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Data Systems and Survey Design Bureau
Downloadable Automated Report Forms
This Webpage contains downloadable report forms that allow county offices and designated agencies to use automated report forms to electronically transmit their statistical data via email.
How does this system work?
The downloadable files are created through Microsoft Excel. They are formatted to mirror the image of an official CDSS statistical report, with a few added features. The user simply downloads the file to their PC from this website. Once downloaded, the user opens the file and fills in the data in the appropriate fields. Once completed, the user clicks the "Email Report" button that is located on the form. Unless the report detects any errors, it will open your Outlook email as a new email message. The report has been programmed to insert the appropriate email address in the "Email Address Field", attach the excel file as an attachment, and insert the appropriate information in the "Subject Field." The user simply sends the email and the process is complete. For detailed instructions, please click here .
CalFresh (Formerly FOOD STAMPS)
- DFA256-Food Stamp Program Participation and Benefit Issuance Report Rev 11-03
(Updated 01/21/10) - DFA296-CalFresh Monthly Caseload Movement Stat Report Rev 01-12
The file will be posted when the All County Letter (ACL) is issued. The projected ACL issue date is on or before the second week in February 2012, effective for the January 2012 report month. - DFA296-Food Stamp Program Monthly Caseload Movement Stat Report Rev 01-99
(Updated 01/29/10) - DFA296X-Food Stamp Program Expedited Service Quarterly Stat Report Rev 10-04
(Updated 07/14/10) - STAT47-Food Stamp Program Work Registrant, Able-Bodied Adults Without Dependents (ABAWD), and Food Stamp Employment and Training (FSET) Program Caseload Report Rev 04-06
(Updated 02/01/10) - STAT48-Annual Work Registrant Food Stamp Employment and Training (FSET) Program Caseload Report Rev 10-06
(Updated 12/16/09)
CALWORKS
- CA237,CA253,CA255-CalWORKs Reports-All three reports combined into one submission Rev 12-02 & 05-04
(Updated 11/24/09) - CA237EA-Title IV-A Emergency Assistance (EA) Program Caseload Report Rev 07-02
(Updated 11/17/11) - CA237HA-CalWORKs Homeless Assistance Program Monthly Stat Report Rev 02-02
(Added 05/11/10) - CW115 and CW115A-Child Care Monthly Report, CalWORKs Families and Two-Parent Families Rev 07-11
This form version is for use during the Cal-Learn suspension period during Fiscal Year 11/12 for report months July 2011 through June 2012.
(Updated 08/10/11) - CW115 and CW115A-Child Care Monthly Report, CalWORKs Families and Two-Parent Families Rev 10-06
This form version is for use during report months October 2006 through June 2011.
(Updated 10/19/10) - STAT45-Welfare-to-Work (WTW) Teen Parent Monthly Status Report Rev 07-11
This form version is for use during the Cal-Learn suspension period during Fiscal Year 11/12 for report months July 2011 through June 2012.
(Updated 10/10/11) - STAT45-Cal-Learn Program Teen Parent Monthly Status Report Rev 01-02
This form version is for use during report months January 2002 through June 2011.
(Updated 01/25/11) - WTW25 Welfare-To-Work Activity Report, All (Other) Families Rev 10-06
(Updated 06/21/10) - WTW25A-Welfare-To-Work Activity, Two-Parent Families Rev 10-06
(Updated 06/21/10)
CHILDREN'S PROGRAMS
- CA237FC-Aid to Families with Dependent Children (AFDC) Foster Care (FC) Caseload Movement and Expenditures Report Rev 07-09
(Updated 11/18/11) - CA237KG-Kinship Guardianship Assistance Payment Program (Kin-GAP) Caseload Movement Report Rev 01-02
(Updated 01/28/11) - CA237KG-F-Kinship Guardianship Assistance Payment (Kin-GAP) Program Caseload Movement Report - Federal Only 01-11
(Added 05/06/11) - FC19-Intensive Treatment Foster Care Program Rev 04-11 (For use beginning April-June 2011 report quarter.)
(Updated 7/19/11) - FC19-Intensive Treatment Foster Care Program Rev 04-02 (For use from April-June 2002 through January-March 2011 report quarters.)
(Updated 03/23/10) - FC23-Probation Foster Care Placement Monthly Caseload Report Rev 01-05
(Updated 12/20/10) - FC-AAP84-Supplement to the Rate Requests for Dual Agency AFDC-FC and AAP Children Quarterly Statistical Report 01-09
(Updated 11/17/11) - SOC405A.1-Independent Living Program (ILP) Annual Statistical Report for ILP Eligible Probation and Aftercare Youth 10-08
(Updated 11/16/09) - SOC405E-Exit Outcomes for Youth Aging Out of Foster Care Quarterly Statistical Report 07-08
(Updated 01/28/11)
COMMUNITY CARE LICENSING
DISABILITY AND ADULT PROGRAMS
- ABD216-Adult Program Monthly Statistical Report Rev 11-92
(Updated 01/21/11) - CA1037-Cash Assistance Program for Immigrants Statistical Report Rev 01-00
(Updated 01/28/11) - GR237-General Relief and Interim Assistance To Applicants For SSI/SSP Monthly Caseload and Expenditure Statistical Report Rev 06-82
(Updated 01/25/11) - SOC242-Adult Protective Services and County Services Block Grant Rev 04-07
(Updated 01/27/11) - SOC808-Quarterly Report of Overpayments for the Cash Assistance Program for Immigrants (CAPI) Rev 07-02
(Updated 04/18/11)
FRAUD
- CA812-Quarterly Report of Overpayments and Collections-CalWORKs Rev 07-03
(Updated 04/28/10) - DPA266-Fraud Investigations Activity Report Rev 07-04
(Updated 01/26/11) - DPA482-Income and Eligibility Verification System (IEVS) Management Rpt Rev 10-01
(Updated 05/24/10)
Additional DSSDB reports will be added to the website soon. Please visit often to see what is newly available.
Contact Us to provide comments, questions, or request assistance to download or utilize the forms.
