California Department of Social Services Forms

This form is used for declaring parental incapacity in the state of California. It allows individuals to provide a statement regarding their inability to fulfill parental responsibilities.

This form is used for verifying educational programs or vocational training for parents or caretakers who are attending school or receiving vocational training in California.

This form is used for stating the composition of LPC (Licensed Professional Counselor) Membership in California.

This Form is used for conducting facility inspections for Community Crisis Homes in California. It is known as the LIC9119 CCH Facility Inspection Checklist.

This form is used for reporting on monthly care fees at Continuing Care Retirement Communities (CCRCs) in California.

This form is used for accessing the program calendar in California.

This Form is used for drafting a board resolution in the state of California.

This form is used for notifying residents of California about the extension of the CalFresh Water Pilot program.

This Form is used for applying to the Commodity Supplemental Food Program (CSFP) in California. CSFP provides free supplemental food to low-income older adults.

This form is used for notifying applicants of the outcome of their application for the Commodity Supplemental Food Program (CSFP) in California.

This form is used for verifying the care and support provided to a household member in California. It is used to determine eligibility for certain benefits or assistance programs.

This form is used for reporting the non-receipt of a WTW (Welfare-to-Work) Attendance/Progress Report in California. It allows individuals to notify the necessary authorities if they have not received the required report.

This document is a notice used in California for employment workshops and job search assistance.

This form is used for obtaining partial waiver approval for overpayment in the Cash Assistance Program for Immigrants in California.

This document is for sponsored noncitizens in California who are applying for or receiving cash aid and/or CalFresh benefits. It is available in large print format for those who need it.