California Department of Social Services

Form PI 1 is an incident report form used to report data incidents related to the Social Security Administration (SSA). This form is used to document and provide detailed information about any unauthorized access, use, disclosure, or other security breaches involving sensitive data within the SSA's purview. It helps ensure prompt reporting of data incidents, enabling appropriate investigation, mitigation, and resolution measures to protect the confidentiality, integrity, and availability of SSA data.

Form NA 1281 is a Notice of Action used to communicate changes in an approved relative caregiver's payment. This form provides detailed information about the changes, including the effective date, the new payment amount, and any conditions or requirements associated with the change. It ensures that approved relative caregivers are aware of the payment modifications and can adjust their financial planning accordingly.

Form NA 1282 is a Notice of Action used specifically for overpayments related to advance pay in the In-Home Supportive Services (IHSS) program. This form provides detailed information regarding the overpayment, including the amount, the reason for the overpayment, and instructions on how to repay or resolve the overpayment. It ensures that IHSS recipients who received advance pay understand the overpayment situation and the necessary steps to address it.

Form PI 2 is a data incident report form specific to the Internal Revenue Service (IRS) Office of Safeguards. This form is utilized to report incidents involving unauthorized access, use, or disclosure of sensitive data under the purview of the IRS. It gathers detailed information regarding the incident for further investigation and implements necessary actions to address the breach, safeguard affected data, and prevent future occurrences.

Form PUB 13 is a comprehensive informational document that outlines the rights of individuals applying for or receiving public aid in California. This publication provides detailed information on various public benefits programs available in California, including eligibility criteria, application processes, and appeal rights. It aims to educate individuals about their entitlements, ensuring they are aware of their rights and can access the support they are eligible for through the state's public benefits programs.

Form PUB 13L is a localized version of Form PUB 13, which serves the same purpose of informing individuals applying for or receiving public aid in California about their rights under the state's public benefits programs. This localized version is tailored to meet the specific needs and requirements of certain communities or language preferences, providing detailed information in a language or format that is accessible and easily understood by the intended audience.

Form PUB 240 is an informational publication that provides detailed information about Continuing Care Retirement Communities (CCRCs) in California. The publication offers a comprehensive overview of CCRCs, explaining what they are and how they function. It covers various aspects, including the different types of CCRC contracts, financial considerations such as entrance fees and monthly fees, available services and amenities, resident rights and responsibilities, levels of care, healthcare options, and consumer protections.

Form PUB 269 serves as a comprehensive guide to California's Child Passenger Safety Law. The publication offers detailed information on the specific laws and regulations governing the transportation of children in motor vehicles. It includes age, height, and weight requirements for child safety seats, booster seat recommendations, proper installation techniques, information on seat belt use, and guidelines for children sitting in the front seat.

Form PUB 56 is an informational publication that provides detailed information about the In-Home Supportive Services (IHSS) program in California. It offers an overview of the program, including eligibility criteria, services provided, and the role of IHSS providers. This form ensures that individuals seeking assistance through the IHSS program have access to comprehensive information about the program's purpose, benefits, and how to navigate the system effectively.

Form PUB 69 is a catalog that provides a comprehensive listing of county-specific forms used within the California Department of Social Services. This catalog includes detailed descriptions and references to various forms utilized by different counties for applications, assessments, reporting, and other processes related to social services programs. It serves as a centralized resource, allowing individuals, caseworkers, and other stakeholders to locate and access the appropriate forms applicable to their specific county.