Darren G. Cefalu Application Package BOARD AND COMMITTEE APPLICATION FORM
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Last Name "* First Name Middle initial
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Home Address City State Zip Code
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Noma Telenhone Work Telephone Cellular Telephone + Email addres..
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eus:ness Name Occupation i )
Business Address City .State Zip Code
`'r ' I Expires
Professional License(describe}: �-- i �-I.�� ���` �-- ��- ��' '�'`�`� i��
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a&b: Members of agencies, boards and committees shall be affiliated with the
City. This requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the City for
a minimum of six months; or b. An individual shall demonstrate ownership/interest for a minimum of six months in a
business established in the City for a minimum of six months.
• Resident of Miami Beach for a minimum of six(6) months: Yes E or No
• Demonstrates ownership/interest in a business In I ti i Beach for a minimum of six months: Yes i or No
•Are you a registered voter in Miami Beach: Yes 1 or No '._
• I am now a resident of: North Beach South Teach Middle Beach 0
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
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•Are you presently a registered lobbyist with the City of Miami Beach?Yes or No
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that
only three(3)choices will be observed by the Office of the City Clerk.
f_J Affordable Housing Advisory Committee ❑Health Facilities Authority Board ❑Normandy Shores Local Government
Neighborhood improvement
rI Art in Public Places Committee ❑Hispanic Affairs Committee I ❑Parks and Recreation Facilities Board°O
71 Board of Ad.ustment•* ❑Historic Preservation Board , (J Personnel Board
7 Budget Advisory Committee 0 Housin.Authority , .0 Planning_Board*
13 Committee on the Homeless ❑LGBT Advisory Committee _ ❑Police Citizens Relations Committee
❑Committee for Quality Education in MB v Marine&Waterfront Protection Authority,). ❑Production Indust Council
❑Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Sustainability Committee
❑Design Review Board** i ❑Miami Beach Cultural Arts Council a Transportation,Parking,&Bicycle-Pedestrian
i Facilities Committee
❑Disabilit Access Committee I if Miami Beach Human Rights Committee ( ❑Visitor and Convention Authority
❑Health Advisory Committee_ 1 ❑Miami Beach Sister Cities Program _ �� __----
* Board members are required to file Form 1 —"Statement of Financial Interest"with the State. - .
' *If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment,De ign Review
Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effective license;andJbrnish the
following information:
Type of Professional License
License Number �.
License Issuance Date, License Expiration Date
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Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board, please indicate your affiliation with
the Scott Rakow Youth Center and/or the North Shore Parks Youth Center: .
• Please describe your past service with the City's Youth Centers(include dates of service):
w Present participation in Youth Center activities by your children:Yes La No
If yes,please list below the names of your children,their ages and the programs in which they participate:
Child's name: A//A Age: Program:
Program: ___ —
Childs name:_ — Age: g
g
✓ Have you ever been convicted of a felony?Yes'4a or No .r If yes, please explain in detail:
i rr of C i ,oi ��ie i t3 aoh ode?yes 'o r-N of
4.f�o;�?oi�currently have�.v`r?,ratir .,;�). '`�`:.p. .�fn , �KreS pieass elspia_in crti detail:
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40 O"a ydti currently oWe tie:QiTy.of Hi re tich'ariy morn ,?'Yes L.:11 or No It ye.., ,e*Ipin in d leil:
'o,.re you cu ntiy si rying ond.a V.City aiCJ or CormniL r 7 Yes or No L-` If.ye.s.wh chrboar Pcomr.mftlee
• In what organization(s)in the City of Miami Beach do you currently hold membership?
Name Position
Name _ . Position
o Lfst:all properties-Oirried dt iii which you hive an''int.erest wiihivthe City.of Mieroll. each
a Are you now employ d, y th citj+,' tv rrii E rg?`:46 i or No . _
Which department and title? v- 1."..)
@ Pursuant to City Code Section 2-25 (b): Do you have arent CD, spouse , child LD brother or sister lj who is
employed City of Miami Beach?Yes or No 4
p Y ed b Y the tY
If"Yes,"identify person(s)and department(s): ,
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for
appointment.It is being asked to comply with City diversity reporting requirements.
Gender:. MaTelZ i~emaieC
Race/Ethnic Categories
What is your race?
African-American/Black
4' Caucasian vVhite
Ca Asian or Pacific Islander
Ea Native-AM'66,:ah/Amer n lariat
Zi Other–Print Race:
C:\Users\CLERLarcuesktoplsc APPLICATION docx
Do you consider yourself to be Spanish, Hispanic or Latino/a?Mack the "No"box if not Spanish, Hispanic, Latino/a,
fr No
Yes
Do you consider yourself Physically Disabled?
CO No
Yes
NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS.THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO:
o Prohibition from directly or indirectly lobbying City personnel(Miami Beach City Code section 2-459).
o Prohibition from contracting with the City(Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before the board/committee you have served on for period of one year after leaving office(Miami Beach
City Code section 2-26).
o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
o CMB Community Development Advisory Committee: prohibition, during tenure and for one year after leaving office, from having
any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom
you have business or immediate family ties(CFR 570.611).
o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chapter 286 of the,Flonda.,{v,tatutes. These statutes establish a basic right of access to most
meetings of boards,commissions and other governing brdi .of state and local governmental agencies or authorities.
o Voting conflict—Form 8B is for use by any persork serving at the county,city or other local level of government on an appointed or
elected board, council, commission, authority of cc:r.if 9rriitlea.:it 4,.piies equally to members of advisory and non-advisory bodies
who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes.
Upon request,copies of these laws may be obtained from the City Clerk.
I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTES ACCORDINGLY."
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pF'frt'srrratjrauh Name of �+!icrst-tPL �AE' 1r1
Received in the Office of the City Clerk by:
Name of Deputy Clerk Control No. Date
PLEASE ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
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}tuttiu Apply Verify Credential
lour Certt Ceiflcation Solution
Welcome Darren Corwin![Loa Off]/[Manage My Account 1
Codification Number: 50143 F _.vaubscribe —?
Certification Holder
First Name:: Darren Middle Name:: Last Name:: Cefalu
Company Name::
Certification Details
Business Nam.: District: Miami-Dade Applied Date: 1114121115
Certification Type: Mental/Behavioral Health Issued By: Darmn Cefalu Issued Date: 71112016
Classification: Mental Health Account Number: Espirallon Date: 6/5012016
Professional(CMHP) Last Renewal Date: None
Certification Year: 2015
Status: Certified
Description: Mental Health
Additional Details
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I Dais olOirtlii !1,'%!`11177 11:10,0iJ AM. Although the following
Information Is not mandatory,It is
requested to assist the FCB In its
commitment to equal certification
opportunity and affirmative
action.It Is unlawful for an
organization to fail or refuse `
I certification to any individual (l
because of race,color,religion,
national organ,marital status,or
handicap. !!
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Wit;i N; * Native American/Alaskan
Native:
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iAeianIPacific Islander: Multi-reclal.
l' Ethnicity: Hispanic/Latino:
Gender: Female:
i Male: FSAA-PAC Fee(Voluntary -
Contribution):
Discount Fee: I
Primary Addross Details Contacts
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Subscribe/Follow On Welcome Darren Cefalul[Len Off i/t Mange My Aceamr
Certification Number: 4003 UnSubscribe
Certification Holder
First Name:: Darren Middle Name:; Last Name:: Cefaiu
Company Name::
Certification Details
Business Name: District: Miami-Dade Applied Date: 7/14/2015
Certification Type: Addiction Issued By: Carla Lohl Issued Date: 7/1/2015
Classification: Addiction Professional Account Number: Expiration Date: 6/3012016
(CAP)
Certification Year: 2015 Last Renewal Date: None
Status: Certified
Description: Addlctlon2
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SSN: 070760252
Do not ue.dashes or spaces for SSN.
Data of Birth: 1/2/1977 12:00:00 AM
Although the following information Is not mandatory,It Is requested to assist the FCB In Its commitment to equal certification opportunity and affirmative
action.If la unlawful for an organization to fail or refuse certification to any individual because of race,color,religion,national origin,marital status,or
disability.
Race
Black: No
White: Yea
Native American/Alaskan Native: No
Asian/Pacific islander: No
Multi racial: No
Ethnicity
Hlspenla/Latino: No
(lender
Female: No
Male: Yes
FSAA•PAC Fee(Voluntary Contribution): No
Discount Fee: Yes
ess><Site/Pro1LicenseNiewB P... 7/24/2015
https.l/energuvcitizenaccess.tylertech.com/I'C,B/G1hzenAc,c � Y
Darren G. Cefalu
635 Euclid Ave. Apt# 101 Miami Beach FL, 33139
305-528-1165
Objective To advocate for and assist those in need by utilizing and developing the
most progressive modalities of treatment in an effort to progress the
discipline of social work.
Education Barry University MSW Program
• 4.O GPA
• 25 Hours of training in Clinical Hypnosis and Rapid Trauma Resolution
Florida Institute of Technology
• B.A. in Psychology
• 3.8 GPA in area of concentration-counseling
• CAP(certified addictions professional) #4003 CMHP(certified mental
health professional)#50143
• Leadership Award Scholarship
• Organization of Student Leaders 1995-2000
Experience Dynamic Waves of Cha p.Treatment Center 311114-Present
Owner and operator of an Outpatient Therapy treatment center servicing
adults with substance use and mental health issues. The center and the
Dynamic Waves of Change"' approach has been featured on Hay House
radio and utilizes a novel integration of science and spirituality to help
promote personal change.
Our Solutions Treatment Center 1011/12-1211!13
Clinical Director responsible for the implementation and development of
an outpatient treatment program servicing young adults in early recovery_
Program developed utilizing cutting edge vtbro acoustic treatment, NLP and
hypnotherapy approaches to achieve maximum gains in brief solution
focused therapy.
G&G Holistic Treatment Center 6/28/2008-Present
Senior therapist responsible for treatment planning psycho-social
assessments, individual family and group therapy facilitation, discharge and
referral. Codeveloper of the Drumming off Drugs m` Harmonic Mood
Enhancement group therapy protocols for a Simbex longitudinal study to
determine effectiveness of rhythmic treatment on symptoms of anxiety and
depression.
High Point Treatment Center 9/27!07-6128/08
Director of Business Development and Marketing. Responsible for
program creation and development as well as all marketing endeavors for a
chemical dope.ndence treatment facility providing delox_ outpatient,
residential and IOP programs. Developed outpatient program specifically for
Miami-Dade drug court, Responsible for increasing referral sources and
census.
The Village-Life Program 4/11/05-9/27/07
Program coordinator of an in home on site substance abuse family
therapy model for adolescents with juvenile justice involvement.
Responsible for daily function and oversight of 8 clinicians as well as psycho-
social, treatment planning, and 4,dividual and family counseling. Participant
in the University of Miami NIDA turned study through the Clinical Tnals
Network.
Here's Help, Inc. 10119/04-4/11/05,
Psychotherapy, treatment planning, intake, discharge and community
outreach for adult and adolescent clients dealing with substance abuse.
Provided group and individual therapy for forensic clients referred by Miami-
Dade County drug court,TASC and Probation.
Fellowship House 3/23/03-10/19/04
Counseling and treatment planning for forensic schizophrenics with
substance abuse issues in a day treatment setting. Implemented the
Addictions Recovery Tract and obtained the organization a substance abuse
license.
Srevard Outpatient Atternative Treatment Center1/10410-3/23/03
Increased funding for low income families by setting up a TANF
program while running group and individual counseling sessions for both
teen and adult drug and alcohol abusers.
Human Services Associates TASC Assessor 1/23/02-3/23103
Mental health and substance abuse assessment and placement for at
risk youth. Worked in conjunction with the Department of Juvenile Justice
and community based resources to locate treatment options for dents.
Private Behavioral Modification tinder Dr.Martinez Diaz
Specializing in autistic children with cognitive deficiencies; used
behavioral modification to better the quality of life.
Current! mintain a CAP Certified Addictions Profesionatt and CMHP
(Certified Mental Health Profs
Internationally Certified Alcohol and Drug Counselor ICADC 24906
Currently act as a supervisor for several CAP applicants seeking certification.
Motivation Enhancement 1`,.. tified as of 3111/06
MET/CBT5 Supervisor status.
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