2007 Notice Of Form Changes

  • 07-088
    LIC 283A (12/07) - Foster Family Home Application Instructions
  • 07-087
    LIC 200 (12/07) - Application For A Community Care Facility Or Residential Care Facility For The Elderly License
  • 07-086
    LIC 9188 (12/07) - Criminal record Exemption Transfer Request
  • 07-085
    LIC 9182 (12/07) - Criminal Background Clearance Transfer Request
  • 07-084
    DPA 479 (12/07) - Administrative Disqualification Hearing Waiver - CalWORKs/Food Stamps
  • 07-083
    LIC 508D (12/07) - Out-Of-State Disclosure And Criminal Record Statement
  • 07-082
    LIC 198B (12/07) - Out-Of-State Child Abuse/Neglect Report Request
  • 07-081
    NA 692 (12/07) - Notice of Change - Cash Assistance Program For Immigrants (CAPI)
  • 07-080
    TEMP 1722A (10/07) - CalWORKs/Food Stamp Welfare Intercept System (WIS) Transmittal
  • 07-079
    LIC 195 (10/07) - Notice of Operation in Violation of Law
  • 07-078
    DPS 526 (4/99) - County Response Document
  • 07-077
    IMM 408 (1/01) - Windows for Immunizations
  • 07-076
    LIC 9191 (6/01) - Substitute Employee Registry Certificate of Eligibility - Child Care Center and Family Child Care Home
  • 07-075
    LIC 508D (9/07) - Criminal Record Statement - Foster Family Homes, Small Family Homes, Certified Family Homes
  • 07-074
    PUB 414 (9/07) - Crisis Nurseries Board of Directors Booklet
  • 07-073
    LIC 198A (9/07) - Child Abuse Central Index Check for State Licensed Facilities
  • 07-072
    LIC 701 (9/07) - Physician's Report - Child Care Centers
  • 07-071
    LIC 700 (9/07) - Identification and Emergency Information - Child Care Centers/Family Child Care Homes
  • 07-070
    SAWS 2 (7/07) - Statement Of Facts For Cash Aid, Food Stamps, And Medi-Cal/34-County Medical Services Program (CMSP)
  • 07-069
    SSP 18 (9/07) - Notice of Action and Right to Request a State Hearing on Interim assistance for Payment Pending Cases
  • 07-068
    DPA 481 (4/02) - County Report of Compliance Transmittal
  • 07-067
    LIC 301A (8/07) - Reference Request - Adoption Facilitator
  • 07-066
    LIC 508B (8/07) - Criminal Record Statement - Long-Term Care Ombudsman Program
  • 07-065
    LIC 508A (8/07) - Criminal Record Statement - Adoption Facilitator
  • 07-064
    LIC 301B (8/07) - Reference Request - Long-Term Care Ombudsman Program
  • 07-063
    LIC 198A (8/07) - Child Abuse Central Index Check (State Licensed Facilities)
  • 07-062
    LIC 165 (8/07) - Board of Directors Statement - Crisis Nurseries
  • 07-061
    FS 11 (8/07) English/Spanish - Notice To All Food Stamp Recipients - Important - Please Read
  • 07-060
    PUB 13 (3/07)- Large Print - Your Rights Pamphlet
  • 07-059
    PUB 373 (5/07) English and Spanish - Important Food Stamp Information For Noncitizens
  • 07-058
    AD 590 ENG/SP (6/07) - Waiver Of Right To Further Notice Of Adoption Planning (Alleged Natural Father In Or Out Of California)
  • 07-057
    SAWS 7 (7/02) English and Spanish - Monthly Eligibility Status Report
  • 07-056
    DPA 487 (5/07) - Request for Access to Protected Health Information
  • 07-055
    LIC 396 (4/07) - Foster Youth Rights
  • 07-054
    PUB 395 (4/07) - You Have Rights Too!
  • 07-053
    LIC 908B (9/99) - Facility File Divider Tabs (Child Care)
  • 07-052E
    PUB 337 (1/04) English and Spanish - SFIS Brochure
  • 07-052
    PUB 337 (1/04) English and Spanish - SFIS Brochure
  • 07-051
    LIC 9224 (12/06) English & Spanish - Acknowledgement of Receipt of Licensing Reports
  • 07-050
    LIC 311D (3/07) Spanish - Forms/Records to Keep in Your Family Child Care Home
  • 07-049
    DPA 19 (4/07) SP - Authorized Representative
  • 07-048
    LIC 9223 (3/07) SP - Child Care Advocate Program
  • 07-047
    SAWS 2A QR (1/07) English and Spanish - Rights and Responsibilities and Other Important Information
  • 07-046
    SAWS 1 (12/06) English and Spanish - Application For Cash Aid, Food Stamps, and.or 34-County CMSP
  • 07-045
    CW 2166 (11/06) Multingual - Work Really pays! Here's How - work Pays Notice
  • 07-044
    DPA 19 (4/07) - Authorized Representative
  • 07-043
    TEMP 2229 (3/07) English and Spanish - Important Notice - KinGAP Informing Notice
  • 07-042
    DFA 285B (4/07) - Food Stamp Budget Worksheet/Change Reporting Household
  • 07-041
    SAWS 2 (1/07) English and Spanish - Statement of Facts For Cash, Food Stamps and Medi-Cal 34-County Medical Services
  • 07-040
    QR 22 (12/06) English and Spanish - Sponsored Noncitizens Applying For Or Receiving Cash Aid and/or Food Stamps
  • 07-039
    AD 904A (3/07) - Waiver Of Rights To Confidentiality For Siblings
  • 07-038
    AD 67A (2/07) - Information About The Birth Father
  • 07-037
    AD 904A (3/07) - Waiver Of Rights To Confidentiality For Siblings - Under The Age Of 18
  • 07-036
    QR 72 (12/06) English and Spanish - Sponsor's Quarterly Income And Resources Report
  • 07-035
    NA 845 (12/06) - English and Spanish - Notice Of Action Welfare To Work
  • 07-034
    NA 817 (12/06) - English and Spanish - Notice Of Action - Cash Aid
  • 07-033
    AD 67 (2/07) - Information About Birth Mother
  • 07-032
    AD 29 (3/07) - Employment Verification
  • 07-031
    LIC 311D (3/07) - Forms/Records To Keep In Your Family Child Care Home
  • 07-030
    LIC 279A (1/07)- English and Spanish - License Application and Instructions for Family Child Care Homes
  • 07-029
    NA 840 (12/06) English and Spanish - Notice of Action - Welfare to Work
  • 07-028
    PUB 394 (12/06) - Family Child Care Home - Notification of Parents' Rights Poster
  • 07-027
    PUB 393 (12/06) - Child Care Center - Notification of Parents' Rights
  • 07-026
    DFA 285-A1 (1/07) - Application For Food Stamp Benefits
  • 07-025
    NA 816 (12/06) English and Spanish - Notice Of Action - Lowering Cash Aid
  • 07-024
    LIC 9223 (3/07) - Child Care Advocate Program
  • 07-023
    LIC 311A (3/07) - Records To Be Maintained At The Facility - Child Care Centers
  • 07-022
    SOC 341 (12/06) - Report Of Suspected Dependent Adult/Elder Abuse
  • 07-021
    FC 1633D (2/07) - SSI Assessment Tool
  • 07-020
    FC 1633C (2/07) - SSI Screening Guide Section C - Application Information
  • 07-019
    FC 1633B (2/07) - SSI Screening Guide Section B - Financial Screening
  • 07-018
    FC 1633A (2/07)- SSI Screening Guide Section A - Disability Screening
  • 07-017
    SOC 828 (1/07) - Conlan II County Verification
  • 07-016
    NA 841 (10/06) - Notice Of Action - Welfare To Work
  • 07-015
    NA 818 (10/06) - Notice Of Action - Cash aid Grant Amount
  • 07-014
    FS 22 QR (12/06) English and Spanish - Applying For Food Stamp Benefits
  • 07-013
    DFA 285-A1 (1/07) English and Spanish - Application For Food Stamp Benefits
  • 07-012
    SSP 18 (12/06) English and Spanish - Notice of Action and Right To Request A State Hearing On Interim Assistance For Payment Pending Cases
  • 07-011
    LIC 281A (1/07) - License Application And Instructions For Family Child Care Centers
  • 07-010
    LIC 279A (1/07) - License Application Instructions For Family Child Care Homes
  • 07-009
    PUB 13 (12/06) - Your Rights Pamphlet
  • 07-008
    LIC 9212 (10/05) English and Spanish - Consumer Awareness Information - Family Child Care
  • 07-007
    PUB 72 (4/03) English And Spanish - What Are Parent's Responsibilities
  • 07-006
    SOC 827 (12/06) - IHSS Program Individual Emergency Back-Up Plan
  • 07-005
    PUB 104 (12/06) ENG/SP - IHSS Individual Provider Benefits And Services Information
  • 07-004
    PUB 56 (12/06) ENG/SP - The In-Home Supportive Services Program
  • 07-003
    SOC 824 (1/07) - In-Home Supportive Services QA/QI, PCSP, IPW and IHSS-R Programs
  • 07-002
    CW 42 (11/06) ENG/SP - Statement Of Facts - Homeless Assistance
  • 07-001
    ILP 1 (1/07) - Independent Living Program Annual Report And Plan Federal Fiscal Year (FFY) 2006