California Department of Social Services Forms

This Form is used for assessing civil penalties in California for immediate payment of $500 and repeat violations.

This form is used for the assessment of civil penalties in California for failure to correct and repeat violations.

This Form is used for assessing civil penalties for death, serious bodily injury, or physical abuse in California.

This form is used for assessing civil penalties in cases involving death, serious injury, or physical abuse in child care facilities in California.

This form is used for assessing civil penalties in cases of death, serious bodily injury, or physical abuse in California.

This Form is used for applying for a foster family home license in the state of California. It provides instructions on how to fill out the application and what documents are required.

This form is used for applying to become a resource family in California. It is a confidential document.

This Form is used for converting a California Resource Family Application.

This form is used for converting a person's license from a standard license to a resource family license in the state of California. It also authorizes the release of information related to the individual's background and suitability for becoming a resource family.

This form is used for the In-Home Supportive Services (IHSS) Program in California. It informs the recipient that their provider's exemption from workweek limits is expiring.

This form is used for notifying the providers of the In-home Supportive Services Program in California about the expiration of their exemption from workweek limits.

This form is used for notifying providers in California's In-home Supportive Services Program that they are ineligible to request an exemption from workweek limits due to extraordinary circumstances.

This form is used for the In-Home Supportive Services (IHSS) program in California. It is a notice to inform providers that they have not received an exemption from the workweek limits specified in the Provider Agreement (APD 006).

This Form is used for notifying recipients of the In-Home Supportive Services (IHSS) program in California when their exemption from workweek limitations for extraordinary circumstances is discontinued.

This form is used for notifying providers of the In-Home Supportive Services (IHSS) program in California about the discontinuance of their exemption from workweek limitations due to extraordinary circumstances.

This Form is used for individuals or organizations who want to apply for a license to operate a home care organization in California. It serves as a declaration of intent to initiate the licensing process.

This form is used for requesting access to California's Cdss Eievs system.

This Form is used to provide an informing notice to individuals in California regarding an action taken on their case.

This form is used for applying to the Functional Assessment Service Team (FAST) Leader Course in California.

This form is used for requesting access to data security in California by Hhsdc Teale.

This form is used for requesting an evaluation of the Family Stabilization Program in California.

This form is used for declaring and surveying shelter costs for Group Home/Short Term Residential Therapeutic Programs (STRTP) in California.

This document displays the total program cost for Form FCR12FFA in California.

This form is used for reporting the number of days of care provided in California. It helps track the amount of care given over a specific time period.

This document is a checklist used for the FCR2FFA Program Description in California. It helps ensure that all necessary information is provided and requirements are met.

This Form is used for data collection and certification of foster family agencies in California.

This form provides application information for the SSI screening guide in Section C. It specifically applies to California.

This form is used for conducting financial screening as part of the SSI application process in California.