Get the free CalWORKs Child Care Request Form and Reimbursement Rules

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES Gasworks CHILD CARE REQUEST FORM AND REIMBURSEMENT RULES Gasworks Child Care Coverage Eligible Gasworks

How to fill out calworks child care request

How to Fill Out CalWORKs Child Care Request:

1. Start by obtaining the CalWORKs Child Care Request form from your local CalWORKs office or online.
2. Fill in your personal information accurately, including your name, address, phone number, and social security number.
3. Provide information about your child, such as their name, date of birth, and any special needs they may have.
4. Indicate your household income and employment status, as this will determine your eligibility for CalWORKs child care assistance.
5. Include details about your child care needs, including the days and hours you require child care services.
6. If you already have a child care provider in mind, provide their contact information and any relevant details about their qualifications.
7. Sign and date the form to certify the information you have provided is true and accurate.
8. Submit the completed form to your local CalWORKs office either in person, by mail, or online, depending on their specific instructions.

Who needs CalWORKs Child Care Request:

1. Parents or legal guardians who are receiving or applying for CalWORKs benefits and require child care assistance.
2. Individuals who are employed or participating in a work or training program that meets the CalWORKs program requirements.
3. Families with children who are 12 years old or younger and who meet the income and eligibility criteria for CalWORKs child care services.

For pdfFiller’s FAQs

What is calworks child care request?

CalWORKs child care request is a form that needs to be filed by eligible CalWORKs recipients to request child care assistance while they participate in welfare-to-work activities.

Who is required to file calworks child care request?

CalWORKs recipients who need child care assistance while participating in welfare-to-work activities are required to file the CalWORKs child care request.

How to fill out calworks child care request?

The CalWORKs child care request can be filled out by providing information about the recipient, their children, and the child care provider. This form must be submitted to the appropriate agency for processing.

What is the purpose of calworks child care request?

The purpose of the CalWORKs child care request is to ensure that eligible recipients have access to child care assistance so that they can successfully participate in welfare-to-work activities.

What information must be reported on calworks child care request?

The CalWORKs child care request typically requires information about the recipient, their children, the child care provider, and any special circumstances that may impact the need for child care assistance.

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