Forms & Publications
CalWORKs
- SAWS 2A SAR - Rights, Responsibilities and Other Important Information English Document (PDF) | SAWS 2A SAR - Rights, Responsibilities and Other Important Information Spanish Document (PDF)
- SAR 7 - Semi-Annual Eligibility Status Report English Document (PDF) | SAR 7 - Semi-Annual Eligibility Status Report Spanish Document (PDF)
- SAR 7 Addendum - Instructions and Penalties English Document (PDF) | SAR 7 Addendum - Instructions and Penalties Spanish Document (PDF)
- AR3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | AR3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
- SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
- CW 8A - Statement of Facts to Add a Child Under 16 English Document (PDF) | CW 8A - Statement of Facts to Add a Child Under 16 Spanish Document (PDF)
- National Voter Registration Act (NVRA) Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)
CalFresh
- SAWS 2A SAR - Rights, Responsibilities and Other Important Information English Document (PDF) | SAWS 2A SAR - Rights, Responsibilities and Other Important Information Spanish Document (PDF)
- SAR 7 - Semi-Annual Eligibility Status Report English Document (PDF) | SAR 7 - Semi-Annual Eligibility Status Report Spanish Document (PDF)
- SAR 7 Addendum - Instructions and Penalties English Document (PDF) | SAR 7 Addendum - Instructions and Penalties Spanish Document (PDF)
- SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
- CW 8A - Statement of Facts to Add a Child Under 16 English Document (PDF) | CW 8A - Statement of Facts to Add a Child Under 16 Spanish Document (PDF)
- NVRA Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)
- CF 377.5 - CalFresh Household Change Report English Document (PDF) | CF 377.5 - CalFresh Household Change Report Spanish Document (PDF)
Medi-Cal / County Medical Services Program
- Application for Medi-Cal and Covered California health care options All Languages Documents
- National Voter Registration Act (NVRA) Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)
- MC 219 - Important Information for Persons Requesting Medi-Cal English Document (PDF) | MC 219 - Important Information for Persons Requesting Medi-Cal Spanish Document (PDF)
Welfare-to-Work (WTW)
- WTW 1 - WTW Plan Rights and Responsibilities English Document (PDF) | WTW 1 - WTW Plan Rights and Responsibilities Spanish Document (PDF)
- Self Sufficiency Services Division (SSSD) 3000 - Monthly Participant Timecard English / Spanish Document (PDF)
- SSSD 3007 - Job Search Log and Mileage English / Spanish Document (PDF)
- CW 2186A - Exemption Request Form English Document (PDF) | CW 2186A - Exemption Request Form Spanish Document (PDF)
- WTW 31 - Request to Stop a WTW Sanction English Document (PDF) | WTW 31 - Request to Stop a WTW Sanction Spanish Document (PDF)
General Assistance
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Self Sufficiency Services (Public Assistance)
Physical Address
2751 Napa Valley Corporate Drive
Building A
Napa, CA 94558
Telephone Numbers for All Offices
Main: 707-253-4511
Toll Free: 800-464-4214
TTY: 1-800-877-8339
CareerPoint: 707-253-4134
Hours
Monday - Friday
8 AM - 5 PM
Closed on County Holidays
Link to a full list of our locations and hours
Auxiliary aids and services are available upon request to individuals with disabilities.