Social Security

Form DSS-5104, "Report to Central Registry / CPS Application," is a critical document issued by the North Carolina Department of Health and Human Services. It serves as a comprehensive tool for reporting incidents or suspicions of child abuse, neglect, or maltreatment to the Central Registry. This form also functions as an application for the Child Protective Services (CPS) program.

Main Uses: The primary uses of Form DSS-5104 include:

Form DSS-8227 provides important information and guidelines for individuals applying for various benefits and services from the North Carolina Division of Social Services. The form outlines essential details about citizenship, immigration status, and the requirement to provide social security numbers. It also explains exceptions, eligibility criteria, and considerations for immigrants and applicants facing special circumstances.

Form SOC 426A is a crucial document within California's In-Home Supportive Services (IHSS) Program, which provides assistance to eligible aged, blind, and disabled individuals to remain safely in their own homes. This form is designed to facilitate the process of designating a provider to offer authorized services to the IHSS recipient. It gathers necessary information about the recipient and the chosen provider, outlines agreements, and ensures compliance with program rules.

The DMAS-99 Community-Based Care Member Assessment form is an essential tool used in the state of Virginia to evaluate the functional status and care needs of individuals receiving community-based care services. This comprehensive form is designed for those under agency-directed or consumer-directed services, aiming to provide a holistic understanding of the member's well-being and support requirements.

The LIC 9150 form, also known as "Parent Notification - Additional Children in Care," is a crucial document used by the California Social Services. It serves the primary purpose of notifying parents or legal guardians about the addition of additional children to their existing child care arrangement.

The form consists of several important fields that must be completed accurately to ensure effective communication and compliance with regulations. These fields typically include:

The LIC 9149 Family Child Care Home Property Owner/Landlord Consent Form is a crucial document used in the context of family child care homes. It serves as a means for obtaining consent from the property owner or landlord to operate a child care business within their premises. This form plays a significant role in ensuring compliance with regulations and establishing a legal agreement between the parties involved.

Form LIC 9273 is used in California by Continuing Care Retirement Communities (CCRCs) to provide a disclosure statement. This form is typically provided to prospective residents during the admission process.

Form LIC 989A is used in California by individuals or organizations to request non-confidential records from the California Department of Social Services. This form is typically completed by the requesting party.

Form LIC 9282 is used in California by various residential facilities, including adult residential facilities, enhanced behavioral supports homes, community crisis homes, residential care facilities for the elderly, residential care facilities for the chronically ill, and social rehabilitation facilities, to develop an infection control plan. This form is completed by the facility administrator or designated personnel.

Form LIC 9280 is used in California by family child care homes as a pre-licensing entrance checklist. This form is typically completed prior to starting the licensing process for a family child care home.