Publications

WE ARE NAPA COUNTY

Self Sufficiency Services Health and Human Services Agency

latina woman on computer

 

 Publications

 CalWORKs

SAWS 2A SAR – Rights, Responsibilities and Other Important Information 

English  Spanish

SAR 7 – Semi-Annual Eligibility Status Report
English  Spanish

SAR 7 Addendum - Instructions and Penalties

English  Spanish

AR3 – Mid-Year Status Report for CalWORKs and CalFresh
English  Spanish

SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh

English  Spanish 
CW 8A – Statement of Facts to Add a Child Under 16
English  Spanish  
NVRA Voter Preference Form

English  Spanish

CalFresh

SAWS 2A SAR – Rights, Responsibilities and Other Important Information 
English  Spanish
SAR 7 – Semi-Annual Eligibility Status Report
 English   Spanish
SAR 7 Addendum - Instructions and Penalties

English  Spanish

SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh

English  Spanish 
CW 8A – Statement of Facts to Add a Child Under 16 
English      Spanish
NVRA Voter Preference Form 
English      Spanish 
CF 377.5 – CalFresh Household Change Report
English   Spanish

Medi-Cal / CMSP

Application for Medi-Cal and Covered California health care options

All languages

NVRA Voter Preference Form 
English      Spanish
MC 219 – Important Information for Persons Requesting Medi-Cal
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