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Forms Brochures - California Dept. of Social Services Any fields in the application or form with unrestricted text are intended for the requested information only Individuals who provide personal information to CDSS have the right to review the information for accuracy and completeness and to request corrections or deletions
Forms and Publications (I-L) - California Dept. of Social Services L Forms LIC 01A (6 23) - Resource Family Application LIC 01C (7 16) - Resource Family Application-Confidential LIC 03 (7 23) - Resource Family Home Health And Safety Assessment Checklist Document For Agency Use Only LIC 05A (8 21) - Resource Family Approval Certificate LIC 08 (2 24) - Intensive Services Foster Care Unit (ISFC) Written Assessment of Risk and Compatibility LIC 12 (8 21
Forms - by Program To find a form, click on the link after the program name to find forms whose form number begins with those letters
Alphabetic List - Forms Don't know the number of the form you need? See Forms - Listed by Program
Home | California Dept. of Social Services For more information about programs, projects, and resources for foster youth and foster youth caregivers, visit the CDSS foster care webpage Also access an issue brief on the efforts underway in California to better meet the needs of individual foster youth and improve California’s foster care system
On-line Forms and Publications A - D 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
Forms and Publications (Q-T) - California Dept. of Social Services SOC 2313 (3 20) - In-Home Supportive Services (IHSS) Program Exemption From Workweek Limits For Extraordinary Circumstances (Exemption 2) State Administrative Review Request Form SOC 2320 (10 17) - In-Home Supportive Services (IHSS) And Waiver Personal Care Services (WPCS) CDSS Violation Removal Request
In Home Supportive Services - California Dept. of Social Services The In-Home Supportive Services (IHSS) program provides in-home assistance to eligible aged, blind, and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their own homes
Forms and Publications (E - H) - California Dept. of Social Services GEN 1321 (1 24) - CDSS System And Application Access Form GEN 1321A (11 03) - HHSDC Teale Data Security Access Request GEN 1388 (6 21) - Language Accessibility Services Complaint Form GEN 1389 (3 16) - Functional Assessment Service Team (FAST) Leader Course Application GEN 1390 (3 17) - Informing Notice - Regarding An Action Taken On Your Case
MEDICAL ASSESSMENT FOR RESIDENTIAL CARE FACILITIES FOR THE ELDERLY MEDICAL ASSESSMENT FOR RESIDENTIAL CARE FACILITIES FOR THE ELDERLY NOTE TO LICENSED MEDICAL PROFESSIONAL: The person patient named below is either a prospective resident or resident of a Residential Care Facility for the Elderly (RCFE) licensed by the Department of Social Services The licensee is required to provide primarily non-medical care and supervision to meet the needs of that person