California Department of Social Services Forms

This Form is used to notify businesses in California about their annual license fee.

This Form is used for earthquake preparedness in California. It is a checklist to help residents ensure they are prepared for an earthquake.

This form is used for obtaining the consent of the property owner/landlord for operating a family child care home in California. It ensures that the property owner is aware and approves of the child care activities being conducted on their premises.

This form is used for parent notification when there are additional children in care in the state of California.

This Form is used for obtaining a Certificate of Approval in California. It is required for certain types of businesses to demonstrate compliance with applicable laws and regulations.

This form is used for property owners or landlords in California to notify the local authorities of the existence of a family child care home on their property.

This Form is used for reporting any unusual incidents or injuries that occur in a family child care home in California.

This form is used for reporting personal property and valuables of clients or residents in California. It allows individuals to document their belongings and their estimated value for insurance and protection purposes.

This Form is used for conducting a functional capability assessment in California. It helps evaluate an individual's ability to perform certain tasks and identify any limitations or disabilities they may have.

This form is used when an individual has decided to place an adult or elderly person who is unable to care for themself in assisted care to evaluate their needs and level of competency.

File this document if you are an employee of a licensed community care facility or home care organization, and wish to apply for a transfer of your active criminal record from one state licensed facility to another.

This form is used for certification of foster family agency homes in California.

This form is used for reporting the death of a client to the California Department of Insurance.

This form is used for reporting the death of a child in a licensed California child care facility. It is necessary to inform the authorities and initiate appropriate investigations and procedures.

This form is used for the Modified Comprehensive Visit Licensee Self-assessment Staff Qualifications/Records Module for Child Care Centers in California.

This form is used for conducting a self-assessment of child care centers in California. It focuses on the children's records module and helps licensees evaluate their compliance with regulations.

This Form is used for evaluating pre-licensing facilities in California.

This form is used for giving consent to a medical examination in the state of California.

This form is used for completing the annual regulation compliance checklist in the state of California. It is used by individuals and businesses to ensure they are in compliance with the applicable regulations in various industries.

This form is used for obtaining consent for emergency medical treatment in children's residential facilities in California. It ensures that proper medical care can be provided in case of an emergency without delay.

This form is used for reporting quarterly county exemptions in California. It is required by the California Department of Insurance.

This form is used for providing notice of a site visit in the state of California. It is typically filled out by the relevant authorities to inform businesses or individuals that they will be conducting an inspection or investigation on the premises.

This form is used for submitting confidential names to the California Department of Insurance.

This form is used for reporting photography of facilities in California.

This form is used for sending a reminder letter regarding the SAR90 form in California.

This form is used for reporting the classification of programs in California.

This form is used for recipients of In-home Supportive Services in California to review and fulfill their responsibilities as employers of their home care workers.

This form is used for assessing the need for protective supervision in the In-Home Supportive Services Program in California.

This form is used for recipients of In-home Supportive Services (IHSS) in California to request the assignment of authorized hours to their providers.

This form is used for notifying the In-home Supportive Services Provider in California.

This form is used for IHSS providers in California to notify the state about new timesheets.

This form is used for the In-home Supportive Services (IHSS) Program in California to notify recipients about the requirement for health care certification.