The easiest and quickest way to apply for CalWORKs, CalFresh and/or Medi-Cal is online at www.C4Yourself.com. Read all the field labels carefully. 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 Technology, Power of If you are unable to buy food to prepare at home, you may qualify for Riverside Countys Restaurant Meals Program. If you need assistance completing any of these forms, please contact the IHSS Helpline at (888) 822-9622. For more information about APS, visit Adult Abuse. RFA Forms Under CDSS Review: Please note these forms are currently under revision FFA Forms: If you need health care coverage, we offer Medi-Cal, a comprehensive health coverage for individuals and families who qualify. Medi-Cal renewals begin June 2023, and mailing begins April 2023. PDF APPLICATION FOR CALFRESH BENEFITS - Los Angeles County, California For translated forms, please click here. Find out more about EBT. PDF Riverside County Department of Public Social Services AFFIDAVIT For families who receive CalWORKs and have children, we offer the Housing Support Program! Apply here and learn more about benefits. DPSS Office Locations | Riverside County Department of Public Social Schools are now a beacon for healthy beginnings. LLC, Internet Get money If approved, you will get an EBT card for groceries within 10 days. 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 Older adults and those with disabilities deserve the freedom to live safely in the comfort of their own home. QPI also prioritizes helping the child maintain connections with their birth family. On-line Forms and Publications A - D 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. 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. If you suspect fraud call the DHCS Medi-Cal Fraud Hotline at 1-800-822-6222. 104-193) eliminated Supplemental Security Income/State Supplementary Payment (SSI/SSP) eligibility for most non-citizens. Forms In-Home Supportive Services (IHSS) Public Authority If you need help finding affordable health coverage, consider Covered California. If buying food to prepare at home is not an option, you may qualify for Riverside Countys Restaurant Meals Program. Adult Services | Riverside County Department of Public Social Services The Public Authority manages a public registry that matches Riverside County clients with a trusted in-home caregiver. We invite open-hearted adults to join our village as either adoptive or foster parents. Stay vigilant against potential scams! Keep you and your family covered! IHSS Public Authority | Riverside County Department of Public Social CalWORKs is designed to give families with children a way to meet their basic living needs. Learn more about the WIC program in Riverside County: Copyright 2023 All Rights Reserved by The County of Riverside. 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. 1. See Forms - Listed by Program. PDF Superior Court of California County of Riverside Proposed Local Rule The County of Riverside is an Equal Opportunity Employer. All Topics No topics created yet Home | County of Riverside, CA The program provides cash aid to qualified refugees who are not eligible for CalWORKs or Supplemental Security Income (SSI). Facebook Icon Instagram Icon Linkedin Icon Reddit Icon Twitter Icon Vimeo Icon Login Find A Job 38670 Sky Canyon Drive, Suite 200 . Enter your official identification and contact details. In Person Find your nearest DPSS office location 3. EFFECTIVE JULY 1, 2023 . Our Self-Sufficiency program helps working-class people and families with low or no income find their path to economic independence. County of Riverside hiring Eligibility Services Clerk in Rubidoux If you are a refugee without children who is not eligible for other cash aid, Refugee Cash Assistance may help. The following are Riverside Countys Commonly Used IHSS Forms. Families requesting assistance must complete application forms. Visit KeepMediCalCoverage.org for more details. Making healthy choices on a budget is easy with CalFresh Healthy Living. Please, see below for location details, contact numbers, and hours of operation. Fill out Riverside County Dpss Forms in several minutes by following the instructions below: Send your Riverside County Dpss Forms in an electronic form when you are done with filling it out. QPI ensures every child removed from their home is cared for by a skilled, nurturing foster family. Get your online template and fill it in using progressive features. #1 Internet-trusted security seal. Dpss 3731 - Fill Out and Sign Printable PDF Template | signNow A copy of your ID. Services include locating and establishing paternity; creating, modifying and enforcing a court order for child support and health coverage. While you work to provide for your family, you need peace of mind that your children are receiving quality care. Have a physician or medical professional determine that you are unable to remain safely in your own home without IHSS. Children's Services | Riverside County Department of Public Social Services To apply or to find out more about CAPI benefits in Riverside County, please call IHSS HOME at 888-960-4477. http://www.cdss.ca.gov/inforesources/Forms-Brochures/Forms-Alphabetic-List/Q-T#soc. http://www.cdss.ca.gov/inforesources/Translated-Forms-and-Publications. The County and State will never text or call and ask for your EBT card and/or PIN. Estate Recovery Forms. CAPI payment amounts vary depending on a person's marital status, living arrangements and other income. Celebrate Earth Day . Riverside County DPSS office locations. This service is completely free. Medi-Cal renewals begin June 2023, and mailing begins April 2023. Open it with online editor and begin altering. Get Form How to create an eSignature for the apply for general relief online Locations. As a result, most immigrants who were not receiving SSI/SSP in August 1996 are no longer eligible for SSI/SSP. : DEPARTMENT OF PUBLICSOCIALSERVICES (DPSS):Adoption of Resolution Number -2022-009, Authorizing the Director of the Department of Public Social Services (DPSS)toAccept the Housing Navigator ProgramRound#2 Allocation Award, andAuthorize . They give a telephone number that is close to a real customer service helpline telephone number (maybe one number is different). Riverside County Attachment to Petition to Determine Succession of Real Property (Form DE-310) (pdf ) RI-PR101. Stay vigilant against potential scams! Quality Assurance Fee Program. The following Commonly Used Recipient and Provider State Forms is available on the California Department of Social Services website at: http://www.cdss.ca.gov/inforesources/Forms-Brochures/Forms-Alphabetic-List/Q-T#soc. Suspected Child Abuse Report (SCAR) | Riverside County Office of Education When a referral is made to the Riverside County Department of Public Social Services under Probate Code 1513(b . To be eligible for CalWORKs, a family must have a child who: Is under age 18 (or under age 19 if the child is currently attending high school or vocational school), and. DPSS Programs | Riverside County Department of Public Social Services CalFresh Benefits Helpline and get a STEP 1: ACCESS THE DPSS WEBSITE For computers: Enter website address: dpssbenefits.lacounty.gov For a mobile device: Note: Your mobile device must have a QR Code Reader to scan the code. Medi-Cal renewals begin June 2023, and mailing begins April 2023. Riverside County is the fourth largest county in California and the eleventh largest in the United States. If you are between the ages of 21 and 64 and need help to pay for acute illnesses and medical care to prevent disability, help is available through the Medically Indigent Services Program (MISP). RFA Forms We work for you, 24-hours a day, 7 days a week. Has at least one parent who is unemployed, disabled, gone (not around to care for the child), in jail, or has died. News & Events . Medi-Cal renewals begin June 2023, and mailing begins April 2023. The day the County receives your signed application starts the time to give you an answer on whether you can get benefits. The county welfare department is listed under the County Government Section of the telephone book. County of Riverside Human Resources Department > HR Services CAPI is a 100 percent state-funded program designed to provide monthly cash benefits to aged, blind, and disabled non-citizens who are ineligible for SSI/SSP solely due to their immigrant status. Complete all the requested boxes (these are yellowish). Your EBT card and/or PIN are never needed to determine eligibility for any service. The Riverside County Department of Public Social Services (DPSS) is hiring multiple Eligibility Services Clerks located throughout Riverside County. All Rights Reserved by The County of Riverside, Restaurant Meals Program Vendor Information. Dental, Request for Access to Protected Health Information. EBT customer service is available 24 hours a day, 7 days a week. Offer of a free government cell phone or free gift cards and you are asked for your personal information, card number and/or PIN. Medi-Cal will NEVER require payment in the application or recertification process. A one-on-one connection can help people quickly find programs and services that improve their health, safety, and wellbeing. Have you received Childrens Services, In-Home Supportive Services or assistance with benefits through our Self Sufficiency Division? Public assistance programs are designed out of good-will to help those in need. Four simple ways you can apply for CalFresh assistance: If you would like help filling out your CalFresh application or to participate in an interview, you may appoint an Authorized Representative (AR). 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. We are to help you too! 01/2021. IHSS Public Authority The Public Authority manages a public registry that matches Riverside County Adult Services clients with a trusted in-home caregiver. Riverside County Department of Public Social Services: Moreno Valley-In Copyright 2023 All Rights Reserved by The County of Riverside. Download a copy of the Suspected Child Abuse Report form. For more consumer information on security please see the California Department of Justice's, " Security Awareness ". RFA 00A (2/17) - Conversion - Resource Family Application. Children 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. Visit KeepMediCalCoverage.org for more details. We offer access to food, housing, cash, child care, employment and health coverage assistance. Date: (TYPE OR PRINT NAME OF ATTORNEY PARTY MAKING DECLARATION) (SIGNATURE) Approved for Optional Use Riverside Superior Court RI-MC012 [New 05/28/21] Visit KeepMediCalCoverage.org for more details. OurCommunity Outreach Branchteam will offer information about cash aid, food assistance and health coverage at this event. Use signNow to e-sign and share Dpss 3731 ihss form for collecting e-signatures. Want to speak to someone face-to-face? April 21, 2023. PDF Save Time! Go Online! Submit Your Sar 7 Report Online!! Medi-Cal will NEVER require payment in the application or recertification process. The division also provides enforcement activities through the issue of citations for violations of county parking ordinances. Reasonable accommodations are available. Maximize your nutrition dollar with Market Match. New benefit recipients are contacted by a protection plan company that says they are part of the state program. Stay vigilant against potential scams! Needy families may apply for CalWORKs at any office located in the county where they live. Apply for California Food Stamps Online | GetCalFresh.org Apply Your county will call you within a week or two for an eligibility interview. Keep you and your family covered! They will direct you to your program representative. Visit KeepMediCalCoverage.org for more details. TopTenReviews wrote "there is such an extensive range of documents covering so many topics that it is unlikely you would need to look anywhere else". If you don't have a . 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. This page will include phone numbers for many different departments such as Administrative Services, Non-Emergency Child Services, The Adoption Team, and more. Medi-Cal renewals begin June 2023, and mailing begins April 2023. 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). Health Insurance Premium Program (HIPP) Application. 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 Forms beginning with the following letters click below: Problems with downloading forms? Address Moreno Valley Office 23119 Cottonwood Avenue Building B Moreno Valley, CA 92553 Get Directions Phone (951) 413-5050 Moreno Valley Office Phone (888) 960-4477 IHSS Toll Free Application and Information Line Web https://rivcodpss.org/ Email dpssinquiry@riversidedpss.org Hours Mon-Fri 8am-5pm (Optional): 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. Medi-Cal renewals begin June 2023, and mailing begins April 2023. Buy groceries EBT cards work in most food stores and farmers' markets. Ensures that a website is free of malware attacks. Experience a faster way to fill out and sign forms on the web. Attorney, Terms of This is the States health insurance marketplace from the Affordable Care Act. MCED Forms MC 200 - California The client decides which caregiver can meet their needs. Recipient Forms All Rights Reserved by The County of Riverside, Restaurant Meals Program Vendor Information, Cash Assistance Program for Immigrants (CAPI), Meet Medi-Cal eligibility requirements in the state of California, Have a disability which is expected to continue longer than 12 months. Keep you and your family covered! We strive to provide exceptional customer service through outreach services. Forms and Publications (Q-T) LAW ENFORCEMENT COUNTY PROBATION AGENCY COUNTY WELFARE / CPS (Child Protective Services) ADDRESS Street City Zip DATE/TIME OF PHONE CALL OFFICIAL CONTACTED - TITLE TELEPHONE ( ) C. VICTIM One report per victim . We understand that our services and benefits are vital to you. Medi-Cal will NEVER require payment in the application or recertification process. Forms and Brochures Apply for Benefits | Riverside County Department of Public Social Services Apply for Benefits Apply for Benefits We believe in helping YOU take care of yourself and your family. Check the entire document to make sure you have filled in all the information and no changes are required. Adult Protective Services (APS) responds to reports of abuse against older and dependent adults in Riverside County. Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. Learn about how to shop and budget your food purchases, ensure your food is safe, plan meals and cook healthy using your CalFresh benefits. PDF Submittal to The Board of Supervisors County of Riverside, State of FOLLOW THESE STEPS TO SUBMIT A SAR 7 ONLINE AND THE VERIFICATION: Complete and submit your SAR 7 report confirmation number. Open it up with online editor and start adjusting. The program allows you to use your CalFresh benefits, or your EBT card, to buy meals from participating restaurants, locally and statewide! Need to apply for food, cash or health coverage assistance but dont want to wait in line? Your data is well-protected, as we keep to the newest security standards. DO NOT submit a copy of this form to the Department of Justice (DOJ). Copyright 2023 All Rights Reserved by The County of Riverside. We believe in your right to dignity, to self-determination, and to live with as much independence as possible. Stay vigilant against potential scams! 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. Keep you and your family covered! Guarantees that a business meets BBB accreditation standards in the US and Canada. Access the most extensive library of templates available. We are part of a countywide multidisciplinary team of legal and health advocates to provide community education and investigate reports of elder and dependent adult abuse. Visit KeepMediCalCoverage.org for more details. Live in California. Handbook, Incorporation This program provides treatment and support services to transition age youth, adults and older adults who have a mental illness and . CalFresh puts food-buying power into the hands of working-class households. Complete all the requested boxes (these are yellowish). Highest customer reviews on one of the most highly-trusted product review platforms. Here's How, CW 2166 (4/21) - Multilingual Work Really Pays! Check out the SNAP-Ed Nutrition Education Materials from the U.S. Department of Agriculture. We believe in your right to dignity, to self-determination, and to live with as much independence as possible. Riverside Office. Your CalFresh dollars can go a long way to help your family stay healthy. Proof of immigration status. File (form JV-570) to the court, you must personally, or by first-class mail, . 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. Your kids are your priority. Through strategic partnerships with departments, we attract and retain a motivated and skilled workforce by championing a Great Place to Work so that employees are committed to delivering valuable and effective services to the people of Riverside County. RFA Forms Department of Social Services Disaster Services Branch CDSS Programs Resource Family Approval Program Forms RFA Forms For finalized forms, please click here. Have income less than the CAPI standards. Medi-Cal renewals begin June 2023, and mailing begins April 2023. In the form included, fill out some information about yourself, and include details on how we can assist. The welfare reform act of 1996 (P.L. These rules apply in all departments of the Riverside Superior Court hearing family Use professional pre-built templates to fill in and sign documents online faster. Stay vigilant against potential scams! . 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! Human Resources | County of Riverside, CA Human Resources The motto of Riverside County's Human Resources department is "putting people first." Visit their website to access job listings for county positions in such fields as health care, public safety and so much more. Fill out Riverside County Dpss Forms in several minutes by following the instructions below: Find the template you need in the library of legal forms. We understand that our services and benefits are vital to you. To learn more about our services and partners visit the links below. My Account, Forms in 120E, Indio, CA 92201 RIVERSIDE 9991 County Farm Rd., Riverside, CA 92503 MURRIETA 30755-G Auld Rd., Murrieta, CA 92563 RI-JV041 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address) FOR COURT USE ONLY TELEPHONE NO. Riverside County Department of Public Social Services AFFIDAVIT Case Number: I, ____________________________________, declare under penalty of perjury under the laws of the State PRINT of California that the statement given below is true and correct to the best of my knowledge and belief: Call the Customer Service Automated Response Unit (ARU) at (877) 328-9677 to: Making healthy choices on a budget is easy with CalFresh Healthy Living.