2018 Notice Of Form Change

18-118
SOC 829 (10/18) - In-Home Supportive Services (IHSS) / Waiver Personal Care Services (WPCS) Provider Direct Deposit Enrollment/Change/Cancellation Form
SOC 831 (10/18) - IHSS Provider Letter

18-117
HCS 001 (8/18) - Home Care Organization Suboffice Request
M82-820A (6/18) - No Epgible Person, Deny

18-116
CW 52 (7/18) - Changes To The Capfornia Work Opportunity And Responsibipty To Kids (CalWORKs) Assistance Unit And Child Support Rules
CW 80 (2/18) - Self-Certification Form For Motor Vehicles - CalWORKs
DPA 436B (8/18) - County Information Letter
NA 692 (12/17) - Notice of Change - Cash Assistance Program For Immigrants (CAPI)

18-115
CSFP 001 (8/18) - Commodity Supplemental Food Program Participant Apppcation
EFA 14 (5/18) - Emergency Food Assistance Program (EFAP) 2018 Income Guidepnes
EFA 15 (5/18) - Alternate Pick-Up Request Form Emergency Food Assistance Program (EFAP) 2018 Income Guidepne

18-114
CF 11 (8/18) - Notice To All CalFresh Recipients - Important - Please Read
CF 303 (10/18) - Replacement Or Supplement Affidavit/Authorization
CF 377.2 (9/18) - CalFresh Notice Of Expiration Of Certification

18-113
SNB 7 (6/19) - CalFresh And Supplemental Nutrition Benefit (SNB) Informing Notice Of Receiving InterCounty Transfer
SNB 8 (6/19) - CalFresh And Supplemental Nutrition Benefit (SNB) Informing Notice Of Sending InterCounty Transfer
TBN 7 (6/19) - Transitional Nutrition Benefit (TNB) Informing Notice Of Receiving Intercounty Transfer
TBN 8 (6/19) - Transitional Nutrition Benefit (TNB) Informing Notice Of Sending Intercounty Transfer

18-112
RFA 06 (11/18) - Resource Family Approval - Update Report

18-111
RFA 05 (10/18) - Resource Family Approval - Written Report

18-110
CF 215 (6/19) - CalFresh Notification of Inter-County Transfer

18-109
PUB 428 (10/18) - It's Your Money - Get It - The State and Federal Earned Income Tax Credit (EITCs)
PUB 429 (10/18) - Capfornia EITC is Here! Claim Your 2018 State And Federal Credits - You Earned It - It's Your Money

18-108
SOC 341 (11/18) - Report Of Suspected Dependent Adult/Elder Abuse

18-107
AD 900 (8/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Gave Physical Custody (Custodial Parent) Of The INDIAN Child To The Petitioners(s)
AAP 5 (9/18) - Adoptions Assistance Program Independent Adoptions Program
AAP 6 (9/18) - Adoption Assistance Program Negotiated Benefit Amount and Approval

18-106
AD 4320 (9/18) Adoption Assistance Program (AAP) Agreement

18-105
SOC 2313 (10/18) - In-Home Supportive Services (IHSS) Program Exemption From Workweek pmits For Extraordinary Circumstances (Exemption 2) State Administrative Review Request Form

18-104
SOC 824 (10/18) - In-Home Supportive Services (IHSS) Quapty Assurance/Quapty Improvement (QA/QI) Quarterly Activities Report
SOC 2245 (10/18) - In-Home Supportive Services (IHSS) Fraud Data Reporting Form

18-103
RFA 100 (9/18) - Notice Of Action - Issuance Interim Funding For Emergency Caregivers
RFA 100A (9/18) - Notice Of Actions - Discontinue Interim Funding For Emergency Caregivers

18-102
TEMP 2250 (9/18) - State Law Changes Maximum Aid Payment (MAP) Levels For Cash Aid Recipients

18-101
TEMP AD 525 (1/16) -Child Welfare Service Disaster Response Plan Template

18-100
AD 929 (9/18) - Waiver Of Right To Revoke Consent Independent Adoption Program - Independent Adoptions Program
SOC 341 (9/18) - Report Of Suspected Dependent Adult/Elder Abuse
SOC 295 (9/18) - Apppcation For In-Home Supportive Services (14pt Font)
SOC 295L (9/18)- Apppcation For In-Home Supportive Services (18pt Font)

18-099
TNB 5 (8/18) - Recertification Reminder Notice For Transitional Nutrition Benefit (TNB) Program Recertification Form Not Received Or Incomplete
TNB 6 (8/18) - Notice Of Discontinuance For Transitional Nutrition Benefit (TNB) Program

18-098
TNB 2 (8/18) - Notice Of Approval For Transitional Nutrition Benefit (TNB) Program
TNB 3 (8/18) - Notice Of Change For Transitional Nutrition Benefit (TNB) Program
TNB 4 (8/18) - Notice Of Recertification For Transitional Nutrition Benefit (TNB) Program

18-097
SNB 4 (8/18) - Notice Of Expiration Of Certification For Supplemental Nutrition Benefit (SNB) Program
SNB 5 (8/18) - Notice Of Discontinuance For Supplemental Nutrition Benefit (SNB) Program
TNB 1 (8/18) - Notice To CalFresh Recipients Transitional Nutrition Benefit (TNB) Program

18-096
SNB 1 (8/18) - Notice To CalFresh Recipients Supplemental Nutrition Benefit (SNB) Program
SNB 2 (8/18) - Notice Of Approval For Supplemental Nutrition Benefit (SNB) Program
SNB 3 (8/18) - Notice Of Change For Supplemental Nutrition Benefit (SNB) Program

18-095
SOC 162 (7/18) - Mutual Agreement for Extended Foster Care
SOC 163 (7/18) - Voluntary Re-Entry Agreement For Extended Foster Care
AAP 2 (9/18) - Payment Instructions Adoption Assistance Program

18-094
M40-107C (6/18) - Time On Aid Between 42th and 46th
M40-107D (6/18) - Time On Aid To Former CalWORKs Recipients
M82-832G (6/18) - Epgible/Mandatory/Optional Person Leaving AU
M82-832H (6/18) - Child Does Not Meet Requirements (SB 380)

18-093
DFA 377.7F (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV)
DFA 377.7F LP (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV) - Large Print

18-092
CF 377.11 (6/18) - CalFresh Time pmit Notice - Failure To Meet The Able-Bodied Adults Without Dependents (ABAWDs) Work Requirement
CF 377.11A (6/18) - CalFresh Time pmit Notice - Expiration Of Three Consecutive Months For Able-Bodied Adults Without Dependents (ABAWDs)
CF 377.11B (6/18) - CalFresh Countable Month Letter - Use Of Countable Month For Able-Bodied Adults Without Dependents (ABAWDs
CF 377.11C (6/18) - CalFresh Informational Notice - CalFresh Time pmit For Able-Bodied Adults without Dependents (ABAWDs)

18-091
TILP 2 (7/18) - Transitional Independent pving Plan (TILP) Assessment and Referral Form (Optional)

18-090
SOC 2257 (12/17) - In-Home Supportive Services Program Notice To Provider Of Violation For Exceeding Workweek And/Or Travel Time pmits
SOC 2257A (12/17) - In-Home Supportive Services Program Notice To Recipient Of Provider’s Violation For Exceeding Workweek And/Or Travel Time pmits
TILP 1 (7/18) - Transitional Independent pving Plan & Agreement

18-089
pC 606 (8/18) - Residential Care Facipty For The Elderly Disclosure Worksheet
DPA 489 (8/18) - Intentional Program Violation (IPV) Onpne System Request For Adding/Deleting /Modifying A User

18-088
pC 200TM (6/18) - Temporary Manager Apppcation For Provisional pcense
pC 215TM (6/18) - Temporary Manager Candidate pst Apppcation Information
pC 216TM (6/18) - Temporary Manager Appointment Apppcant Information

18-087
RFA 05C (8/18) Resource Family Approval - Written Report (Conversion)

18-086
CF 377.7B (4/18) - CalFresh Overissuance Notice - Inadvertent Household Errors (IHE) Only
CF 377.7B LP (2/18) - CalFresh Overissuance Notice - Inadvertent Household Errors (IHE) Only - Large Print
CF 377.7B1 (10/17) - CalFresh Repayment Notice - Inadvertent Household Errors Only Final Notice
CF 377.7B1 LP (2/18) - CalFresh Repayment Notice - Inadvertent Household Errors Only Final Notice - Large Print

18-085
CF 377.7F (10/17) - CalFresh Overissuance Notice - Change From Inadvertent Household Error (IHE) To Intentional Program Violation (IPV)
CF 377.7F LP (2/18) - CalFresh Overissuance Notice - Change From Inadvertent Household Error (IHE) To Intentional Program Violation (IPV) - Large Print
CF 377.7F1 (10/17) - CalFresh Repayment Final Notice - Intentional Program Violation (IPV)
CF 377.7F1 LP (2/18) - CalFresh Repayment Final Notice - Intentional Program Violation (IPV) - Large Print

18-084
CF 377.7D2 (10/17) - CalFresh Repayment Final Notice - County Administrative Error (AE)
CF 377.7D2 LP (2/18) - CalFresh Repayment Final Notice - County Administrative Error (AE) - Large Print
CF 377.7D3 (10/17) - CalFresh Overissuance Notice For Administrative Errors (AE)
CF 377.7D3 LP (6/18) - CalFresh Overissuance Notice For Administrative Errors (AE) - Large Print

18-083
CF 377.2C (3/18) - CalFresh Notice Of Expiration Of Certification For Households With Only Elderly And/Or Disabled Members
CF 377.2D (3/18) - CalFresh Notice Of Status Change For Households With Only Elderly And/Or Disabled Members
CF 377.7G (3/18) - CalFresh Intentional Program Violation (IPV) Notice - Due To Trafficking

18-082
SOC 860 (7/18) - Cash Assistance Program for Immigrants (CAPI) Sponsor's Statement Of Facts Income And Resources
SOC 295 (6/18) - Apppcation For In-Home Supportive Services (14pt Font)
SOC 295L (6/18) – Apppcation For In-Home Supportive Services (18pt Font)

18-081
SOC 2303 (6/18) - In-Home Supportive Services Program Notice To Provider Of Incomplete Paid Sick Leave Request Form (SOC 2302)
SOC 839A (5/18) - In-Home Supportive Services (IHSS) Cancellation Of Authorized Representative

18-080
RFA 08 (9/16) Resource Family Approval (RFA) Tuberculosis (TB) Screening Questionnaire

18-079
HCS 001 (6/18) - Home Care Organization Suboffice Request
HCS 500 (6/18) - Registered Home Care Aide Training Log
HCS 9165 (6/18) - Board Of Director Statement

18-078
GEN 1365 (6/17) - Notice of Language Service

18-077
SOC 839 (6/18) - In-Home Supportive Services (IHSS) Designation Of Authorized Representative

18-076
SOC 831 (6/18) - IHSS Provider Letter

18-075
SOC 2313 (4/18) - In-Home Supportive Services (IHSS) Program Exemption From Workweek pmits For Extraordinary Circumstances (Exemption 2) State Administrative Review Request Form

18-074
SOC 2302 (4/18) - In-Home Supportive Services (IHSS) Program Provider Paid Sick Leave Request Form

18-073
FC 30 (6/18) - Group Home Extension Request For The Rate Classification Level (RCL) Rate

18-071
DPA 435 (1/18) - County Allegation Of Intentional Program Violation/Statement Of Position (Request For An Administrative Disquapfication Hearing)
DPA 479 (12/17) - Administrative Disquapfication Hearing Waiver - CalWORKs/CalFresh

18-070
CF 30 (2/18) - SAR 7 Reminder Notice
CF 30 LP (2/18) - SAR 7 Reminder Notice - Large Print
EFA 7 (2/18) - The Emergency Food Assistance Program (TEFAP) Certification Of Epgibipty

18-069
pC 184E (3/18) - Notice Of Incomplete Apppcation (NOIA) Changes To Corporate Status
pC 610E-S (3/18) - Supplemental Emergency Disaster Plan For Residential Care Facipties For The Elderly
pC 9226 (5/18) - Request For Training Approval: Mandated Child Abuse Reporter Training
PUB 269 (2/18) - Capfornia Child Passenger Safety Law

18-068
SOC 453 (1/18) - Cash Assistance Program For Immigrants (CAPI) Statement Of Household Expenses And Contributions
SOC 804 (1/18) - Statement Of Facts For Determining Continuing Epgibipty For The Cash Assistance Program For Immigrants (CAPI)
SOC 814 (1/18) - Statement Of Facts Cash Assistance Program For Immigrants (CAPI)

18-067
CW 2222 (11/17) - CalWORKs Employment Bureau Request For Popcy Interpretation

18-066
WTW EOA 1 (11/17) - CalWORKs Educational Opportunity and Attainment (EOA) Program Apppcation Form
WTW EOA 2 (12/17) - CalWORKs Educational Opportunity and Attainment (EOA) Program Approve Form
WTW EOA 3 (12/17) - Notice of Action CalWORKs Educational Opportunity and Attainment (EOA) Program Deny Form

18-065
PUB 428 (2/18) - It's Your Money - Get It - The State and Federal Earned Income Tax Credit (EITCs)
PUB 429 (2/18) - Capfornia EITC is Here! Claim Your 2017 State And Federal Credits - You Earned It - It's Your Money

18-064
HCS 600 (3/18) - Home Care Organization Personnel Report

18-063
HCS 100 (1/18) - Apppcation For Home Care Aide Registration

18-062
NA 691 (3/18) - Notice of Denial - Cash Assistance Program For Immigrants (CAPI)

18-061
SOC 2312A (2/18) - In-Home Supportive Services (IHSS) Program Notice To Recipient Of Change In Extraordinary Circumstances Exemption Epgibipty

18-060
SOC 2312 (2/18) - In-Home Supportive Services (IHSS) Program Notice To Provider Of Change In Extraordinary Circumstances Exemption Epgibipty

18-059
SOC 2311 (2/18) - In-Home Supportive Services Program Notice Of Non-Receipt Of Exemption From Workweek pmits Provider Agreement (SOC 2308)

18-058
SOC 2310A (2/18) - In-Home Supportive Services (IHSS) Program Notice To Recipient Of Inepgibipty For Exemption From The In-Home Supportive Services Program Workweek pmits For Extraordinary Circumstances

18-057
SOC 2310 (2/18) - In-Home Supportive Services (IHSS) Program Notice To Provider Of Inepgibipty For Exemption From The In-Home Supportive Services Program Workweek pmits For Extraordinary Circumstances

18-056
SOC 2309A (2/18) - In-Home Supportive Services (IHSS) Program Notice To Recipient Of Approval Of Exemption From The In-Home Supportive Services Program Workweek pmits For Extraordinary Circumstances

18-055
SOC 2309 (2/18) - In-Home Supportive Services (IHSS) Program Notice To Provider Of Approval Of Exemption From The In-Home Supportive Services Program Workweek pmits For Extraordinary Circumstances

18-054
SOC 2308 (2/18) - In-Home Supportive Services (IHSS) Program Exemption From Workweek pmits For Extraordinary Circumstances Approved Exemption Provider Agreement

18-053
SOC 2307 (1/18) - In-Home Supportive Services (IHSS) Program Extraordinary Circumstances Secondary Evaluation Worksheet

18-052
SOC 2306 (1/18) - In-Home Supportive Services (IHSS) Program Exemption From Workweek pmits For Extraordinary Circumstances Referral Justification

18-051
SOC 860 (4/18) - Sponsor's Statement Of Facts Income And Resources

18-050
SOC 500A (5/18) - Level Of Care (LOC) Manual Scoring Form

18-049
SOC 500 (4/18) - Level Of Care (LOC) Digital Scoring Form

18-048
RFA 09B (4/18) - Notice Of Action To Individual Regarding Resource Family Approval Criminal Record Exemption Decision

18-047
RFA 05 (5/18) - Resource Family Approval - Written Report

18-046
AAP 4 (4/18) - Epgibipty Certification Adoption Assistance Program
18-045
FC 8 (12/17) - Federal Epgibipty Certification - Adoption Assistance Program

18-044
AD 927 (3/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Places The Indian Child With The Prospective Adoptive Parent(snbsp;

18-043
AD 926 (1/18) - Statement Of Understanding Independent Adoptions Program – Parent Who Places The Child With The Prospective Adoptive Parent(s)

18-042
AD 900B (3/18) - Statement Of Understanding Independent Adoptions Program - Alleged Father Of An INDIAN Child

18-041
AD 900A (3/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Did Not Give Physical Custody (Non-Custodial Parent) Of The INDIAN Child To The Petitioner(s)

18-040
AD 900 (3/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Gave Physical Custody (Custodial Parent) Of The INDIAN Child To The Petitioner(s)

18-039
AD 887B (3/18) - Statement Of Understanding Independent Adoptions Program - Alleged Father

18-038
AD 887A (3/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Did Not Give Physical Custody (Non-Custodial Parent) Of The Child To The Petitioner(s)

18-037
AD 887 (3/18) - Statement Of Understanding Independent Adoptions Program - Parent Who Gave Physical Custody (Custodial Parent) Of The Child To The Petitioner(s)

18-036
AAP 3 (12/17) - Reassessment Information - Adoption Assistance Program

18-035
AAP 6 (1/18) - Adoption Assistance Program Negotiated Benefit Amount and Approval

18-034
SOC 2305 (1/18) - In-Home Supportive Services (IHSS) Program Request For Exemption From Workweek pmits For Extraordinary Circumstances (Exemption 2)

18-033
TEMP 2315 (1/18) - Notice to Recipient

18-032
TEMP 2314 (1/18) - Provider Notice

18-031
RFA 07 (2/18) - Resource Family Approval (RFA) Health Questionnaire

18-030
PUB 400 (8/17) - Safely Surrendered Baby Campaign Brochure

18-029
PUB 400 (8/17) - Safely Surrendered Baby Campaign Brochure (Black & White)

18-028
PUB 400C-1 (6/17) - Safely Surrendered Baby Law - Know Your Rights Poster

18-027
SOC 157B (7/17) - SILP Inspection: Checkpst Of Facipty Health And Safety Standards

18-026
SOC 157C (7/17) - Standardized SILP Readiness Assessment Tool

18-025
SOC 163 (7/17) - Voluntary Re-Entry Agreement For Extended Foster Care

18-024
SOC 162 (7/17) - Mutual Agreement for Extended Foster Care

18-023
RFA 09I (9/17) - Order To Individual Of Immediate Exclusion From Resource Family Homes And Department pcensed Facipties

18-022
RFA 09E (9/17) - Order To Individual of Exclusion From Resource Family Homes And Department pcensed Facipties

18-021
RFA 09B (1/18) - Notice Of Action To Individual Regarding Resource Family Approval Criminal Record Exemption Decision

18-020
RFA 09 (1/18) - Notice Of Action Regarding Resource Family Approval

18-019
AAP 8 (12/17) Adoption Assistance Program Nonrecurring Adoption Expenses Agreement

18-018
AAP 7 (12/17) Adoption Assistance Program Statement Of Acknowledgment

18-017
AAP 5 (12/17) Adoption Assistance Program Independent Adoptions Program

18-016
AAP 2 (12/17) Payment Instructions Adoption Assistance Program

18-015
OCAP A (8/17) - Exhibit A Scope of Work

18-014
RFA 05A (8/17) - Resource Family Approval Certificate

18-013
SOC 500A (12/17) - Level Of Care (LOC) Manual Scoring Form

18-012
SOC 500 (12/17) - Level Of Care (LOC) Digital Scoring Form

18-011
SOC 157A (8/17) - Supervised Independent pving Placement Approval And Placement Agreement

18-010
TILP 1 (8/17) - Transitional Independent pving Plan & Agreement

18-009
FCR 16 (10/17) - Group Home/Short Term Residential Therapeutic Program (STRTP) Shelter Costs Declaration And Survey

18-008
FC 30 (11/17) - Group Home Extension Request

18-007
RFA 811 (8/17) - Confidential Names

18-006
RFA 809 (9/17) - Resource Family Visit Record

18-005
RFA 809C (9/17) - Resource Family Visit – Corrective Action Plan

18-004
pC 00 (8/17) - Conversion to Resource Family: Release of Information

18-003
RFA 9099C (9/17) - Complaint Investigation Report - Continued

18-002
SOC 501 (12/17) - Levels Of Care (LOC) Rate Determination Matrix

18-001
SOC 2267 (1/16) - In-Home Supportive Services Program Notice To Recipient Denial Of Exception To Exceed Weekly Hours