commission on Aging
If you answered no to the above question, what year will you turn 55? Question applies to
Commission on Aging
Are you age 55 or older?

Yes

No
Question applies to
Commission on Aging
Are you a paid representative of an elder service?

Yes

No
Question applies to
Commission on Disabilities
Thank you for your interest in serving on the Commission on Disabilities.

It is the policy of the City of Riverside to promote the full integration and participation of persons with disabilities into all areas of economic, political and community life. In order to adequately represent the needs of residents with access and functional needs.

Please fill out supplemental
form
.

Gary A. Ringrose

Page 4 of 6 ends

Upload a Resume
Additional document(s)
Additional document(s)
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? None Selected
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
2_-_Ringrose__Gary.pdf
Gary A. Ringrose Page 5 of 6

All boards and commissions

Submit Date: Sep 06, 2021
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 3

Which Boards would you like to apply for?
Community Police Review Commission: Submitted
Commission on Disabilities: Submitted
Ms./Mr.

Ms.

Business Address
Business Phone
Length of residence in City of Riverside
48 years
Are you a registered voter of the City of Riverside?

Yes

No
Constance
B.

Wahlin
Riverside
CA
Retired
Constance B. Wahlin

Page 1 of 5 ends

Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

I retired in 2017 from the Riverside Unified School District and have been taking my time to decide how I want to spend my time. I have always been interested in city government and its role in a vibrant community. I have had leadership experiences in various local and national organizations which could enhance my volunteer board experience.

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

My professional degree is in the area of speech and language pathology; however from 2000-2017 until my retirement I worked as a Special Education Program Specialist (administrator, manger) in the Riverside Unified School District. My responsibilities included overseeing secondary/adult programs for students with significant disabilities.

EDUCATIONAL BACKGROUND:

BA Augustana College, Communication Disorders Level II Administrative Credential State of California OCCUPATIONAL EXPERIENCE:

Speech Pathologist Madison WI 1968-71 Speech Pathologist Riverside Unified School District 1971-1974; 1990-2000 Program Specialist Riverside Unified School District 2000-2017 PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

Speech Therapy organizations in past

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

Junior League of Riverside, President 1983-84 Director, Junior League International 1980's Riverside County Law Alliance, President 1980's
Constance B. Wahlin Page 2 of 5

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Constance B. Wahlin

Page 3 of 5 ends

Upload a Resume
Additional document(s)
Additional document(s)
Question applies to
Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to
Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor?

Yes

No
Question applies to
Community Police Review Commission
Do you have basic computer skills?

Yes

No
Question applies to
Commission on Disabilities
Thank you for your interest in serving on the Commission on Disabilities.

It is the policy of the City of Riverside to promote the full integration and participation of persons with disabilities into all areas of economic, political and community life. In order to adequately represent the needs of residents with access and functional needs.

Please fill out supplemental
form
.

Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies?

Social Media

Other

Constance B. Wahlin

Page 4 of 5 ends

Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
Constance B. Wahlin Page 5 of 5
Submit Date: Nov 18, 2020
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 3

Which Boards would you like to apply for?
Commission on Aging: Not Submitted
Community Police Review Commission: Submitted
Ms./Mr.

Ms
Business Address
Business Phone
Length of residence in City of Riverside
Riverside
Are you a registered voter of the City of Riverside?

Yes

No
Cheryl
M
Romano
Riverside
CA
Romano’s Innovative Coaching
Strategies
Managing Owner
Cheryl M Romano

Page 1 of 9 ends

Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

I have been a volunteer since 1984 for the American Red Cross, and have also participated in lobbying for Global Health on Capital Hill, and was part of a previous political campaign. I enjoy public service, and believe every hour spent volunteering, is a valuable and worthwhile. As noted below, I have forensic experience, and I believe this committee will suit my skills very well EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

I came from a family with several law enforcement members, so when attending graduate school, and seeking out clinical training, I chose to work at the Women’s prison in Chino, and for my doctoral internship, a Correctional Psychology Training Program in Illinois, at two maximum security prisons.

Further, I have worked for a grant funded program, assisting released offenders with children, and was a member of a team of researchers from Cal State University, that assessed offenders in the jails in San Bernardino, for the purpose of program planning, I was a Pro Bono Evaluator for the Veterans Court in San Bernardino and have held an Adjunct Professor position in Forensic Psychology for over 11 years.

EDUCATIONAL BACKGROUND:

Education Master of Public Health (MPH) Purdue University Global In Progress Chicago, IL, Online est. completion 03/2021 Doctor of Psychology (Psy.D.). - Loma Linda University - Clinical Psychology 2006 Loma Linda, CA, USA Master of Arts: Loma Linda University - Psychology 2002 Loma Linda, CA, USA Certificate in Humanitarian Assistance: Loma Linda University - Humanitarian Assistance, Global Health 2000 Loma Linda, CA, USA Bachelor of Science, Cum Laude: University of La Verne – Psychology 1996 La Verne, CA, USA Board Certifications Diplomat, Board Certified Expert in Traumatic Stress (D.A.A.E.T.S., B.C.E.T.S..) American Academy of Experts in Traumatic Stress, National Center for Crisis Management Certifications 2009 Certified Trainer, Parent-Child Interaction Training (PCIT). University of California, Davis 2009 CANS Child and Adolescent Needs and Strength Assessment Certified Examiner and Trainer 2008 Parent-Infant Mental Health Certification, Fielding Institute, CA 2007 NCAST-AVENUW PCI Certified, University of Washington Nursing Feeding and Teaching Scales 2004 Domestic Violence Certification Training Program, Certificate; State of Illinois, Chicago, IL. Post Graduate Professional Certifications and Training 1988 FBI Profiler Special Agent Robert Ressler Seminar on Bioterrorism (4 hours) 2010 Motivational Interviewing, University of California, San Bernardino County Jail (32 hours) 2004 Seeking Safety Program for PTSD and Substance Abuse Disorders, Normal, IL, Certificate; Evidence-Based Treatment (32 hours) 2004 Illinois Department of Corrections Correctional Employee Orientation and Training (40 hours) 2005 Police Psychology Training, (8 hours) Boston Police Department 2004 Cognitive Behavioral Therapy for Personality Disorders, Chicago, IL with Judith Beck (8 hours) 2004 Dialectical Behavior Theory for Borderline Personality Disorder; Strategies for Prisons, Schaumburg, IL (8 hours) 2009 CANS Child and Adolescent Needs and Strength Assessment, Certified and Trainer, VCSS from Dr. John Lyons, University of Ottawa, Canada (24 hours) 2004 Domestic Violence Certification Training Program, (40 hours) State of Illinois, Chicago, IL. 2005 Argosy University Correctional Cheryl M Romano Page 2 of 9
Psychology Training Program (1500 hours) 2011 National Drug Court Institute; Veterans Treatment Court Discipline Specific Training (40 hours),
Costa Mesa, CA
2017 July 20 Pandemic Influenza: A Justice Case
Study: Public Health Ethics #5; The North Carolina Institute of Public Health 2017, July 18 Counseling on Access to Lethal Means (CALM) Suicide Prevention Resource Center Training Institute
2017 May 16
Introduction to Outbreak Investigation, University of Washington 2015, March 12 Schizophrenia vs PTSD; Why it Matters in Trauma Formed System of Care, NAADAC 2017, March 14 Suicide Prevention Resource Center Training Institute
2017 March 14 FEMA IS-00200.hca Applying ICS to Healthcare Organizations ICS-200 for Health
Care/Hospitals; 250, 300 & 700 1991 Defensive Firearms Training and Practice: Orange County Sheriff’s Department 2000 to 2004 Gestalt Associates Training Los Angeles (GATLA) Postgraduate Training in Gestalt Therapy (4 years) 2009 Certified Trainer, Parent-Child Interaction, including supervised hours (PCIT). University of California, Davis (200 supervised hours) 2008
Parent-Infant Mental Health Certification, Fielding Institute, Santa Barbara, CA (32 hours) 2007 Circle of Security Training, University of Washington, San Bernardino, CA (32 hours) 2003 Wait, Watch and
Wonder, Sponsored by Loma Linda University, Loma Linda, CA (18 hours) 2007 NCAST-AVENUW PCI
Feeding and Teaching Scales Certified, University of Washington, (32 hours) 2017, May 17
Presenting
Public Health Data
University of Washington 2017 May 17 Cause and Effect in Epidemiology, University of Washington 2017 May 16 Analysis and Interpretation of Public Health Data Part 1 Northwest Center of PHP 2017 May 16 Analysis and Interpretation of Public Health Data Part 2 Northwest Center of PHP 2017 April 08 What is Epidemiology in Public Health? University of Washington 2017 May 16 Screening in Public Health Practice University of Washington 2017 May 13 Study Types in Epidemiology 2017 March 28 Basic Infectious Disease Concepts in Epidemiology 2017 May 16 Introduction to Public Health Surveillance, University of Washington 2017 June 08 Immunization Essentials; USAID 2017 April 08 Antimicrobial Resistance Part 1, Centers for Disease Control (CDC) 2017 April 10 Antimicrobial Resistance Part II
Centers for Disease Control (CDC) 2017 January 04 Overview of Public Health Surveillance, CDC 2017 May 17 Measuring Risk in Epidemiology American Red Cross Training and
Coursework…
First Aid/Safety: First Aid
(current) CPR/ALS for Healthcare Professionals (current) 1982
California Certified Emergency Medical Technician (4 years), Golden West College Basic Training:
11/6/94 Intro to Disaster Services, Orange County, CA Functional Training:
2/1/85 Agency
Representative, Orange County, CA
1/11/85 & 7/16/86 Orange ARC 3074 Shelter Management County, CA
3/25/85 Disaster Welfare Inquiry Orange County, CA
1/15-16/85 Emergency Assistance to Families,
Orange County, CA
5/17/86 Service Center Manager Workshop
Orange County, CA 2/22/86 Public
Affairs in Disaster Orange County, CA 11/24/87 Debriefing Training Orange County, CA
7/16/86 ARC
3072 Emergency Assistance to Families
Orange County, CA 8/21/86
SONGS (Nuclear Power Plant) --
EOC Orientation
Orange County, CA 4/15/85
Government Liaison
Orange County, CA Records and
Reports
So Cal Disaster Institute Building and Repair So Cal Disaster Institute Disaster Mental Health Orange County, CA Crisis Intervention 1, 2, & 3
Supervisory Training:
12/7/86
Supervision in Disaster
Orange County, CA 4/11/86
ARC 3090 Instructor Training in Disaster
Orange County, CA
8/7/86
ARC
3082 Family Services Supervision Module 1
So Cal Disaster Institute American Red Cross Cycle Training Courses:

Primary Region: Desert to the Sea Region, Home Chapter: American Red Cross of Riverside County
Cheryl M Romano

Page 3 of 9 ends

OCCUPATIONAL EXPERIENCE:

Professional Experience
Owner/Coach
2014 - Present Romano Coaching
Riverside, CA Coaching
diverse populations, including parent and child, youth, TAY (including bullying and self-esteem), academic and career coaching, spiritual direction, business success, sexual orientation, gender issues, empowering victims of violent crime, abuse, and neglect Adjunct Professor
12/2009
- 05/2018Kaplan
University Online
Ft. Lauderdale, FL
Courses taught in graduate psychology
Ethics and Professional
Psychology Expert
Associate Professor Ashford University.
9/2016
- 7/2018
Teaching GEN 499:

General
Education Capstone courses.

San Diego, CA
Adjunct Professor.
2006-20012;2016Chapman/Brandman
University
Moreno Valley/ Irvine, CA Courses Taught in undergraduate and graduate psychology; Current:

PSYU 595: Crisis and Trauma Counseling
Adjunct Professor
2012 - 2014National University San
Bernardino, CA Advanced courses in Masters in Counseling Psychology program Education Supervisor
(Grant funded position)
2010 - 2013Maternal Intervention Project, Foundation at Cal State University & Department of Psychology
San Bernardino, CA Developed curriculum and facilitated groups of recently released women from prison.Supervised students conducting an adjacent children's group Grant writing to sustain programReporting to stakeholders.Collecting and evaluating data from over 300 female offenders in San Bernardino County jails.

Adjunct Professor
2008 - 2017Argosy University
Los Angeles,
Orange and Ontario, CA Advanced level courses in graduate counseling and forensic psychology.

Dissertation chairComprehensive exam readerDeveloped a national course in trauma assessment and treatment
Adjunct Professor
2009 – 2011 Antioch University Culver City, CACourses taught in graduate psychology
Guest Lecturer
2010 California State University San Bernardino, CA Lecturer in the Department of Psychology Graduate Counseling Program
Clinician
(Grant Funded Position)
2008 -
2009Victor Community Support Services (VCSS) San Bernardino, CA Parent Child Interaction Therapy Administrator and Trainer Children’s Assessment of Needs and Strengths Administrator and Trainer Worked in a multidisciplinary team, including MD’s OT’s, SLP’s, and developmental specialists.

Responsible for neurodevelopmental assessments with children, age 0-5 years of ageHome and clinic- based treatment with "at risk" children, aged 0-5 years; DPSS or parent referredSupervision of clinical team members involved in client's treatmentCoordinator of treatment for children age 0-3 years old Postdoctoral Fellow (Grant Funded Position)
2006 - 2008S.T.A.R.T. Pediatric Neuro-Assessment
Development San Bernardino, CA Objective and projective assessment of children aged 0-5 years of age.Observational assessment of children at play, group interactions, at school, and at home. Strength based assessments for mental deficiency, abnormal behavior, and maladjustment.Administered standardized cognitive and psychological assessments to children aged 0-5 yearsComposed in-depth evaluation reports for parents, guardians, Department of Children’s Services and the court. Attended IEP with caregivers, to communicate report findings to the school district and assist in obtaining services Doctoral Intern
2004 - 2005 Argosy University Schaumburg, Illinois Developed and initiated treatment plans for offenders placed into mental health service program Assessed offenders in reception, upwards
of 250 a day.

Counseled Individuals and groups of male and female offenders Developed an Anger Management Group that demonstrated marked reduction of anger.

Assisted licensed psychologists with
the documentation needed for forced medication and civil commitment. Conducted rounds in prison hospital, reception, segregation, general, and mental health population areas and housing Analyzed data, interview notes, test results, and reference manuals to identify needs for offenders to be more successful.

Daily limit setting, and crisis interventionWorked with extreme cases of psychopathology including schizophrenia and personality disorders.Supervision of practicum students Research Assistant
2002 –
2004; 2005 - 2006 Loma Linda University
Loma Linda, CA Peer Supervisor; Trained clinical doctoral students to conduct neurodevelopmental assessments. Conducted quality control of all student work Conducted a program evaluation of treatment outcomes, clinic effectiveness, and satisfaction of clientsDeveloped the operational and training manual for the clinic employees and students in externship Peer Supervisor and Student Trainee Loma Linda University Pediatric Neurodevelopmental Assessment Program (PNAP).
1998 to 2004
Infant and child assessment in university clinic, children’s hospital wards, cranial facial clinic,
Loma Linda, CA pediatric neurology, and children’s weight loss program Cheryl M Romano

Page 4 of 9 ends

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

Alpha Chi, Honor Society in AcademiaPhi Chi, Honor Society in PsychologyGolden Circle Award for Voluntarism, American Red Cross Professional Affiliations American Academy of Experts in Traumatic Stress American Counseling Association Presentations Salamat, A & Romano, C.M. (2009, September).

Learning to be a child again: A Case study of siblings exposed toexcessive abuse and trauma and the benefits of collaborative treatment. Presented at the Children's Network 23rd AnnualConference. Ontario CA Gomez, M., Mc Clure, F.H., Kamptner, L., Romano, C.M., Patterson, T. (2010, September). Maternal intervention projectjail and re-entry programs (CSUSB and Glen Helen Rehabilitation Center). Presented at the 24th Annual Conference ofChildren's Network San Bernardino, Ontario, CA. Patterson, T., Romano, C., Ramirez, J, Kamptner, L., Mc Clure, F (2011, April). Multigenerational history of personaland family instability in incarcerated women. Presented at the Western Psychological Association (WPA) 91st AnnualConference, Los Angeles, CA. Wolfarth, S., Romano, C., Mc Clure, F., Kamptner (2011, April). Psychotherapeutic attachment and child developmentbased parenting program.

Presented at the Western Psychological Association (WPA) 91st Annual Conference. LosAngeles, CA.

Publications Romano, C. M. (2006) "Doctoral dissertation entitled "Benefits of assessment in children: A program evaluation"." August2006, 436. Outcome and program effectiveness of a university based neurodevelopmental assessment clinic for childrenaged 0-18 years (Doctoral Project accepted as a Dissertation by the College of Arts and Sciences)

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

American Red Cross, Riverside, California, Volunteer Staff 1982 - Present•Coordinating and conducting peer and professional counseling.•Founding member of the task force for the development of ARC Disaster Mental Health•Certified and experience in debriefing and defusingPositions held:
•Chairman: Staffing;•Chairman: Public Information Officer Program•Chairman: Speakers Bureau •Chairman: Disaster Welfare Inquiry (DWI)
•Coordinator: Disaster Volunteers and Training•Coordinator: Disaster Action Team•Liaison to the DMH Committee for Family Services.•Chair/Lead Disaster Mental Health Veterans Treatment Court of San Bernardino, Evaluator. 2011 to 2013 Needs assessment and program evaluation for the San Bernardino County Veterans Treatment Court.

Completed 40 hour training course; Equipped to set up a VTC. Inland Aids Project, Riverside, CA Volunteer Counselor. 2004 - 2005
•Conducted intake assessments, treatment planning, and counseling services with individuals and families affected by HIV/AIDS
Cheryl M Romano Page 5 of 9

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Only an NGO
Cheryl M Romano

Page 6 of 9 ends

Upload a Resume
Additional document(s)
Question applies to
Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to
Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor?

Yes

No
Question applies to
Community Police Review Commission
Do you have basic computer skills?

Yes

No
Question applies to
Commission on Aging
COMMISSION ON AGING:

Members must be at least 55 years old and not be a paid representative of an elder service.

Question applies to
Commission on Aging
If you answered no to the above question, what year will you turn 55? Question applies to
Commission on Aging
Are you age 55 or older?

Yes

No
Question applies to
Commission on Aging
Are you a paid representative of an elder service?

Yes

No
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 Cv_2020.docx
Cheryl M Romano

Page 7 of 9 ends

Additional document(s)
How did you learn about the Board and Commission vacancies? Web Site
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
Cheryl M Romano Page 8 of 9

CHERYL MARIE ROMANO
Highlights
Experienced, innovative, higher education professor for 14 years, with a history of excellent student, and supervisor evaluations. Thrive while working in a range of high-stress settings. An experienced coach, and motivator. Appreciate diversity, and learn from others experience. Work in a non-judgmental way, from a place of respect for all persons.

Experience in program evaluation, needs assessment, quality analysis, and clinical outcome assessment. Expertise in public speaking, report writing, and presenting outcomes to stakeholders. Experienced in a variety of internet based academic and research technical platforms, including MS Office programs, SPSS, SAS, Tableau, and other statistical programs, Blackboard, E-College, Canvas, Brightspace, psychological and academic software, and scripts.

Education
Master of Public Health (MPH) Purdue University Global In Progress Chicago, IL, Online est. completion 03/2021
Doctor of Psychology (Psy .D.). - Loma Linda University - Clinical Psychology2006 Loma Linda, CA, USA
Master of Arts: Loma Linda University - Psychology2002
Loma Linda, CA, USA
Certificate in Humanitarian Assistance: Loma Linda University - Humanitarian Assistance, Global Health 2000 Loma Linda, CA, USA
Bachelor of Science, Cum Laude: University of La V erne – Psychology1996 La V erne, CA, USA
Board Certifications
Diplomat, Board Certified Expert in Traumatic Stress (D.A.A.E.T.S., B.C.E.T.S..) American Academy of Experts in Traumatic Stress, National Center for Crisis Management Certifications
2009 Certified Trainer, Parent-Child Interaction Training (PCIT). University of California, Davis 2009 CANS Child and Adolescent Needs and Strength Assessment Certified Examiner and Trainer 2008 Parent-Infant Mental Health Certification, Fielding Institute, CA 2007 NCAST -A VENUW PCI Certified, University of W ashington Nursing Feeding and Teaching Scales 2004 Domestic Violence Certification Training Program, Certificate; State of Illinois, Chicago, IL .

License Eligible Psychologist, California Board of Psychology, California Department of Education, Riverside County Emergency Credential Professional Experience
Owner/Coach 2014 - Present
Romano Coaching Riverside, CA
Coaching diverse populations, including parent and child, youth, TAY (including bullying and self- esteem), academic and career coaching, spiritual direction, business success, sexual orientation, gender issues, empowering victims of violent crime, abuse, and neglect

Adjunct Professor12/2009 -
05/2018
Kaplan University Online Ft. Lauderdale, FL
Courses taught in graduate psychology
Ethics and Professional Psychology Expert
Associate Professor
Ashford University.9/2016 - 7/2018
Teaching GEN 499: General Education Capstone courses. San Diego, CA Adjunct Professor. 2006-20012;2016
Chapman/Brandman University Moreno V alley/ Irvine, CA Courses Taught in undergraduate and graduate psychology; Current: PSYU 595: Crisis and Trauma Counseling Adjunct Professor 2012 - 2014
National UniversitySan Bernardino, CA
Advanced courses in Masters in Counseling Psychology program Education Supervisor (Grant funded position) 2010 - 2013 Maternal Intervention Project, Foundation at Cal State University & Department of Psychology San Bernardino, CA Developed curriculum and facilitated groups of recently released women from prison.

Supervised students conducting an adjacent children's group Grant writing to sustain program
Reporting to stakeholders.

Collecting and evaluating data from over 300 female offenders in San Bernardino County jails .

Adjunct Professor 2008 - 2017
Argosy University Los Angeles, Orange and Ontario, CA Advanced level courses in graduate counseling and forensic psychology .

Dissertation chair
Comprehensive exam reader
Developed a national course in trauma assessment and treatment Adjunct Professor 2009 – 2011
Antioch UniversityCulver City, CA
Courses taught in graduate psychology
Guest Lecturer 2010
California State UniversitySan Bernardino, CA
Lecturer in the Department of Psychology Graduate Counseling Program Clinician (Grant Funded Position) 2008 - 2009
Victor Community Support Services (VCSS)San Bernardino, CA Parent Child Interaction Therapy Administrator and Trainer Children’s Assessment of Needs and Strengths Administrator and Trainer Worked in a multidisciplinary team, including MD’s OT’s, SLP’s, and developmental specialists.

Responsible for neurodevelopmental assessments with children, age 0-5 years of age Home and clinic-based treatment with "at risk" children, aged 0-5 years; DPSS or parent referred Supervision of clinical team members involved in client's treatment Coordinator of treatment for children age 0-3 years old Postdoctoral Fellow (Grant Funded Position) 2006 - 2008 S.T.A.R.T. Pediatric Neuro-Assessment DevelopmentSan Bernardino, CA Objective and projective assessment of children aged 0-5 years of age.

Observational assessment of children at play, group interactions, at school, and at home.

Strength based assessments for mental deficiency, abnormal behavior, and maladjustment.

Administered standardized cognitive and psychological assessments to children aged 0-5 years Composed in-depth evaluation reports for parents, guardians, Department of Children’s Services and the court.

Attended IEP with caregivers, to communicate report findings to the school district and assist in obtaining services Doctoral Intern 2004 - 2005
Argosy UniversitySchaumburg, Illinois
Developed and initiated treatment plans for offenders placed into mental health service program Assessed offenders in reception, upwards of 250 a day .

Counseled Individuals and groups of male and female offenders Developed an Anger Management Group that demonstrated marked reduction of anger .

Assisted licensed psychologists with the documentation needed for forced medication and civil commitment.

Conducted rounds in prison hospital, reception, segregation, general, and mental health population areas and housing Analyzed data, interview notes, test results, and reference manuals to identify needs for offenders to be more successful .

Daily limit setting, and crisis intervention
W orked with extreme cases of psychopathology including schizophrenia and personality disorders.

Supervision of practicum students
Research Assistant 2002 – 2004; 2005 - 2006
Loma Linda University Loma Linda, CA
Peer Supervisor; Trained clinical doctoral students to conduct neurodevelopmental assessments , Conducted quality control of all student work
Conducted a program evaluation of treatment outcomes, clinic effectiveness, and satisfaction of clients Developed the operational and training manual for the clinic employees and students in externship Peer Supervisor and Student Trainee
Loma Linda University Pediatric Neurodevelopmental Assessment Program (PNAP). 1998 to 2004 Infant and child assessment in university clinic, children’s hospital wards, cranial facial clinic, Loma Linda, CA pediatric neurology, and children’s weight loss program Community Service
American Red Cross, Riverside, California, V olunteer Staff 1982 - Present •Coordinating and conducting peer and professional counseling. •Founding member of the task force for the development of ARC Disaster Mental Health •Certified and experience in debriefing and defusing
Positions held :
•Chairman:Staffing;
•Chairman: Public Information Officer Program
•Chairman: Speakers Bureau
•Chairman: Disaster Welfare Inquiry (DWI)
•Coordinator: Disaster V olunteers and Training
•Coordinator: Disaster Action Team
•Liaison to the DMH Committee for Family Services.
•Chair/Lead Disaster Mental Health
V eterans Treatment Court of San Bernardino, Evaluator. 2011 to 2013 Needs assessment and program evaluation for the San Bernardino County V eterans Treatment Court.

Completed 40 hour training course; Equipped to set up a VTC.

Inland Aids Project, Riverside, CA V olunteer Counselor. 2004 - 2005
•Conducted intake assessments, treatment planning, and counseling services with individuals and families affected by HIV/AIDS
Awards
Alpha Chi, Honor Society in Academia
Phi Chi, Honor Society in Psychology
Golden Circle A ward for V oluntarism, American Red Cross Professional Affiliations
American Academy of Experts in Traumatic Stress
American Counseling Association
Presentations
Salamat, A & Romano, C.M. (2009, September). Learning to be a child again: A Case study of siblings exposed to excessive abuse and trauma and the benefits of collaborative treatment. Presented at the Children's Network 23rd Annual Conference. Ontario CA
Gomez, M., Mc Clure, F.H., Kamptner, L., Romano, C.M., Patterson, T. (2010, September). Maternal intervention project jail and re-entry programs (CSUSB and Glen Helen Rehabilitation Center). Presented at the 24th Annual Conference of Children's Network San Bernardino, Ontario, CA.

Patterson, T., Romano, C., Ramirez, J, Kamptner, L., Mc Clure, F (2011, April). Multigenerational history of personal and family instability in incarcerated women. Presented at the Western Psychological Association (WP A) 91st Annual Conference, Los Angeles, CA.

W olfarth, S., Romano, C., Mc Clure, F ., Kamptner (2011, April). Psychotherapeutic attachment and child development based parenting program. Presented at the W estern Psychological Association (WP A) 91st Annual Conference. Los Angeles, CA.

Publications
Romano, C. M. (2006) "Doctoral dissertation entitled "Benefits of assessment in children: A program evaluation"." August 2006 ,436 .Outcome and program effectiveness of a university based neurodevelopmental assessment clinic for children aged 0-18 years (Doctoral Project accepted as a Dissertation by the College of Arts and Sciences) Appendix I
List of courses taught:

Ashford University
2016 to 2018
Online Undergraduate Course
GEN 499: General Education Capstone
Chapman University, changing to Brandman University, Moreno Valley/Riverside and Irvine Campus (current) Undergraduate and graduate courses in psychology (current) 2006-2012 ;2016
• Crisis and Trauma Counseling (Current)
• Research Methods for the Behavioral Sciences
• Research/Bibliographic Methods
• Theories of Personality
• Pediatric Neuropsychology
• Introduction to Counseling
• Motivation and Emotion
• Cognitive Psychology
Argosy University: Los Angeles, Ontario and Orange Campus Masters and Doctorate in Counseling Psychology and Masters in Forensic Psychology programs. Last campus: Orange County 2008 to 2017
• Professionalism I and 2
• Practicum Seminar I, 2, and 3 and Practicum Extension • Counseling 1 and 2
• Counseling Skills
• Child and Adolescent Counseling
• Techniques of Child and Adolescent Counseling
• Maladaptive Behavior and Psychopathology
• Psychopathology I and II
• Models in Clinical Supervision
• Clinical Consultation
• Introduction to Psychological Testing
• Psychological Assessment
• Ethics in Practice
• Substance Abuse Interventions
• Substance Abuse Counseling
• Social and Cultural Diversity
• Forensic Individual Assessment,
• Sex Offender Assessment and Treatment
• Forensic Seminar
• Psychology of the Victim
• Advanced Academic Writing
• Multicultural Issues in Counseling
• Research Methods and Program Evaluation
• Human Growth and Development
• Program Development
• Psychology of Stalking
• Forensic Profiling
• National Course Developer for Trauma Throughout the Lifespan • Consultation, Triage and Testimony in Forensic Psychology • Theories of Family Process and Development
• Family Therapy Counseling Skills
Additionally, chaired and committee member for Ed.D. in counseling psychology dissertations Comprehensive exam reader and grading for both masters and doctorate programs Kaplan University Online
2009 to 2018
Undergraduate course in Psychology
Social Relationships in Childhood
Graduate courses in General Psychology (Current)
· Applied Statistics for the Behavioral Sciences
· Research Methods I
· Neuropsychology
· Maladaptive Psychology
· Ethics in Psychology (previous course lead)
· Chemical and Psychological Dependency Counseling
· Professional Foundations in Psychology (current)
Antioch University, Culver City Campus
2010-2011
Research and Writing in Psychology
National University, San Bernardino campus
2012-2014
Graduate courses in Counseling Psychology Master’s program • Introduction to Assessment for Marriage and Family Counselors • Clinical Psychopharmacology
Appendix II
Professional Certificates and Training Courses
Board Certifications
Diplomat, Board Certified Expert in Traumatic Stress (B.C.E.T.S., D.A.A.E.T.S). American Academy of Experts in Traumatic Stress in Collaboration with the National Center for Crisis Management Post Graduate Professional Certifications and Training
1988 FBI Profiler Special Agent Robert Ressler Seminar on Bioterrorism (4 hours) 2010 Motivational Interviewing, University of California, San Bernardino County Jail (32 hours) 2004 Seeking Safety Program for PTSD and Substance Abuse Disorders, Normal, IL, Certificate; Evidence- Based Treatment (32 hours)
2004 Illinois Department of Corrections Correctional Employee Orientation and Training (40 hours) 2005 Police Psychology Training, (8 hours) Boston Police Department 2004 Cognitive Behavioral Therapy for Personality Disorders, Chicago, IL with Judith Beck (8 hours) 2004 Dialectical Behavior Theory for Borderline Personality Disorder; Strategies for Prisons, Schaumburg, IL (8 hours)
2009 CANS Child and Adolescent Needs and Strength Assessment, Certified and Trainer, VCSS from Dr. John Lyons, University of Ottawa, Canada (24 hours)
2004 Domestic Violence Certification Training Program, (40 hours) State of Illinois, Chicago, IL. 2005 Argosy University Correctional Psychology Training Program (1500 hours) 2011 National Drug Court Institute; Veterans Treatment Court Discipline Specific Training (40 hours), Costa Mesa, CA
2017 July 20 Pandemic Influenza: A Justice Case Study: Public Health Ethics #5; The North Carolina Institute of Public Health
2017 ,July 18 Counseling on Access to Lethal Means (CALM) Suicide Prevention Resource Center Training Institute
2017 May 16 Introduction to Outbreak Investigation, University of Washington 2015 ,March 12 Schizophrenia vs PTSD; Why it Matters in Trauma Formed System of Care, NAADAC 2017 ,March 14 Suicide Prevention Resource Center Training Institute 2017 March 14 FEMA IS-00200.hca Applying ICS to Healthcare Organizations ICS-200 for Health Care/Hospitals; 250, 300 & 700
1991 Defensive Firearms Training and Practice: Orange County Sheriff’s Department 2000 to 2004 Gestalt Associates Training Los Angeles (GATLA) Postgraduate Training in Gestalt Therapy (4 years)
2009 Certified Trainer, Parent-Child Interaction, including supervised hours (PCIT). University of California, Davis (200 supervised hours)
2008 Parent-Infant Mental Health Certification, Fielding Institute, Santa Barbara, CA (32 hours) 2007 Circle of Security Training, University of Washington, San Bernardino, CA (32 hours) 2003 Wait, Watch and Wonder, Sponsored by Loma Linda University, Loma Linda, CA (18 hours) 2007 NCAST-A VENUW PCI Feeding and Teaching Scales Certified, University of Washington, (32 hours) 2017 ,May 17 Presenting Public Health Data University of Washington 2017 May 17 Cause and Effect in Epidemiology, University of Washington 2017 May 16 Analysis and Interpretation of Public Health Data Part 1 Northwest Center of PHP 2017 May 16 Analysis and Interpretation of Public Health Data Part 2 Northwest Center of PHP 2017 April 08 What is Epidemiology in Public Health? University of Washington 2017 May 16 Screening in Public Health Practice University of Washington 2017 May 13 Study Types in Epidemiology
2017 March 28 Basic Infectious Disease Concepts in Epidemiology 2017 May 16 Introduction to Public Health Surveillance, University of Washington 2017 June 08 Immunization Essentials; USAID
2017 April 08 Antimicrobial Resistance Part 1, Centers for Disease Control (CDC) 2017 April 10 Antimicrobial Resistance Part II Centers for Disease Control (CDC) 2017 January 04 Overview of Public Health Surveillance, CDC 2017 May 17 Measuring Risk in Epidemiology
American Red Cross Training and Coursework…
First Aid/Safety:

First Aid (current)
CPR/ALS for Healthcare Professionals (current)
1982 California Certified Emergency Medical Technician (4 years), Golden West College Basic Training :
11/6/94 Intro to Disaster Services, Orange County, CA
Functional Training :
2/1/85 Agency Representative, Orange County, CA
1/11/85 & 7/16/86 Orange ARC 3074 Shelter Management County, CA 3/25/85 Disaster Welfare Inquiry Orange County, CA
1/15-16/85 Emergency Assistance to Families, Orange County, CA 5/17/86 Service Center Manager Workshop Orange County, CA 2/22/86 Public Affairs in Disaster Orange County, CA
11/24/87 Debriefing Training Orange County, CA
7/16/86 ARC 3072 Emergency Assistance to Families Orange County, CA 8/21/86 SONGS (Nuclear Power Plant) -- EOC Orientation Orange County, CA 4/15/85 Government Liaison Orange County, CA
Records and Reports So Cal Disaster Institute
Building and Repair So Cal Disaster Institute
Disaster Mental Health Orange County, CA
Crisis Intervention 1, 2, & 3
Supervisory Training :
12/7/86 Supervision in Disaster Orange County, CA
4/11/86 ARC 3090 Instructor Training in Disaster Orange County, CA 8/7/86 ARC 3082 Family Services Supervision Module 1 So Cal Disaster Institute American Red Cross Cycle Training Courses: Primary Region: Desert to the Sea Region, Home Chapter: American Red Cross of Riverside County
1/15/18 Direct Client Assistance Fundamentals
Disaster Cycle Services: Online Class
Disaster Cycle Services ; Legacy;
Recover
1/15/18 Using EDGE as a Learner
Human Resources
Online Class
Human Resources
1/15/18 EDGE Transcripts Everyone Is Welcome
1/15/18 Disaster Cycle Services Online Class Disaster Cycle Services ; Respond 1/14/18 Shelter Fundamentals
1/14/18 Disaster Cycle Services ; Respond
Deployment Fundamentals
1/14/18
Disaster Cycle Services Online Class Disaster Cycle Services ; Deploy Materials, Workers and Technology
Disaster Cycle Services: An Overview
12/12/17
Disaster Cycle Services ; Legacy;
Whole Cycle
Psychological First Aid: Helping Others
in Times of Stress
11/20/17
Disaster Cycle Services
Online Class
Disaster Cycle Services ; Respond
Meet the Client: What is a "Family?"
Completed
10/9/17
Disaster Cycle Services
Online Class
Disaster Cycle Services ; Recover
Concept of Operations Overview
10/9/17
Disaster Cycle Services
Online Class
Disaster Cycle Services ; Legacy;
Opera
International Basic :
1/31/2002 International Relief and Development Orange County, CA Submit Date: Jun 11, 2018
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 3

Which Boards would you like to apply for?
Commission on Aging: Submitted
Airport Commission: Submitted
Community Police Review Commission: Submitted
Cultural Heritage Board: Submitted
Commission on Disabilities: Submitted
Human Relations Commission: Submitted
Human Resources Board: Submitted
Board of Library Trustees: Submitted
Museum of Riverside Board: Submitted
Park and Recreation Commission: Submitted
Planning Commission: Submitted
Board of Public Utilities: Submitted
Transportation Board: Submitted
Ms./Mr.

Mr.

Business Address
Business Phone
Robert
M.

Righter
Riverside
CA
Robert M. Righter

Page 1 of 6 ends

Length of residence in City of Riverside
Are you a registered voter of the City of Riverside?
Yes No
Have you ever been convicted of a crime of moral turpitude? Yes No
Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

EDUCATIONAL BACKGROUND:

OCCUPATIONAL EXPERIENCE:

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

Robert M. Righter Page 2 of 6

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Question applies to
Cultural Heritage Board
Thank you for your interest in serving on the Cultural Heritage Board.

The issues and challenges facing the Cultural Heritage Board increasingly require specialized expertise; therefore, the following special criteria guide appointments to the Board.

Please fill out supplemental
form
.

Robert M. Righter

Page 3 of 6 ends

Question applies to
Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to
Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor?

Yes

No
Question applies to
Community Police Review Commission
Do you have basic computer skills?

Yes

No
Question applies to
Human Relations Commission
HUMAN RELATIONS COMMISSION:

So far as is reasonably possible, the Human Relations Commission shall include representation in the fields of education, medicine, health and welfare, law, real estate, industry, business, finance, law enforcement, and labor. The diversity of the Commission is important to achieving its stated objective.

Question applies to
Human Relations Commission
Please state your field of endeavor as it applies to the Human Relations Commission:

Question applies to
Commission on Aging
COMMISSION ON AGING:

Members must be at least 55 years old and not be a paid representative of an elder service.

Question applies to
Commission on Aging
If you answered no to the above question, what year will you turn 55? Question applies to
Commission on Aging
Are you age 55 or older?

Yes

No
Question applies to
Commission on Aging
Are you a paid representative of an elder service?

Yes

No
Question applies to
Commission on Disabilities
Thank you for your interest in serving on the Commission on Disabilities.

It is the policy of the City of Riverside to promote the full integration and participation of persons with disabilities into all areas of economic, political and community life. In order to adequately represent the needs of residents with access and functional needs.

Please fill out supplemental
form
.

Robert M. Righter

Page 4 of 6 ends

Upload a Resume
Additional document(s)
Additional document(s)
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? None Selected
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
3_-_Righter__Robert_M..pdf
Robert M. Righter Page 5 of 6
11-6-08

11-1-13

Submit Date: Jun 05, 2018
First Name
Middle Initial
Last Name
Home Address
Suite or Apt
City
State
Postal Code
Primary Phone
Alternate Phone
Email Address
Employer
Job Title
The City of Riverside, CA Boards & Commissions
Application Form
Profile
Office Use Only:

Ward 3

Which Boards would you like to apply for?
Community Police Review Commission: Submitted
Cultural Heritage Board: Submitted
Ms./Mr.

Ms.

Business Address
Business Phone
Length of residence in City of Riverside
Are you a registered voter of the City of Riverside?

Yes

No
Have you ever been convicted of a crime of moral turpitude?

Yes

No
Janice
E.

Bielman
Riverside
CA
Janice E. Bielman

Page 1 of 5 ends

Do you have adequate time to serve?
Yes No
*Eligibility requirements per City Charter Article VIII Section 805.

Applications may be screened on the basis of information submitted with this form.

You are welcome to provide a resume and/or letters of endorsement.

Interests & Experiences
WHY YOU WANT TO SERVE ON A CITY BOARD OR COMMISSION:

EXPERIENCE OR SPECIAL KNOWLEDGE PERTAINING TO AREA(S) OF INTEREST:

EDUCATIONAL BACKGROUND:

OCCUPATIONAL EXPERIENCE:

PROFESSIONAL OR TECHNICAL ORGANIZATION MEMBERSHIPS:

CIVIC OR COMMUNITY EXPERIENCE, MEMBERSHIPS, OR PREVIOUS PUBLIC SERVICE APPOINTMENTS:

Janice E. Bielman Page 2 of 5

COMMISSION ON AGING
AIRPORT COMMISSION *
BUDGET ENGAGEMENT COMMISSION *

COMMUNITY POLICE REVIEW COMMISSION
CULTURAL HERITAGE BOARD *

COMMISSION OF THE DEAF

COMMISSION ON DISABILITIES

BOARD OF ETHICS

HUMAN RELATIONS COMMISSION

HUMAN RESOURCES BOARD
BOARD OF LIBRARY TRUSTEES *

MUSEUM OF RIVERSIDE BOARD
PARK AND RECREATION COMMISSION *
PLANNING COMMISSION *
BOARD OF PUBLIC UTILITIES *
TRANSPORTATION BOARD *
*A Statement of Economic Interests is required. Any information listed on this application is a matter of public record and will be disclosed upon request.

Under existing California law, a member of a board or commission may not make, participate in making, or attempt to influence a governmental decision if it is reasonably foreseeable that the decision could have a material financial effect on that member, the member’s immediate family, or any of his or her financial interests. There is also a special category of conflicts of interest which strictly forbids members and/or their employers from having financial interests in city contracts.

Careful consideration should be given to this issue and applicants are encouraged to contact the City Clerk’s Office if they have any questions.

NOTICE REGARDING INCOMPATIBLE OFFICES
Under existing California law, no member of City boards or commissions may simultaneously hold two public offices that are incompatible. (California Government Code Section 1099) Offices are incompatible if one of the offices has supervisory, auditory or removal power over the other, if there would be any significant clash of duties or loyalties between the offices, or if public policy considerations make it improper for one person to hold both offices.

Do you currently hold a position as an appointed or elected member of a governmental board, commission, committee, or other body?

Yes

No
If “Yes”, please state position:

Question applies to
Cultural Heritage Board
Thank you for your interest in serving on the Cultural Heritage Board.

The issues and challenges facing the Cultural Heritage Board increasingly require specialized expertise; therefore, the following special criteria guide appointments to the Board.

Please fill out supplemental
form
.

Janice E. Bielman

Page 3 of 5 ends

Upload a Resume
Additional document(s)
Additional document(s)
Question applies to Community Police Review Commission

COMMUNITY POLICE REVIEW COMMISSION
CPRC applicants must undergo a limited background check by the Police Department prior to serving on the Commission due to the sensitivity and confidentiality of the materials you will review that have certain legal restrictions. The background check consists of completion of a Background Personal Information form, live scan fingerprint process through the FBI and Department of Justice, a local police records check, a records check of the National Crime Information Center (NCIC), and a DMV records check that includes vehicles registered to the applicant. The DMV records check relates to City liability issues since Commissioners occasionally rive their personal vehicles to public outreach events. The background check takes approximately two weeks to complete.

Question applies to Community Police Review Commission
Have you ever been convicted of a felony or misdemeanor? Yes No
Question applies to Community Police Review Commission
Do you have basic computer skills?
Yes No
Members of boards and commissions are covered by Workers’ Compensation insurance while serving. If appointed, completion of a LiveScan background screening is required prior to commencement of service.

Please call the City Clerk’s Office at 826-5557 or visit RiversideCA.gov/city_clerk for more information. City Clerk’s Office, City Hall, 3900 Main Street, 7th floor, Riverside, CA 92522 How did you learn about the Board and Commission vacancies? None Selected
Are you interested in being contacted by the Registrar of Voters to volunteer as a poll worker?
Yes No
3_-_Bielman__Janice_E..pdf
Janice E. Bielman Page 4 of 5
11-17-09 CPRC
Cultural Heritage Board
11-8-13

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