To view these tools, click on the names below.
Follow the instructions listed there to download or print for your immediate use. If you experience any difficulties downloading, or encounter any dead links, please contact us.
Language Preference Forms
These forms can be used to capture information about the primary language spoken and read by applicants/recipients. The forms are from a variety of sources and contain different information. If you have any questions about the source of the forms or the design of the forms, contact your county liaison at the Civil Rights Bureau.
Advocates` Suggested Form
Other Suggested Forms Used by Counties
These represent some forms used currently by San Joaquin County:
- Children's Services Civil Rights Compliance
- Adult Services Civil Rights Compliance Checklist
- Certification of Confidentiality-Non-HSA Interpreter
This is a link to Ventura County's Cultural Competence Plan.
Civil Rights Posters
Posters on nondiscrimination must be displayed by county welfare departments in all public waiting rooms and reception areas (Div. 21-107.211). CDSS ACIN 31-05 (June 15, 2005) explains how to order the CDSS nondiscrimination poster, “Equal Under the Law”, Pub 86. Click here to view the ACIN.
The USDA nondiscrimination poster, “And Justice for All,” Form AD-475B, must be displayed in all Food Stamps certification and issuance offices.
To order the Pub 86 and the Form AD-475B, contact the CDSS Warehouse through this link to order these required posters.