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  • Forms Brochures - California Dept. of Social Services
    CDSS collects personal information directly from individuals who volunteer to obtain some of our services Collection of this information is required to deliver the specific services, but use of these services is voluntary
  • 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
  • Alphabetic List - Forms
    Don't know the number of the form you need? See Forms - Listed by Program
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • How to Order Forms - California Dept. of Social Services
    In accordance with existing California Department of Social Services (CDSS) regulations, all County Welfare Departments (CWDs) and public and private agencies may print supplies of CDSS-developed forms However, any modification to or substitution of a required department form must be approved by CDSS before any CWD or agency use





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