MC 300 Forms: MC 306 (11/15) - Appointment of Representative; Alt: Spanish (01/08) MC 322 (05/07) - Real and Personal Property - Supplement to Medi-Cal Mail-in Application For tips on how to use PDF files or to download a free copy of Acrobat Reader, Get your free copy . 6. Based On Your Medi-Cal Eligibility Your Household May Be Eligible For CalFresh Food Benefits, PUB 521 (10/21) - In-Home Supportive Services (IHSS) Protective Supervision Services For Adults, PUB 521L (10/21) - In-Home Supportive Services (IHSS) Protective Supervision Services For Adults, PUB 522 (10/21) - In-Home Supportive Services (IHSS) Protective Supervision Services For Minor Children, PUB 522L (10/21) - In-Home Supportive Services (IHSS) Protective Supervision Services For Minor Children, PUB 523 (1/23) - Parent Appeal Information Pamphlet, PUB 524 (2/23) - Protect Your Benefits Beware Of Skims And Scams. Search more forms. Name: ICWA-020. PUB 403 (1/13) - English and Spanish - We Accept EBT - EBT Retailers Posters ; PUB 403A (1/13) - English and . DFA 285D (8/11) - CalFresh Budget . You may give this form to your local county office in person or by mail, phone or electronically. IHSS is considered an alternative to out-of-home care, such as nursing homes or board and care facilities. Every child maltreatment case under s. 39.30 (1) is to be reported and a report made by a child maltreatment case manager or a designee of the child maltreatment case manager with the information or records to . Supplemental Security Income Self Certification. Provide a description of any physical and/or mental condition or functional limitation that has Failure to provide requested information may result in a denial of services. K Forms. You are here: what is a chalk landing place / shooting in vallejo today / cdss forms spanish. Please do not post private or sensitive information such as names, addresses, phone numbers, emails, confidential financial and legal details. 7. www.courts.ca.gov. Any personal information collected is governed by the requirements of the following authorities and all other laws pertaining to personal information: CDSS collects personal information directly from individuals who volunteer to obtain some of our services. Within 30 days of a signed collective bargaining agreement, memorandum of understanding (MOU), extension or addendum, a Contract Data Summary Sheet (CDSS) and a copy of the signed agreement is required to be filed with SERB. aural josiah lewis. Minimum of 10 characters. CD-278-Spanish: Safe Sleep Flyer - Spanish: None: Case Management/Licensing/Resource Development: No: No: 10/21: CS2-ATT Spanish: Parent Response Form: None: Case . (This Publication Is Designed To Be Folded For Use As A Wallet Card. Purchasing Authority Change Request (PACR) Link opens a document. To receive the Parentage Opportunity Program Online Access Request form, please email askpop@dcss.ca.gov and request the form. bury grammar school staff list. Application for Services Forms. Personal information may include: name, social security number, physical description, home address, home telephone number, education or financial, medical or employment history, etc. FCCH - Pre-Orientation Registration Information: Wait! Rena toda la documentacin para presentar su solicitud. Narcissistic dimensions impact depressive symptoms and their improvement during inpatient and outpatient treatment across mental disorders and therapeutic methods They will direct you to your program representative. rest of the form including the certification in PART D at the bottom of the form. MC 210 A (09/07) - Supplement to Statement of Facts for Retroactive Coverage/Restoration. This posting also provided a link and deadline information for the grant. Alt: Arabic, Armenian, Chinese, Farsi, Hmong, Cambodian, Korean, Spanish, Tagalog, Vietnamese. Department of Health Care Services . On 3/2/2023, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1-Year inspection at the Velasco Family Child Care.Upon arrival, the LPA met with the licensee, Bertha Velasco, who guided the LPA on a tour of the facility. Here's How - Use Starting June 1, 2020, CW 2166 (11/21) - Multilingual Work Really Pays! Public Records Act - Government Code section 6250 et seq. Medi-Cal Eligibility Divisi on forms are listed below, alphabetically, by form number and has been translated into Spanish. Electronic theft is any loss of cash benefits taken by an unauthorized withdrawal or use of benefits that does not occur with the use of a physical EBT card issued to the benefit recipient or authorized third party to directly access the benefits. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. KG 1 (12/11) - Kin-GAP Mutual Agreement For 18 Year Olds ; KG 2 (1/11) - Statement Of Facts Supporting Eligibility For Kinship Guardianship Assistance Payment (Kin-GAP) Program . California Department of Social Services Copies of alien status documents are in the case file. Lic 9108 Form is not the form you're looking for? Dental, Request for Access to Protected Health Information. Estate Recovery Forms. State of CaliforniaHealth and Human Services Agency . Document Verification Request (INS Form G-845) and copies of documentation of satisfactory immigration status sent to INS. (DHCS), California Department of Social Services (CDSS) and/or the County in which I receive services. Documents (used by county governments) N Forms. Quality Assurance Fee Program. 0. textbook form 21-22.pdf. Averige si califica. Spanish - NOA will be issued in Spanish. Page 1 of 1. ATTORNEY OR PARTY WITHOUT ATTORNEY . On 3/14/2022, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1 Year inspection at the Velasco Family Child Care.Family members residing in the home are three adults (licensee, two adult renters who utilize the separate section of the house property-separated by a common wall which is the off-limits television room). Information Practices Act - Civil Code section 1798 et seq. Medi-Cal Personal Injury Program. CDSS Licensing Administrative Action Personnel Flagging Attachment ; LIC 9015 (9/00) - Legal Case Transmittal ; LIC 9020 (5/17) - Register Of Facility . It is intended to help individuals understand their rights and responsibilities in the In-Home Supportive Services (IHSS) program. English | Spanish | Request accessible version. Family members residing in the home are three adults (licensee, and 2 adult renters who utilize the separate section of the house property . Use Get Form or simply click on the template preview to open it in the editor. The School Food Hero DayMarch 2023 (added 13-Apr-2023) The School Food Hero Day is May 5, 2023. The Student Assistant will review for completeness and accuracy the CDSS system access and data security forms submitted by CCLD managers, and upon form completion, forward these documents to the . The SOC 832 in Chinese can be found on the CDSS website. Problems with downloading forms? Request accessible version. is mackenzie salmon married Statewide Information Management Manual (SIMM) 5310 - A & B. PUB 393 (12/06) - Notification of Parents' Rights - Child Care Center, PUB 394 (12/06) - Notification of Parents' Rights - Family Child Care Home, PUB 400 (8/17) - Safely Surrendered Baby Campaign Brochure, PUB 400 (8/17) - Safely Surrendered Baby Campaign Brochure (Black & White), PUB 400B (5/18) - Safely Surrendered Baby Kit-Order Form, PUB 400C (6/17) -Safely Surrendered Baby Know Your Rights, PUB 400C-1 (6/17) - Safely Surrendered Baby Law- Know Your Rights Poster, PUB 401 (3/10) - Safely Surrendered Baby Campaign Poster - poster size, PUB 403 (1/13) - English and Spanish - We Accept EBT - EBT Retailers Posters, PUB 403A (1/13) - English and Spanish - We Accept EBT - Farmers' Market Poster, PUB 403B (1/13) - English and Spanish - We Accept EBT - Merchant EBT Poster, PUB 411 (8/11) - 20 Facts About Child Abuse And Neglect (Paper size 8 1/2" x 11" printed landscape), PUB 412 (Multilingual) (8/13) - State Hearing Information (Print Letter Size), PUB 412 (Multilingual) (8/13) - State Hearing Information (Print Tabloid Size), PUB 414 (9/18) - Crisis Nurseries Board Of Directors Booklet, PUB 420 (10/08) - Supplemental Security Income (SSI) Information for Transitioning Foster Youth, PUB 421 (10/08) - Supplemental Security Income (SSI) for Youth with Disabilities, PUB 422 (10/08) - Supplemental Security Income (SSI) for Foster Youth with Disabilities, PUB 428 (1/23)- It's Your Money -Get It - The State and Federal Earned Income Tax Credit (EITCs), PUB 429 (1/23)- California EITC is Here! Kasiya Cdss 2013 Msce Results Extreme Correlation of International Equity Markets - Oct 30 2019 Diseases of the Newborn - Jan 26 2022 Over 9000 English-language entries to medical terminology, with etymology given in Japanese and English. FY2023 Team Nutrition Grant (added 13-Apr-2023) This posting notifies school food authorities (SFAs) that neither the CDE nor the CDSS plan to apply for the 2023 Team Nutrition grant, which means SFAs are eligible to apply. Rules of Court, rule 5.481 . Try it now! Health Insurance Premium Payment Program. Spanish - California Department of Social Services - CA.gov CDSS forms and publications are available only in Portable Document Format (PDF). DGS PD 14-001 Sub-Purchase Order Link opens a document. Comments and Help with lic 9108 form california. The following resources are provided for program recipients/consumers. cdss forms spanishaustin, mn jail roster April 9, 2023 . Report welfare fraud to the California Department of Social Services (CDSS) Welfare Fraud Hotline at 800-344-8477 , or DPSS Central Fraud Reporting Line at 800-349-9970 , or at lacounty . . Form Adopted for Mandatory Use Judicial Council of California ICWA-020 [Rev. or b. eneficiary name: Mailing . When Spanish or Chinese forms are completed the SW must: Manually enter the referral number, client name(s) and allegation information Import the completed form into CWS/CMS. Welfare and Institutions Code section 10850. . Privacy Notice on Collection SOC 2302 (Spanish) (4/18) Page 1 of 2 PROGRAMA DE SERVICIOS DE APOYO EN EL HOGAR (IHSS) FORMULARIO DE SOLICITUD DEL PROVEEDOR PARA PAGO POR AUSENCIA REQUISITOS DEL PROVEEDOR: Solamente puede solicitar pago por enfermedad si ha acumulado pago por ausencia por enfermedad. textbook form 21-22.pdf. A tech-savvy physician with a demonstrated history of working in medical and health information technology fields in various capacities for over two decades. For Issuance Of California Department Of Social Services Acknowledgement . Confidential Referral/Follow-Up Report - PM 161. The Department of Social Services has free forms and publications that can provide you with information and guidance in a number of important areas. Any fields in the application or form with unrestricted text are intended for the requested information only. Desired Results Developmental Profile (DRDP) (2015) (PDF; 1MB) Preschool View for use with preschool-age children. The person authorized on the completed and submitted DPA 19 form can represent the applicant/recipient at a state administrative . MC 200 Forms: MC 209 (05/12) - Changes to your Medi-Cal coverage during your pregnancy and after you give birth. Part A: Tell us about you: Applicant. AD 898 (1/11) - Consent Of CDSS Or Delegated County Adoption Agency - Independent Adoptions Program ; AD 899 (3/08) - Statement of Understanding - Mother or a Presumed Father of the Indian Child Who is Not Detained, a Juvenile Court Dependent in Out-of-home Care, or a Ward of a Legal Guardian . Prior to a welcome email, the user and their supervisor will receive a status email, with account login information upon . Servicios Sociales de California (CDSS), y/o el Condado en donde yo reciba servicios. Child Abuse and Neglect Reporting Forms The following forms are for use by government agencies and mandated reporters pertaining to child abuse cases. AD 867 (3/08) - Relinquishment of an Indian Child - Out-of-State - Presumed Father Denies He is the Birth Father. Required Form - Substitute with Prior CDSS Approval - Section 23-400.112, Management and Office Procedures - Forms Management Forms in this category are required forms for which modifications or substitutions are permitted with the prior approval of the California Department of Social Services (CDSS). For additional resources, go to IHSS Recipient/Consumer Resources. 3. Su saldo de estas horas se muestra en su taln de cheque. For more consumer information on security please see the California Department of Justice's, " Security Awareness ". Application for Registration as a School Audiometrist - PM 101. STD 40 A Nonprofit Veteran Service Agency (NVSA) Small Business Certification Application Link opens a document. All questions and comments are moderated and publicly viewable. Individuals who provide personal information to CDSS have the right to review the information for accuracy and completeness and to request corrections or deletions. 1 - 25 of 62 Forms. Search for another form here. Spanish forms beginning with the letters M through Z The CWDs/Agencies may modify these forms Forms. Statewide Administrative Manual (SAM) section Privacy 5310 et seq. For more consumer information on security please see the California Department of Justices, Security Awareness 3. These cards will have benefits for the . [1] [4] Natural aphrodisiacs like cannabis or cocaine are classified into plant-based and non-plant-based substances. Welfare & Institutions Code, 224.2; Family Code, 177(a); Probate Code, 1459.5(b); Cal. Aphrodisiac. 48 close to the numerical solution and major trends of the well BHP and average . Tips for Using Adobe PDF Files, Notice of Action Documents(used by county governments), Copyright 2023 California Department of Social Services, NA Back9 (5/22) - Your Hearing Rights (Full Rights Are Listed in CDSS PUB 412), NA Description Of Services L (3/15) - Description Of services, NA IHSS Back L (3/15) - Your Hearing Rights, NA 200 (12/20) - Notice Of Action - Multipurpose - Include Budget, NA 200 (7/21) - Notice Of Action - Multipurpose - Include Budget, NA 210 (5/20) - Discontinue, Suspend Financial Eligibility, NA 213 (10/21) - Deny - Financial Eligibility, NA 213A (12/20) Notice Of Action Deny Financial Eligibility, NA 213A (7/21) Notice Of Action Deny Financial Eligibility, NA 214 (4/00) - Discontinue, Suspend Transfer of Property, NA 215 (1/00) - Continuation Page, Sponsor Non Citizens Deemed Income, NA 216 (11/99) - Sponsored Non Citizens Property, NA 271 (12/20) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 271 (7/21) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 274 (4/99) - Continuation Page Overpayment Computations (prior to 10-1-89), NA 274B (4/99) - Continuation Page Overpayment Computations (for 10/1/89 to 8/31/91), NA 274C (4/99) - Continuation Page - Overpayment Computations (for 9/1/91 to 8/31/95), NA 274D (1/00) - Continuation Page - Overpayment Computations (Ortega 9/1/95 to 12/31/97), NA 274E (6/11) - Notice Of Action Overpayment Computations For 1-1-98 to 6-30-2011, NA 274F (6/11) - Notice Of Action - Overpayment Amount Owed (For Overpayments Occurring On Or After 7/1/2011), NA 274G (7/19) - Notice Of Action - Continuation Page - Overpayment ComputationsOccurringOn Or After10/1/2013, NA 274H (12/20) - Notice Of Action - Continuation Page - Overpayment Computations Between 6/1/2020 and 05/31/2021, NA 274I (7/21) - Notice Of Action - Continued - Overpayment Amount Owed For Overpayments Occurring Between 6-1-2021 and 5-31-2022, NA 274J (7/21)-Notice of Action Continued - Overpayment Amount Owed For Overpayments Occurring On or after 6-1-2022, NA 275 (4/99) - Continuation Page - Overpayment Adjustment Computation - Cash Aid, NA 277 (1/00) - Continuation Page Optional Persons Transfer of Property, NA 278 (1/00) - Discontinue/Suspend Optional Persons Transfer of Property, NA 279 (1/00) - Excess Property (with Good Faith), NA 280 (1/00) - Excess Property (w/o Good Faith), NA 281 (6/11) - Notice Of Action - Underpayment Amount Owed (For Underpayments Occurring on or After 1-1-98 thru 6-30-2011), NA 281A (6/11) - Notice Of Action Underpayment Amount Owed (For Underpayments Occurring On Or After 7/1/2011), NA 281B (5/13) - Notice Of Action Continuation Page - Underpayment Computations On Or After 10/1/2, NA 281C (7/19) - Notice Of Action - Continuation Page - Underpayment Computations Occurring On Or After 6/1/2020, NA 281C (12/20) - Notice Of Action Continuation Page - Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2020 and 5-31-2021), NA 281D (7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2021 and 5-31-2022), NA 281E(7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring On Or After 6-1-2022), NA 290 (2/14) -Notice Of Action - Multipurpose, NA 300 (7/19) - Notice Of Action - Continuation Page - Recipient Financial Eligibility Test, NA 300 (10/21) - Notice Of Action - Continuation Page - RecipientFinancial Eligibility Tests, NA 301 (10/21) - Continuation Page - Applicant Financial Eligibility Test, NA 403 (2/23)- Notice Of Action - Approval, Change or Discontinued - For Resource Families, Including Homes Certified By AFoster Family Agency, County Approved Relative Homes, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians, Intensive Treatment Foster Care and/or Intensive Services Foster Care, Group Homes and Short-Term Residential Therapeutic Programs, NA 403A (4/17) - Notice Of Action Approval, Change Or Discontinued For Kinship - Guardians Only, NA 421 (6/21) Assistance Dog Special Allowance (ADSA) - Notice Of Action - Approval, NA 422 (11/21) - Assistance Dog Special Allowance (ADSA), NA 422L (1/22) -Assistance Dog Special Allowance (ADSA) Notice of Action Denial, NA 530 (4/11) - Notice Of Action -48-Month Time Limit, NA 530 (4/21) - Notice Of Action - 60-Month Time Limit, NA 531 (12/20) - Notice Of Action - Continuation Page-48-Month Time Limit- Includes Budget, NA 531 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 531 (7/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 532 (7/19) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue, NA 532 (12/20) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue - Includes Budget, NA 532 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 532 (11/21) - Notice Of Action- Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 691 (3/18) - Notice Of Denial - Cash Assistance Program For Immigrants (CAPI), NA 692 (12/17) - Notice Of Change - Cash Assistance Program For Immigrants (CAPI), NA 693 (9/22) - Notice Of Approval - Cash Assistance Program For Immigrants (CAPI), NA 791 (9/18) - Notice Of Action - Approval/Denial/Change, NA 816 (3/14) - Notice Of Action - Sanction Of Other Parent After Failed Compliance Plan, NA 817 (3/14) - Notice Of Action - Sanction Of Participant After Failed Compliance Plan, NA 818 (3/14) - Notice Of Action - Taking You Out Of Welfare To Work, NA 820 (1/01) - Notice Of Action - Transportation Approval, NA 821 (1/01) - Notice Of Action - Transportation Approval/Denial, NA 822 (7/16) - Notice Of Action - Transportation Change, NA 823 (8/00) - Notice Of Action - Ancillary Expenses Approval/Denial, NA 825 (8/00) - Notice Of Action - Payment Adjust Transportation, NA 827 (7/99) - Notice Of Action - Recoupment Unused Advance Payment, NA 828 (7/99) - Notice Of Action - Transportation And Ancillary Exp Overpayment, NA 832 (3/20) - Notice of Action - Child Care Services, NA 833 (4/20) - Notice of Action - Child Care Services Change, NA 834 (3/20) - Notice of Action - Child Care Services Denial, NA 835 (3/20) - Notice of Action - Child Care Services Discontinuance, NA 840 (3/14) - Notice Of Action - Welfare To Work Plan, NA 840A (10/03) - Notice Of Action - Determination Of Good Cause/No Good Cause, NA 841 (3/14) - Notice Of Action - Welfare-To-Work Plan, NA 843 (6/99) - Notice Of Action - Ineligible, NA 844 (8/99) - Notice Of Action - Adequate Progress, NA 845 (3/14) - Notice Of Action - Sanction and Removal Of The Other Parent's Needs, NA 960X SAR (9/13) - Notice Of Action - Stop Aid;Report Not Received, NA 960Y SAR (10/14) - Notice Of Action - Stop Aid;Report Incomplete, NA 991 (10/03) - Notice Of Action - Refugee Cash Assistance (RCA)/Entrant Cash Assistance (ECA) MC-Decrease/Expiration (Time-Expiration), NA 992 (5/03) - Refugee Cash Assistance (RCA) Application Approval, NA 994 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Requirement (Violation Prior To Three Consecutive Month Grace Period), NA 995 (5/13) - Food Stamp Notice of Denial/Disqualification For The California Food Assistance Program, NA 996 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Rule (Violation After Receipt Of Three Consecutive Month Grace Period, NA 1209 (2/02) - Notice Of Action - Change In The Amount Of Kin-Gap Payment, NA 1210 (4/02) - Notice Of Action - Discontinue, NA 1211 (2/00) - Notice Of Action - Denial, NA 1212 (2/00) - Notice Of Action - Discontinue Property, NA 1213 (2/00) - Notice Of Action - Discontinue Restricted Account, NA 1214 (2/00) - Notice Of Action - Change Under/Overpayment, NA 1217 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice of Overpayment, NA 1218 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice Of Underpayment, NA 1230 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Approval, NA 1231 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Partial Waiver Approval, NA 1232 (2/21) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Denial, NA 1233 (3/02) - Notice Of Action - Multipurpose, NA 1239 AR (12/20) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 AR (8/21) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 SAR (12/20) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1239 SAR (8/21) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1240 (4/13) -Notice Of Action - Food Stamp Overissuance & Dormant EBT Account, NA 1250 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1250L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1251 (5/09) -Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1251L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1252 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1252L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1253 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1253L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1254 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1254L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1255 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1255L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1256 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1256L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1257 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1257L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1261 (1/16) - Notice Of Action - Form and Instructions - For Group Homes, Short-Term Residential Treatment Centers, Foster Family Agencies, Transitional Housing Placement-Plus Foster Care and Transitional Housing Placement Program, NA 1261A (3/20) - Notice Of Action For Approved Relatives, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians or Non-Minor Dependents Residing In A Supervised Independent Living Setting, NA 1261B (1/16) - Notice Of Action - Form And Instructions - For Kinship-Guardians Only, NA 1263 (8/11) - Notice Of Action - Overissuance Budget Worksheet, NA 1267 (4/13) - CalFresh Informing Notice Of Receiving Intercounty Transfer, NA 1268 (4/13) - CalFresh Informing Notice Of Sending Intercounty Transfer, NA 1269 (11/11) - Notice Of Action - Approve Non-Minor Dependent, NA 1270 (11/11) - Notice Of Action - Discontinue Non-Minor Dependent, NA 1271 (5/14) - Notice Of Action - Denial Of Home Assessment/Approval, NA 1273 (7/13) - Electronic Notification Agreement, NA 1274 (7/13) - Electronic Notification Notice, NA 1275 (7/13) - Electronic Notification Cancellation Notice, NA 1276 (1/15) - Notice Of Action - Welfare-to-Work 24-Month Time Clock Limit Notice, NA 1277 (1/16) - Notice Of Action - Approved Relative Caregiver (ARC) Overpayment, NA 1278 (11/16) - Notice Of Action - Approve Approved Relative Caregiver (ARC) Payment, NA 1279 (5/22) Notice of Action Deny Approved Relative Caregiver (ARC) Payment, NA 1280 (5/22) Notice of Action Discontinue Approved Relative Caregiver (ARC) Payment, NA 1281 (11/16) - Notice Of Action - Change Approved Relative Caregiver (ARC) Payment, NA 1282 (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, NA 1282L (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, PI 2 (6/15) - IRS Office Of Safeguards Data Incident Report, PUB 13 (5/22) - Your Rights Under California Public Benefits Programs - For People Applying For Or Receiving Public Aid In California, PUB 13L (5/22) - Your Rights Under California Public Benefits Programs - For People Applying For Or Receiving Public Aid In California, PUB 56 (12/06) - The In-Home Supportive Services Program, PUB 69 (5/22) - County Forms Catalog2021-2022, PUB 104 (12/06) - In-Home Supportive Services Individual Provider Benefits and Services Information, PUB 190 (8/06) - How To Hire And Supervise Your In-Home Supportive Services (IHSS) Provider, PUB 203 (1/04) - In-Home Supportive Services - Guide to Workers Compensation Benefits for Individual Providers. , confidential financial and legal details Adopted for Mandatory Use Judicial Council of California Department of Social has! 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