Service, Contact Open it with online editor and begin altering. Proof of immigration status. Ensures that a website is free of malware attacks. If you need help finding affordable health coverage, consider Covered California. They will direct you to your program representative. Facebook Icon Instagram Icon Linkedin Icon Reddit Icon Twitter Icon Vimeo Icon Login Find A Job 38670 Sky Canyon Drive, Suite 200 . Keep you and your family covered! Helping you and your family be self-sufficient. This individual would need: You could receive your CalFresh benefits as quickly as three days if your household: Note: Interpretation services are available in all languages. Riverside County DPSS office locations. SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE INDIO 46-200 Oasis St. Rm. Read all the field labels carefully. The IHSS Public Authority comes alongside In-Home Supportive Services (IHSS) consumers by recruiting, screening, and training in-home care providers. Online www.getcalfresh.org or www.benefitscal.com 2. Copyright 2023 All Rights Reserved by The County of Riverside. Visit KeepMediCalCoverage.org for more details. Department of Public Social Services (DPSS) website. Date: (TYPE OR PRINT NAME OF ATTORNEY PARTY MAKING DECLARATION) (SIGNATURE) Approved for Optional Use Riverside Superior Court RI-MC012 [New 05/28/21] Riverside County Department of Public Social Services Apply For Benefits Cash Assistance Food & Nutrition Health Care Children and Families Job Services Housing Help Seniors & Disabilities Community Outreach Doing Business About Us Other Resources Announcements Please click on any of the slides to view more information 24 Hour Hotlines Riverside County Department of Public Social Services 1-800-665-KIDS (5437) Foster/Adoption Resource Family Program Orientation Packet Welcome Future Foster/Adoptive Resource Family! To report suspected abuse, call our 24-hour hotline at 1-800-442-4918 or click here. Medi-Cal will NEVER require payment in the application or recertification process. Medi-Cal will NEVER require payment in the application or recertification process. Learn about how to shop and budget your food purchases, ensure your food is safe, plan meals and cook healthy using your CalFresh benefits. services, For Small Name Source of income One time payment or monthly How much CERTIFICATION - FRAUD WARNING SIGNATURE OR MARK SIGNATURE OF WITNESS TO MARK, INTERPRETER, OR OTHER PERSON COMPLETING FORM DATE SIGNED HOME PHONE CONTACT/CELL PHONE RFA 01B (5/21) - Resource Family Criminal Record Statement. Probate/Decedents/Estate Administration. Riverside County is the fourth largest county in California and the eleventh largest in the United States. Thank you for. RFA Forms Under CDSS Review: Please note these forms are currently under revision FFA Forms: Check the entire document to make sure you have filled in all the information and no changes are required. LLC, Internet Business. Medi-Cal renewals begin June 2023, and mailing begins April 2023. Using our solution filling out Riverside County Dpss Forms will take a few minutes. Both bi-lingual and non-bi-lingual applicants . declare under penalty of perjury under the laws of the State of California that the above is true and correct. This is the States health insurance marketplace from the Affordable Care Act. To learn more about our services and partners visit the links below. You may apply in person - at any Kern County Department of Human Services offices in Bakersfield or districts. If you are unable to buy food to prepare at home, you may qualify for Riverside Countys Restaurant Meals Program. Here's How, CW 2166 (4/21) - Multilingual Work Really Pays! By Mail Call 1-877-410-8827 Monday - Friday between the hours of 8:00 AM - 5:00 PM and request an application be sent to you by mail, or Copyright 2023 All Rights Reserved by The County of Riverside. We are to help you too! Give the application to the County in person, by mail, by fax, or online. A Forms AAP 1 (11/22) - Request For Adoption Assistance Program Benefit AAP 2 (11/22) - Payment Instructions Adoption Assistance Program AAP 3 (6/22) - Reassessment Information - Adoption Assistance Program AAP 4 (4/22) - Eligibility Certification Adoption Assistance Program County of Los Angeles DPSS. Medi-Cal will NEVER require payment in the application or recertification process. Stay vigilant against potential scams! Have income less than the CAPI standards. We believe in your right to dignity, to self-determination, and to live with as much independence as possible. Adult Protective Services (APS) responds to reports of abuse against older and dependent adults in Riverside County. Other Contact Numbers, Copyright 2023 California Department of Social Services, CF 1 (10/14) - Notice To All CalFresh Recipients - Important Please Read, CF 10 (12/13) - Dependent Care Cost Affidavit, CF 11 (8/15) ENG/SP - Notice To All CalFresh Recipients Important - Please Read, CF 18 ENG/SP (2/14) - Important Information, CF 20 (2/14) - You Do Not Owe Anything For Receiving CalFresh Benefits, CF 24 (7/12) - CalFresh Program Request For Policy/Regulation Interpretation, CF 28 Coversheet (2/14) - CalFresh Program Restricted Account Coversheet - Important To Know, CF 28A (2/14) - CalFresh Program Restricted Account Agreement Part A, CF 28B (2/14) -CalFresh Program Restricted Accounting Agreement part B, CF 29 (10/13) -CalFresh Recertification Appointment Letter, CF 29A (2/14) - CalFresh Initial Appointment Letter, CF 29B (2/14) - CalFresh Initial On-Demand Appointment Letter, CF 29C (2/14) - CalFresh Recertification Appointment Letter, CF 29D (2/14) -CalFresh Recertification On-Demand Appointment Letter, CF 31 (4/15) - CalFresh Supplemental Form For Special Medical Deductions, CF 32 (6/13) - CalFresh Request For Contact, CF 37 (7/15) - Recertification For CalFresh Benefits, CF 215 (9/14) - CalFresh Notification Of Inter-County Transfer, CF 286 SAR (12/15) - CalFresh Budget Worksheet/Semi-Annual Reporting Households, CF 303 (2/14) - Replacement Affidavit/Authorization, CF 377.1 (9/15) - Notice Of Approval For CalFresh Benefits, CF 377.2 (10/13) - CalFresh Notice Of Expiration Of Certification, CF 377.2A (12/13) -CalFresh Notice Of Expiration Of Certification For Households In Which All Adults Are Elderly Or Disabled, CF 377.2A1 (4/14) - Important Information For Households In Which All Adults Are Elderly Or Disabled With No Earned Income, CF 377.4 SAR (6/13) - CalFresh Notice Of Change For Semi-Annual Reporting Households, CF 377.4A (2/14) - CalFresh Notice Of Change (Non-Citizen), CF 377.4 CR (1/14) -CalFresh Notice Of Change For Change Reporting Households, CF 377.5 CR (11/13) - CalFresh Household Change Report, CF 377.5 SAR (9/13) - CalFresh Mid-Certification Period Status Report, CF 377.6 (8/13) - Information/Verification Needed, CF 377.7A (2/14) - Notice Of Administrative Disqualification, CF 377.7A1 (2/14) - Request For Restoration Of CalFresh Benefits After Administrative Disqualification, CF 377.7B (2/14) - CalFresh Overissuance Notice For Inadvertent Household Errors (IHE) Only, CF 377.7B1 (2/14) - CalFresh Repayment Notice For Inadvertent Household Errors Only Final Notice, CF 377.7C (2/14) - CalFresh Repayment Agreement For Inadvertent Household Errors Only, CF 377.7D (1/14) - CalFresh Overissuance Notice For Administrative Errors (AE) Only, CF 377.7D1 (1/14) - CalFresh Overissuance Notice For Administrative Errors (AE) Only, CF 377.7D3 (1/14) - CalFresh Overissuance Notice For Administrative Errors (AE), CF 377.7E1 (1/14) - CalFresh Repayment Agreement For Administrative Errors Only, CF 377.9 (2/14) - Notice Of Back CalFresh Benefits, CF 385 (10/15) - Application For Disaster CalFresh, CF 386 (2/14) - CalFresh Notice Of Missed Interview, CF 387 (5/14) - CalFresh Request For Information, CF 388 (8/13) - CalFresh Notice Of Restoration Approval, CF 389 (2/14) - Notice Of Denial Of Restoration, CF 478 (2/14) - Disqualification Consent Agreement CalFresh Program, CF 842 (2/14) - Claim Determination Worksheet, CF 1239(5/13) - CalFresh Notice Of Approval/Denial/Termination Transitional Benefits, CalFresh Guidelines Insert for Brochures (. 104-193) eliminated Supplemental Security Income/State Supplementary Payment (SSI/SSP) eligibility for most non-citizens. Healthcare is critical to human life. English and Spanish Riverside County DPSS - Affidavit (General Purpose) - DPSS 1917 English and Spanish Authorized Representative Designation Form Register to Vote Cash Assistance Program for Immigrants (CAPI) Low Income Utility Resources for Riverside County Office on Aging Friendship Line Office on Aging Hospital Liaison Services presented on Judicial Council form DE-122 / GC-322: (1) Examination Concerning Assets of Estate under Probate Code 2616 et . Third-Party Applications are phone applications (apps) that allow the cardholder to obtain access to account information, such as the account balance and transaction history. riverside county department of social services photos, Identity Keep you and your family covered! Follow the simple instructions below: Experience all the advantages of submitting and completing legal documents online. We invite open-hearted adults to join our village as either adoptive or foster parents. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Stay vigilant against potential scams! The client decides which caregiver can meet their needs. Here's How, CW 2166 (11/21) - Multilingual Work Really Pays! **Due to browser constraints please download forms for full functionality. RFA Forms Department of Social Services Disaster Services Branch CDSS Programs Resource Family Approval Program Forms RFA Forms For finalized forms, please click here. Visit KeepMediCalCoverage.org for more details. An EBT (Electronic Benefit Transfer) card is the benefit delivery system that allows CalFresh and cash assistance recipients to access their food and cash benefits, much like a debit card. DPSS Office Locations | Riverside County Department of Public Social Services DPSS Office Locations DPSS Office Locations Want to speak to someone face-to-face? Visit KeepMediCalCoverage.org for more details. Childrens Services partners with families, communities, and agencies to help children thrive and find the best outcomes be it reunification with birth parents or finding permanent homes with adoptive families. Stay vigilant against potential scams! DO NOT submit a copy of this form to the Department of Justice (DOJ). IHSS Public Authority The Public Authority manages a public registry that matches Riverside County Adult Services clients with a trusted in-home caregiver. Update! Keep you and your family covered! Use professional pre-built templates to fill in and sign documents online faster. Medi-Cal renewals begin June 2023, and mailing begins April 2023. TheRiverside County Department of Public Social Services(DPSS) is comprised of employees who work collectively and in partnership with community-based organizations to serve the needs of the community.The Riverside County Department of Public Social Services (DPSS) provides services and assistance to protect and empower vulnerable people in our . We want to hear from you. Stay vigilant against potential scams! A cardholder calls the number, and then is asked for personal information, account number and a PIN. Schools are now a beacon for healthy beginnings. We believe in your right to dignity, to self-determination, and to live with as much independence as possible. We work for you, 24-hours a day, 7 days a week. For those struggling with low income, we offer assistance programs for food, cash, housing and health coverage. Have a physician or medical professional determine that you are unable to remain safely in your own home without IHSS. Probate/Decedents/Estate Administration. Forms, Real Estate Learn more bywatching this video. Want more information or to apply? Schools are now a beacon for healthy beginnings. Proof of any income. Fraud and abuse diminish services for those who truly need them. For more information about APS, visit Adult Abuse. Sorry, you need to enable JavaScript to visit this website. All Rights Reserved by The County of Riverside, Restaurant Meals Program Vendor Information. Phones: (888) 470-4477 or (951) 321-6160 Information & Assistance Office: CUSTODIAN OF RECORDS Riverside County In-Home Supportive Services (IHSS) Public Authority (PA) 12125 Day Street, Suite S-101 Moreno Valley, CA 92557 Provider Signature:Date: County Representative:Date: Employer MUST complete this information DPSS 4365 (6/18) TheFactsAbout Planning, Wills Join millions of satisfied users who are already filling out legal documents from their apartments. Live in California. Riverside Office. The County of Riverside has established family and medical leave practices that enables employees to be away from work while maintaining the status of employee. Murrieta Office. Riverside County Department of Public Social Services 1-800-665-KIDS (5437) Foster/Adoption Resource Family Program Orientation Packet Welcome Future Foster/Adoptive Resource Family! As a result, most immigrants who were not receiving SSI/SSP in August 1996 are no longer eligible for SSI/SSP. Estate Recovery Forms. This service is completely free. Check your BenefitsCal.com account to see the month of your renewal, and make sure your contact information, such as changes to your name, address, phone number, and email address, is correct. For personal information access requests, send an email to CDSS' Public Inquiry and Response Unit piar@dss.ca.gov and/or call (916) 651-8848. Get Form How to create an eSignature for the apply for general relief online for non-citizens We work for you, 24-hours a day, 7 days a week. If you are a refugee without children who is not eligible for other cash aid, Refugee Cash Assistance may help. All cardholders may use their EBT card at participating retailers with a Point-of-Sale (POS) device and Automated Teller Machines (ATM) for cash withdrawals displaying the Quest logo throughout California and across the country. Instructions for completing the application are provided. RFA 01A (10/22) - Resource Family Application. The County and State will never text or call and ask for your EBT card and/or PIN. Here's How, CW 2184 (8/16) - CalWORKs 48-Month Time Limit, CW 2184 (4/21) - CalWORKs 60-Month Time Limit, CW 2186A (12/12) - CalWORKs Exemption Request Form, CW 2186A (4/21) - CalWORKs Exemption Request Form, CW 2186B (12/12) - CalWORKs Exemption Determination, CW 2186B (4/21) - CalWORKs Exemption Determination, CW 2187 (4/11) - YOUR CalWORKs 48-Month Time Limit, CW 2187 (4/21) - Your CalWORKs 60-Month Time Limit, CW 2188 (4/02) - Verification of Aid for Temporary Assistance for Needy Families (TANF) Program, CW 2189 (3/15) - Notice of your CalWORKs Time Limit - 42nd Month on Aid, CW 2189A (9/20) Notice Of Your CalWORKs Time Limit 54TH Month On Aid (Use Starting May 1, 2022), CW 2189B (9/20) Notice Of Your CalWORKs Time Limit 57TH Month On Aid (Use Starting May 1, 2022), CW 2190A (4/16) - CalWORKs 48-Month Time Limit Extender Request Form, CW 2190A (4/21) - CalWORKs 60-Month Time Limit Extender Request Form, CW 2190B (5/16) - CalWORKs 48-Month Time Limit Extender Determination Form, CW 2190B (4/21) - CalWORKs 60-Month Time Limit Extender Determination Form, CW 2191 (6/11) - Time On Aid Verification For CalWORKs/TANF 48-Month Time Limits, CW 2191 (4/21) - Time On Aid Verification For CalWORKs/TANF 60-Month Time Limits, CW 2192 (6/11) - Tracking Non-California TANF Assistance For Time Limits, CW 2192 (4/21) - Tracking Non-California TANF Assistance For Time Limits, CW 2200 (5/22) - Request For Verification, CW 2200LP (5/22) - Request For Verification, CW 2201 (6/09) - Unemployment Insurance Benefits Referral Form, CW 2202W (9/15) - CalWORKs Program Request For Policy Interpretation, CW 2203 (11/09) - Request For Supplemental Payment By Check Or Direct Deposit, CW 2205 (10/12) - New Rules For CalWORKs Welfare-To-Work Activities, CW 2208 - (2/13) - Your Welfare-To-Work 24-Month Time Clock, CW 2209 (12/14) - Immunization Good Cause Request Form, CW 2211 (11/14) - Your CalWORKs Reporting Rules Have Changed, CW 2212 (11/14) - The Rules For Your CalWORKs Case Have Change, CW 2213 (10/15) - Response To Request To Inspect Case Record CalWORKs, CalFresh, TCVAP, And Refugee Programs, CW 2215 (10/20) - California Work Opportunity and Responsibility to Kids (CalWORKs) Important Information for Safety Net And Certain Child-Only Case, CW 2217 (1/15) - CalWORKs Request For Voluntary Repayment, CW 2218 (7/19) - Rights, Responsibilities And Other Important Information For The California Work Opportunity And Responsibility To Kids (CalWORKs) Program (Non-Needy Caretaker Relative With Relative Foster Child), CW 2218 (6/21) - Rights, Responsibilities And Other Important Information For The California Work Opportunity And Responsibility To Kids (CalWORKs) Program (Non-Needy Caretaker Relative With Relative Foster Child), CW 2218 (3/22) - Rights, Responsibilities And Other Important Information For The California Work Opportunity And Responsibility To Kids (CalWORKs) Program (Non-Needy Caretaker Relative With Relative Foster Child), CW 2219 (5/16) Application For California Work Opportunity And Responsibility To Kids (CalWORKs) (Non-Needy Caretaker Relative With Relative Foster Child), CW 2222 (11/17) - CalWORKs Employment Bureau Request For Policy Interpretation, CW 2223 (9/18) - Demographic Questionnaire For CalWORKs, Refugee Cash Assistance (RCA), Entrance Cash Assistance (ECA), Trafficking And Crime Victims Assistance Program (TCVAP) And CalFresh Programs, CW 2224 (2/20) - CalWORKs Home Visiting Program (HVP), DFA 377.7A (4/21) - Notice Of Administrative Disqualification, DFA 377.7D2 (10/00 ) - Food Stamp Repayment Notice For Administrative Errors Only Final Notice, DFA 377.7E (7/04) - Food Stamp Repayment Agreement For Administrative Errors Only, DFA 377.7F (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV), DFA 377.7F LP (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV), DFA 377.7F1 (10/00) - Food Stamp Repayment Notice For An Intentional Program Violation (IPV) Only Final Notice, DFA 377.7G (5/02) - Food Stamp Repayment Agreement For An Intentional Program Violation (IPV) Only, DFA 377.10 (6/04) - Food Stamp Notice Of Discontinuance, DFA 874 (10/00) - Statewide Intercounty Lost Warrant Replacement Affidavit, DPA 13 (7/99) - Request For State Hearing Before The State Department Of Social Services, DPA 19 (6/22) - Appointment OfAuthorized Representative, DPA 315 (7/99) - Withdrawal/Conditional Withdrawals Of Request For Hearing, DPA 421 (7/99) - Notification Of Open Record And Waiver Of Time, DPA 435 (4/20) - County Allegation Of Intentional Program Violation/Statement Of Position (Request For An Administrative Disqualification Hearing), DPA 436B (8/18) - County Information Letter, DPA 479 (3/22) - Administrative Disqualification Hearing Waiver - CalWORKs/CalFresh, DPA 481 (4/02) - County Report of Compliance Transmittal, DPA 487 (5/07) - Request For Access To Protected Health Information, DPA 488 (6/08) - Intentional Program Violation (IPV) Deletion Request Form, DPA 489 (8/18) - Intentional Program Violation (IPV) Online System Request For Adding/Deleting /Modifying A User, DPS 249 (12/10) - Welfare Intercept System County Transaction Document, DPS 524 (3/00) - Disqualified Recipient Report, DPS 526 (4/99) - IEVS/Payment Verification System County Response Document, DPS 528 (4/01) - IEVS/Deceased Persons Match - County Response Document. Locations. Find your local participating farmers market, use your CalFresh benefits, and receive credit toward the purchase of fruits and vegetables. Be taking care of at least one child who is under the age of 18 (or 19, if the child is expected to graduate from high school before their 19th birthday). If you suspect fraud call the DHCS Medi-Cal Fraud Hotline at 1-800-822-6222. CalFresh puts food-buying power into the hands of working-class households. Disaster Services Branch CDSS Programs CalFresh Forms and Brochures Forms and Brochures Forms and Notices CF 1 (10/14) - Notice To All CalFresh Recipients - Important Please Read CF 10 (12/13) - Dependent Care Cost Affidavit CF 11 (8/15) ENG/SP - Notice To All CalFresh Recipients Important - Please Read CF 18 ENG/SP (2/14) - Important Information how to identify civil war rifles, how to make an obituary using powerpoint,
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