California Department of Social Services Forms

This Form is used for submitting a plan of operation or program statement for a short-term residential therapeutic program in California.

This form is used for applying to renew benefits in the Assistance Dog Special Allowance (ADSA) program in California.

This Form is used for requesting an extension of the 60-month time limit for CalWORKs in California.

This form is used for verifying the time on aid for CalWORKs/TANF recipients in California who are subject to the 60-month time limits.

This form is used for tracking and monitoring the CalWORKs 60-month time limit in the state of California. It helps determine eligibility and manage the benefits received under the CalWORKs program.

This form is used for determining eligibility to extend the CalWORKs 60-month time limit in California.

This form is used for notifying individuals in California about a 60-month time limit for certain actions.

This form is used for providing a continuation page for the NA531 Notice of Action. It includes a 60-month time limit and budget information. It is specific to the state of California.

This form is used for providing a summary of facts for the Care Provider Management Bureau (CPMB) in California. It is specifically related to managing care providers.

This form must be completed if you wish to work at, be licensed, or present at a licensed community care facility or organization.

This form is used for subcontract certification in California.

This form is used for submitting a continued funding application for educational programs in California.

This form is used for reporting and summarizing the results of the Infant-Toddler Environment Rating Scale, a tool used in California to assess the quality of environments for infants and toddlers.

This Form is used for appealing decisions made by the Nutrition Services Division/Program Integrity Unit in California for education and nutrition services.

This form is used for self-certification of external water samplers in California.

This form is used for determining the level of care rate for the Adoption Assistance Program in California.