Original Document Signed By Sample Clauses

Original Document Signed By. ▇▇▇▇▇▇▇ ▇. ▇▇▇▇ Deputy Director Children and Family Services Division Attachments A nonminor dependent shall meet the eligibility standard for Extended ▇▇▇▇▇▇ Care (EFC) or a nonminor former dependent for extended payment benefits for Adoption Assistance Program (AAP) or Kinship Guardianship Assistance Payment Program (Kin-GAP) by participating in at least one of the following five conditions. The nonminor dependent’s plan of participation shall be described in his or her Transitional Independent Living Case Plan shall include a written description of the services that will help the nonminor dependent which provides the basis for the six month certification of eligibility made by the placing agency’s case manager to the eligibility worker and the court. During the six month certification period, the nonminor dependent shall report to his or her worker any changes in the participation plan and they shall work together collaboratively to ensure ongoing eligibility as the nonminor dependent assumes increasing levels of responsibility and independence.

Original Document Signed By. ▇▇▇▇▇▇▇ ▇. ▇▇▇▇ Deputy Director Children and Family Services Division Attachments Attachment A GUIDELINES FOR SHARED LIVING AGREEMENT (SLA) BETWEEN CAREGIVER AND NON-MINOR DEPENDENT (NMD) The guidelines in this document outline a SLAgreement as a basis for a written understanding between the caregiver and NMD on an array of expectations for placement in a household. It is broad in scope, covering many aspects of shared daily living; however each agreement will be individualized, reflecting the specific values, concerns and personalities of the caregiver and non-minor dependent who is now an adult. The agreement should aid in the creation and maintenance of a successful placement, which supports NMD’ continued transition to independent adulthood. Since individuals and circumstances change, the agreement will be renegotiated and updated, as needed and appropriate.

Original Document Signed By. ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇, Chief Child and Youth Permanency Branch Children and Family Services Division

Original Document Signed By. ▇▇▇▇ ▇▇▇▇▇▇▇▇ Chief Deputy Director California Department of Social Services Attachment c: CWDA County of , Department/Agency of

Original Document Signed By. ▇▇▇▇▇▇▇ ▇. ▇▇▇▇ Acting Deputy Director Children and Family Services Division Enclosures c: County Welfare Directors Association Youth: Date of Birth: Age Ethnicity Address:

Original Document Signed By. ▇▇▇▇ ▇▇▇▇▇▇▇▇ Chief Deputy Director California Department of Social Services Attachment c: CWDA the California Department of Social Services and the County of , Department of The California Department of Social Services (CDSS) and the County of , Department of (County Department) enter into this Data Privacy and Security Agreement (Agreement) in order to ensure the privacy and security of Social Security Administration (SSA), Medi-Cal Eligibility Data System (MEDS) and Applicant Income and Eligibility Verification System (IEVS) Personally Identifiable Information (PII), covered by this Agreement and referred to hereinafter as PII, that the counties access through CDSS and the Department of Health Care Services (DHCS). This Agreement covers the following twelve (12) programs; please check the applicable box(s) for your County Department: The CDSS has an Inter-Agency Agreement (IAA) with DHCS that allows CDSS and local county agencies to access SSA and MEDS data for the purpose of determining eligibility for the programs listed above. The IAA requires that CDSS may only share SSA and MEDS data if its contract with the entity with whom it intends to share the data reflects the entity's obligations under the IAA. The County Department in its administration of the social services programs utilizes SSA and MEDS data in conjuction with other system data, for eligibility determinations. This Agreement covers the County of , Department of

Original Document Signed By. ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Acting Deputy Director Disability and Adult Programs Division Attachment STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES ■ Release of Information Attached Attending PATIENT’S NAME: PATIENT’S DOB: / / Physician’s / MEDICAL ID#: (IF AVAILABLE) COUNTY ID#: Medical Professional’s IHSS SOCIAL WORKER’S NAME: mailing address COUNTY CONTACT TELEPHONE #: COUNTY FAX #: Your patient is an applicant/recipient of In-Home Supportive Services (IHSS) and is being assessed for the need for Protective Supervision. Protective Supervision is available to safeguard against accident or hazard by observing and/or monitoring the behavior of non self-directing, confused, mentally impaired or mentally ill persons. This service is not available in the following instances:

Original Document Signed By. ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ On August 12, 1999

Original Document Signed By. ▇▇▇▇▇▇▇ ▇. ▇▇▇▇ Deputy Director Children and Family Services Division c. CPOC Attachment September 9, 2010 Regulation Package # 0508-03 CDSS MANUAL LETTER NO. CWS-10-01 TO: HOLDERS OF THE CHILD WELFARE SERVICES MANUAL, DIVISION 31 Regulation Package # 0508-03 Effective 9/3/10 Sections 31-003, 31-021, 31-410, and 31-501 This manual letter has been posted on the Office of Regulations Development website at ▇▇▇▇://▇▇▇.▇▇▇.▇▇▇▇▇▇▇.▇▇▇/ord/PG603.htm. In 2004, the California Department of Social Services (CDSS) was party to a lawsuit, ▇▇▇▇▇ ▇. ▇▇▇▇▇, which alleged that individuals' names were submitted to the Child Abuse Central Index (CACI), a child abuse registry maintained by the California Department of Justice, without a right to challenge the placement, which the plaintiff alleged was a violation of due process guarantees of the California Constitution. In addition, the lawsuit challenged the accuracy of information retained on the CACI, alleging that a significant number of listings were maintained on the CACI without adequate underlying files to support the listing. This lawsuit was settled in October 2007 and as part of the agreement between the parties, CDSS agreed to amend current regulations to reflect the new grievance hearing procedures as required by the settlement. Pursuant to Penal Code Section 11169, an individual's name is submitted to the CACI whenever a county child welfare services agency determines that a child abuse and/or neglect (excluding general neglect) allegation regarding that individual is found to be inconclusive or substantiated. Prior to ▇▇▇▇▇ ▇. ▇▇▇▇▇, individuals with due process by allowing them to dispute their listing on the CACI. The settlement agreement further stipulates that county CWD agencies are to furnish a request for grievance hearing and notice of listing on CACI forms to persons subject to listing on CACI. The stipulation to create regulations based on ▇▇▇▇▇ ▇. ▇▇▇▇▇ requires the adoption of a new section in the Manual of Policies and Procedures, Division 31 regulations. In addition, amendments to other portions of Division 31 were necessary to provide consistency and to accurately reflect the due process requirements pursuant to the ▇▇▇▇▇ ▇. ▇▇▇▇▇ settlement agreement. Emergency regulations were adopted effective August 31, 2009 and were heard at a public hearing held on January 13, 2010. Subsequent to the public hearing, emergency regulations were revised and noticed for 15-days with no further revisions. Thi...