Publications

WE ARE NAPA COUNTY

Self Sufficiency Services Health and Human Services Agency

latina woman on computer

 CalWORKs


SAWS 2A QR – Rights, Responsibilities and Other Important Information
English      Spanish

QR 7 – Quarterly Eligibility / Status Report
English      Spanish

QR 7A – How to Fill Out your QR 7 Quarterly Eligibility / Status Report
English      Spanish

QR 3 – Mid-Quarter Status Report
English      Spanish

SSSD 2005 – Authorization of Direct Deposit (coming soon)
English/Spanish

CW 8A – Statement of Facts to Add a Child Under 16
English      Spanish

NVRA Voter Preference Form
English      Spanish

 

CalFresh


SAWS 2A QR– Rights, Responsibilities and Other Important Information 
English      Spanish

QR 7 – Quarterly Eligibility / Status Report 
English      Spanish 

QR 7A – How to Fill Out your QR 7 Quarterly Eligibility / Status Report 
English      Spanish

QR 3 – Mid-Quarter Status Report 
English      Spanish

CW 8A – Statement of Facts to Add a Child Under 16 
English      Spanish

NVRA Voter Preference Form 
English      Spanish

DFA 377.5 – Food Stamp Household Change Report
English      Spanish

 

Medi-Cal / CMSP


NVRA Voter Preference Form 
English      Spanish

MC 210 – Medi-Cal Mail-In Application
English/ Spanish

MC 219 – Important Information for Persons Requesting Medi-Cal
English      Spanish

MC 210 RV – Medi-Cal Annual Redetermination Form
English      Spanish

MC 176 S – Medi-Cal Status Report
English      Spanish

CMSP 210 – Application for Path2Health & County Medical Services Program (CMSP)
English      Spanish

CMSP 219 – Path2Health & CMSP Rights, Responsibilities, and Other Information
English      Spanish

 

Welfare-to-Work


WTW Handbook (coming soon)
English Spanish

WTW 1 – WTW Plan Rights and Responsibilities
English      Spanish

Time and Attendance Sheet (coming soon)
English/Spanish

Employer Contact Log (coming soon)
English/Spanish

TEMP CW 2186A – Exemption Request Form
English      Spanish

WTW 31 – Request to Stop a WTW Sanction
English      Spanish

 

General Assistance


Employer Contact Log (coming soon)
English/Spanish

 

Miscellaneous


SSSD 2000 – Commonly Requested Documents
English/Spanish