You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
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CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
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FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
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FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
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FAA-0255A | Separate Household Status Statement | 05/01/2023 |
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FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
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DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
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CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
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FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
AAA-1350B | Family Caregiver Support Program Evaluation | 05/01/2021 |
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AAA-1350C | Annual Follow Up | 05/01/2021 |
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CCA-1287A | Emergency Evacuation Drill Record | 05/01/2021 |
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CCA-1287A-S | Registro de Simulacros de Evacuación de Emergencia | 05/01/2021 |
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DDD-1530A-LP | Managed Risk Agreement Services and/or Placement (Large Print) | 05/01/2021 |
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DDD-1530A-S | Managed Risk Agreement Services and/or Placement (Spanish) | 05/01/2021 |
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CCA-1211B | Attachment to Request for Search of Background Checks (CCA-1211A) Disqualifying Acts (English) | 04/01/2021 |
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CCA-1211B-S | Attachment to Request for Search of Background Checks (CCA-1211A-S) Disqualifying Acts (Spanish) | 04/01/2021 |
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CCA-1234A | Family Child Care Home Backup Provider Backup, Discipline, and Transportation Agreement | 04/01/2021 |
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CCA-1234A-S | Proveedor Suplente de Cuidado de Niños en el Hogar Acuerdo de Suplente, Disciplina y Transporte | 04/01/2021 |
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