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Download Number Form Name Effective Date
DDD-1727A-S Puesto de Servicio Directo 07/01/2018
FAA-1004A Designation of EBT Alternate Card Holder 07/01/2018
CCA-1015A Withdrawal or Termination Request 07/01/2018
CCA-1015A-S Solicitud de Retiro o Terminación 07/01/2018
LCR-1005A-S Aviso de los Derechos Durante Inspección 07/01/2018
AAA-1301A-S Servicios de Protección al Adulto (APS) Solicitud de Registros 07/01/2018
FAA-1004A-S Designación de Titular Sustituto para la Tarjeta de EBT 07/01/2018
LCR-1005A Notice of Inspection Rights 07/01/2018
FAA-1533A Verification of Unfitness for Work for Adults 07/01/2018
DDD-1370A-S Información Sobre el Menor 07/01/2018

Download Number Form Name Effective Date
Statistical Bulletin April 2013 Statistical Bulletin April 2013 05/15/2013
30th Month March 2013 30th Month Report March Fiscal Year 2013 05/09/2013
Statistical Bulletin March 2013 Statistical Bulletin March 2013 04/16/2013
30th Month February 2013 30th Month Report February Fiscal Year 2013 04/09/2013
30th Month January 2013 30th Month Report January Fiscal Year 2013 03/28/2013
Statistical Bulletin February 2013 Statistical Bulletin February 2013 03/26/2013
Statistical Bulletin January 2013 Statistical Bulletin January 2013 02/15/2013
30th Month December 2013 30th Month Report December Fiscal Year 2013 02/14/2013
IDEA Part C Child Count FFY 2012 Child Count and Setting 2012 02/01/2013
Statistical Bulletin December 2012 Statistical Bulletin December 2012 01/30/2013

No results available.

Download Number Form Name Effective Date
Register Data Security Register for Basic Data Security 09/27/2007
FA-155-2-FFS Trasfondo del Empleo/Capacitación Más Reciente 01/01/2006
AAA-1075A Assisted Living Residents Rights 07/01/2005
AAA-1041A A Guide for Caregivers 10/01/2002
PAY-066 Child Care Homes 09/01/2002


Download Number Form Name Effective Date
DDD-1985A Personal Identification Information (PIF) 03/01/2019
WIO-1114A Second Chance Centers 03/01/2019
DDD-1985A-S Información de Identificación Personal (PIF) 03/01/2019
RSA-1365A Authorization/Consent for Disclosure and Use of Confidential Information Between DDD and RSA 03/01/2019
FA-559A Food Distribution Program Participation 03/01/2019
DDD-1986A PRC Contact Information 03/01/2019
CSE-1016A Waiver of Paternity Affidavit (Eng/Span) 03/01/2019
GCI-1021A Individualized Family Service Plan - Packet 03/01/2019
DDD-1986A-S Información de Contacto del Comité de Revisión del Programa (PRC) 03/01/2019
DDD-1987A Team Agreement of Behavior Treatment Plan 03/01/2019

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