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Forms & Publications
CalWORKs
- SAWS 2A SAR - Rights, Responsibilities and Other Important Information
English Document (PDF) | Spanish Document (PDF) - SAR 7 - Semi-Annual Eligibility Status Report
English Document (PDF) | Spanish Document (PDF) - SAR 7 Addendum - Instructions and Penalties
English Document (PDF) | Spanish Document (PDF) - AR3 - Mid-Year Status Report for CalWORKs and CalFresh
English Document (PDF) | Spanish Document (PDF) - SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh
English Document (PDF) | Spanish Document (PDF) - CW 8A - Statement of Facts to Add a Child Under 16
English Document (PDF) | Spanish Document (PDF) - NVRA Voter Preference Form
English Document (PDF) | Spanish Document (PDF)
CalFresh
- SAWS 2A SAR - Rights, Responsibilities and Other Important Information
English Document (PDF) | Spanish Document (PDF) - SAR 7 - Semi-Annual Eligibility Status Report
English Document (PDF) | Spanish Document (PDF) - SAR 7 Addendum - Instructions and Penalties
English Document (PDF) | Spanish Document (PDF) - SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh
English Document (PDF) | Spanish Document (PDF) - CW 8A - Statement of Facts to Add a Child Under 16
English Document (PDF) | Spanish Document (PDF) - NVRA Voter Preference Form
English Document (PDF) | Spanish Document (PDF) - CF 377.5 - CalFresh Household Change Report
English Document (PDF) | Spanish Document (PDF)
Medi-Cal / County Medical Services Program
- Application for Medi-Cal and Covered California health care options
All Languages Documents - NVRA Voter Preference Form
English Document (PDF) | Spanish Document (PDF) - MC 219 - Important Information for Persons Requesting Medi-Cal
English Document (PDF) | Spanish Document (PDF)
Welfare-to-Work
- WTW 1 - WTW Plan Rights and Responsibilities
English Document (PDF) | Spanish Document (PDF) - 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) | Spanish Document (PDF) - WTW 31 - Request to Stop a WTW Sanction
English Document (PDF) | Spanish Document (PDF)
General Assistance
- SSSD 3007 - Job Search Log and Mileage
English / Spanish Document (PDF)
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Self Sufficiency Services
Physical Address
2751 Napa Valley Corporate Drive
Building A
Napa, CA 94558
Phone: 707-253-4511
American Canyon Location
4381 Broadway Street, Suite 101, American Canyon CA 94503
Alternate Phones
Career Center: 707-253-4134
Toll Free: 800-464-4214
TTY Number: 800-445-1312
Auxiliary aids and services are available upon request to individuals with disabilities.
Hours
Monday - Friday
8 a.m. - 5 p.m.
Closed Holidays