2008 Notice Of Forms Changes

  • 08-141
    LIC 627B (9/08)  Consent For Emergency Medical Treatment - Children's Residential Facilities
  • 08-140
    LIC 627A (9/08)   Consent To A Medical Examination
  • 08-139
    LIC 627 (9/08)  Consent For Emergency Medical Treatment - Child Care Centers Or Family Child Care Homes
  • 08-138
    BCII 9002 (4/08) Substitute Agency Notification Request
  • 08-137
    SOC 815 (11/08)  Approval of Family Caregiver Home 
  • 08-136
    LIC 9163B (12/08) Request For Live Scan Services - Long Term Care
  • 08-135
    PUB 429 (12/08) ENG/SP -  It's Your Money - Flyer
  • 08-134
    PUB 428 (12/08) ENG/SP - It's Your Money Brochure
  • 08-133
    SOC 837 (11/08) Supplement To The Rate Questionnaire
  • 08-132
    SOC 836 (11/08) Supplement To The Rate Eligibility Form
  • 08-131
    SOC 835 (11/08) Supplement To The Dual Agency Rate - Multiple Questionnaire Worksheet
  • 08-130 
    TLR 9163A (11/08)  Request for Live Scan Service for TrustLine Registry Applicants
  • 08-129
    TLR 9163 (11/08)  Request for Live Scan Service for Subsidized TrustLine Registry Applicants
  • 08-128
    TLR 1  (11/08)  TrustLine Registry - The California Registry of In-Home Child Care Providers Subsidized Application
  • 08-127
    PUB 422  (10/08)  Supplemental Security Income (SSI) for Foster Youth with Disabilities
  • 08-126
    PUB 421  (10/08)  Supplemental Security Income (SSI) for Youth with Disabilities
  • 08-125 
    PUB 420 (10/08)  Supplemental Security Income (SSI) Information for Transitioning Foster Youth
  • 08-124
    SOC 369 (9/08) Agency-Relative Guardianship Disclosure
  • 08-123
    FS 24 (8/08) Food Stamp Program Request For Regulation Interpretation
  • 08-122
    TLR 2 (12/08) Trustline Registry - "The California Registry Of In-Home Child Care Providers"
  • 08-121
    LIC 995 (9/08)  Child Care Center - Notification of Parents' Rights
  • 08-120
    LIC 995C (8/08) Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Reinstatement)
  • 08-119
    LIC 701 (8/08)  Physician's Report - Child Care Centers
  • 08-118
    LIC 601 (8/08) - Indentification and Emergency Information
  • 08-117
    FS 11 (8/08) ENG/SP - Notice To All Food Stamp Recipients - Important - Please Read
  • 08-116
    GEN 1365 (3/08) Multilingual - Notice Of Language Services
  • 08-115
    LIC 9224 (8/08) Acknowledgement of Receipt of Licensing Reports
  • 08-114
    LIC 9221 (8/08) Parent Consent for Administration of Medications and Medication Chart
  • 08-113
    LIC 9185 (8/08) Foster Family Agency Certified Home
  • 08-112
    LIC 9150 (8/08)  Parent Notification - Additional Children in Care
  • 08-111
    LIC 995B  (8/08)  Family Child Care Home - Addendum to Notification of Parents' Rights
  • 08-110
    LIC 995A (8/08)  Family Child Care Home - Notification of Parents' Rights
  • 08-109
    LIC 702 (8/08)  Child's Preadmission With Prior DSS Approval
  • 08-108
    LIC 700 (8/08)  Identification and Emergency Information - Child Care Centers/Family Child Care Homes
  • 08-107
    LIC 624B (8/08)  Unusual Incident/Injury Report - Family Child Care Home
  • 08-106
    LIC 613A (8/08)  Personal Rights - Child Care Centers
  • 08-105
    LIC 282  (8/08)  Affidavit Regarding Liability Insurance for Family Child Care Home
  • 08-104
    SOC 414 (8/93)  Level of Care Assessment
  • 08-103
    LIC 200 (7/08)  Application For A Community Care Facility or Residential Care Facility For The Elderly
  • 08-102
    AD 20B (3/08) Refusal To Give Consent To Adoption - Alleged Natural Father
  • 08-101
    AD 501A (3/08) Relinquishment Out-of-State (Birth Mother/Presumed Father)
  • 08-100
    AD 586 (3/08) Relinquishment In or Out of County (Alleged Natural Father in California)
  • 08-099
    AD 591 (3/08) Relinquishment Out of State (Alleged Natural Father)
  • 08-098
    AD 594 (3/08) Alleged Natural Father's Consent To Adoption (In Or Out Of California)
  • 08-097
    AD 862 (3/08) Relinquishment Of An Indian Child Out Of State Alleged Natural Father
  • 08-096
    AD 864 (3/08) Relinquishment Of An Indian Child In Or Out Of County - Birth Mother/Presumed Father In California
  • 08-095
    AD 867 (3/08) Relinquishment Of An Indian Child Out of State - Presumed Father Denies He is the Birth Father
  • 08-094
    Ad 868 (3/08) Relinquishment Of Indian Child - In/Out of County - Alleged Natural Father In California
  • 08-093
    AD 866 (3/08) Relinquishment Of An Indian Child In Or Out of County - Presumed Father Denies He Is The Birth Father In California
  • 08-092
    PUB 69 (7/08) 2008/2009 County Forms Catalog
  • 08-091
    NA 840 (5/08) Notice Of Action - Welfare To Work Plan
  • 08-090
    NA 1242 (6/08) Notice Of Action - Sanctions Budget
  • 08-089
    NA 817 (5/08) Notice Of Action - Sanction Of Participant After Failed Compliance Plan
  • 08-088
    NA 816 (5/08) Notice Of Action - Sanction Of Other Parent After Failed Compliance Plan
  • 08-087
    NA 845 (5/08) Notice Of Action - Sanction And Removal Of The other Parent's Needs
  • 08-086
    FS 29 (5/08) Food Stamp Recertification Appointment Letter
  • 08-085
    QR 377.2 (5/08) Food Stamp Notice Of Expiration Of Certification
  • 08-084
    FS 13 ENG/SP (9/99) Notice To All Food Stamp Household Members Who Must Pay Child Support Important Please Read
  • 08-083
    PUB 438 (6/08) Changes To The Trustline Registration  Requirements
    PUB 439 (6/08) License Exempt Provider Pamphlet - Trustline Registration Requirements
  • 08-082
    AD 2B (3/08) Consent To Adoption By Parent Outside California Giving Custody To Husband Or Wife Or Domestic Patner Of Other Paent
  • 08-081
    AD 166 (3/08) Consent To Adoption By Father Outside California - To Be Used When Presume Father Denies He Is The Natural Father
  • 08-080
    AD 863 (3/08) Relinquishment Of An Indian  Child Out Of State - Birth Mother/Presumed Father
  • 08-079
    AD 590 (3/08) Waiver Of Right To Further Notice Of Adoption Planning - Alleged Natural Father In Or Out Of California
  • 08-078
    AD 584 (3/08) Relinquishment Out Of State - Presume Father Denies He Is The Birth Father
  • 08-077
    AD 588 (3/08) Denial Of Paternity By Alleged Natural Father (In Or Out Of California)
  • 08-076
    AD 590A (3/08) Waiver Of  Right To Further Notice Of Adoption Planning - Presumed Father In Or Out Of California
  • 08-075
    AD 20 (3/08) Refusal To Give Consent To Adoption
  • 08-074
    AD 583 (3/08) Relinquishment In Or Out Of County - Presumed Father Denies He Is The Birth Father In California
  • 08-073
    AD 2D (3/08) Stepparent Adoption Consent To Adoption By Parent Outside California In Armed Forces Giving Custody To Husband Or Wife Or Domestic Partner Of Other Parent
  • 08-072
    AD 1F (3/08) Consent To Adoption By Parent(s) Outside California In Armed Forces
  • 08-071
    AD 1C (3/08) Consent By Parent(s) Outside California
  • 08-070
    LIC 200A (6/08)  Application For A Child Care Center License
  • 08-069
    DFA 386 (3/08) Notice Of Missed Interview
  • 08-068
    SSP 14 (3/08) Authorization For Reimbursement Of Interim Assistance Initial Payment Or Initial Posteligibility Payment
  • 08-067
    SSP 18 (3/08) Notice Of Action And Right To Request A State Hearing On Interim Assistance
  • 08-065
    SOC 834 (6/08)  Request for Grievance Hearing
  • 08-064
    LIC 279 (5/08)  Application For A Family Child Care Home License
  • 08-063
    SOC 832 (5/08)  Notice of Child Abuse Central Index Listing
  • 08-062
    SOC 454 (4/99) Cash Assistance Program For Immigrants (CAPI) Sponsor To Alien Deeming Worksheet
  • 08-061
    SOC 369 (4/08) Agency-Relative Guardianship Disclosure
  • 08-060
    DFA 285D (8/07) Food Stamp Budget Worksheet - Special Medical/Shelter Deductions
  • 08-059
    SOC 834 SP  (3/08)  Request for Grievance Hearing
  • 08-058
    SOC 833 SP  (3/08)  Child Abuse Central Index Listing Grievance Procedures
  • 08-057
    SOC 832 SP (3/08)  Notice of Child Abuse Central Index Listing
  • 08-056
    TEMP 2232  SP (4/08)  Notice of Possible Listing on the Child Abuse Central Index
  • 08-055
    LIC 9163 (4/08)  Request for Live Scan Service - Community Care Licensing
  • 08-054
    PUB 422 (4/08)  Supplemental Security Income (SSI) for Foster Youth with Disabilities
  • 08-053
    PUB 421 (4/08)  Helping Your Child Receive Supplemental Security Income (SSI) for Youth with Disabilities
  • 08-052
    PUB 420 (4/08)  Supplemental Security Income (SSI) Information for Transitioning Foster Youth
  • 08-051
    TEMP 2232 (4/08) Notice of Possible Listing on the Child Abuse Central Index
  • 08-050
    WTW 13 (7/99) Welfare To Work/Cal-Learn Supportive Services Overpayment Final Notice
  • 08-049
    WTW 11 (7/99) Welfare To Work/Cal-Learn Supportive Services Overpayment/Underpayment Notice
  • 08-048
    WTW 12 (7/99) Welfare To Work/Cal-Learn Supportive Service Repayment Agreement
  • 08-047
    RS 36 (3/08) Employment And Training Requirements For Refugee Cash Assistance (RCA)
  • 08-046
    RS 1 (3/08) Refugee Resettlement Program Services Application And Assessment Information
  • 08-045
    SOC 831 (3/08) Provider Direct Deposit Outreach Letter
  • 08-044
    SOC 829 (3/08) IHSS Provider Direct Deposit Enrollment/Change/Cancellation Form
  • 08-043
    SOC 834 (3/08) - Request for Grievance Hearing
  • 08-042
    SOC 832 (3/08) - Notice of Child Abuse Central Index Listing
  • 08-041
    SOC 826 (3/08) - Child Fatality/Near Fatality - County Statement of Findings and Information
  • 08-040
    SOC 833 (3/08) - Child Abuse Central Index Listing Grievance Procedures
  • 08-039
    LIC 627B  SP (1/08)  - Consent for Emergency Medical Treatment - Children's Residential Facilities
  • 08-038
    LIC 627A  SP (1/08)  - Consent to a Medical Examination
  • 08-037
    LIC 200 SP (12/07) - Application For A Community Care Facility or Residential Care Facility for the Elderly License
  • 08-036
    SOC 830  SP (1/08)  Request for Conditional CAPI After Naturalization Pending SSI/SSP Eligibility Determination
  • 08-035
    LIC 627 SP (1/08)  Consent for Emergency Medical Treatment - Child Care Centers or Family Child Care Centers
  • 08-034
    LIC 283A SP (12/07)  Foster Family Home application Instructions
  • 08-033
    ICPC 100A (10/03)  Interstate Compact Placement Request
  • 08-032
    LIC 9224 (1/08)  Acknowledgement of Receipt of Licensing Reports
  • 08-031
    LIC 9221 (1/08)  Parent Consent for Administration of Medications and Medication Chart
  • 08-030
    LIC 9150 (1/08)  Parent Notification - Addditional Children in Care
  • 08-029
    LIC 9185 (1/08)  Foster Family Agency Certified Home
  • 08-028
    LIC 995C (1/08)  Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Reinstatement)
  • 08-027
    LIC 995B (1/08)  Family Child Care Home Addendum to Notification of Parents' Rights (Regarding Removal/Exclusion)
  • 08-026
    LIC 995A (1/08)  Family Child Care Home - Notification of Parents' Rights
  • 08-025
    LIC 995 (1/08)  Child Care Center - Notification of Parents' Rights 
  • 08-024
    LIC 702 (1/08)  Child's Preadmission Health History - Parent's Report
  • 08-023
    LIC 701 (1/08)  Physician's Report - Child Care Centers
  • 08-022
    LIC 282 (1/08) Affidavit Regarding Liability Insurance For Family Child Care Home
  • 08-021
    LIC 9211 (1/08)  Request for Inactive Child Care License Status
  • 08-020
    LIC 700 (1/08)  Identification and Emergency Information - Child Care Centers/Family Child Care Homes
  • 08-019
    LIC 627B (1/08)  Consent for Emergency Medical Treatment - Children's Residential Facilities
  • 08-018
    LIC  627A (1/08)  Consent to a Medical Examination
  • 08-017
    LIC 627 (1/08)  Consent for Emergency Medical Treatment - Child Care Centers or Family Child Care Homes
  • 08-016
    LIC 624B (1/08)  Unusual Incident/Injury Report - Family Child Care Home
  • 08-015
    LIC 613A (1/08)  Personal Rights - Child Care Centers
  • 08-014
    LIC 601 (1/08)  Identification and Emergency Information
  • 08-013
    LIC 122 (1/08)  Release of Information
  • 08-012
    LIC 9029A (1/08) Statement of Facts Summary Sheet
  • 08-011
    LIC 184A (1/08) Notification of Incomplete Foster Family Home Application
  • 08-010
    NA 834 (1/08) Notice Of Action - Child Care Denial
  • 08-009
    NA 833 (1/08) Notice Of Action - Child Care Change
  • 08-008
    NA 832 (1/08) Notice Of Action - Child Care Approval
  • 08-007
    CCP 7 (1/08) CalWORKs Stage One Child Care Request Form And payment Rules
  • 08-006
    CCP 4 (1/08) Health And Safety Self-Certification (For License-Exempt Providers)
  • 08-005
    CCP 1 (1/08) Declaration Of Exemption From Trustline Registration And Health And Safety Self-Certification
  • 08-004
    SOC 830 (1/08) Request for Conditional CAPI After Naturalization Pending SSI/SSP Eligibility Determination
  • 08-003
    NA 835 (1/08) Notice Of Action - Child Care Discontinuance
  • 08-002
    TEMP 2230 (9/07) English and Spanish - Important Notice To Food Stamp Households
  • 08-001
    PUB 275 (4/07) English and Spanish - Family Planning - Making The Commitment For A Healthy Future