CalWORKs Verification Chart

This chart only provides a verification summary and is not intended to be all inclusive. Before eligibility can be cleared, the EW must verify ALL of the client's statements on the Application for CalFresh, Cash Aid and/or Medi-Cal/Health Care Programs (SAWS 2 Plus) as well as any pertinent information received during the interactive interview.

Verification provided should be entered in the appropriate CalSAWS page(s). When there are changes and documentation is required for the explanation, use the Journal Detail page in CalSAWS.

Mandatory Verification		When Required	Documentation Required
Photo identification (ID)		At application	Acceptable forms of photo ID may include, but are not limited to: Driver’s License Photo ID (from government agency, school, etc.) Passport USCIS documents with photo. Refer to Verification Needed to Establish Eligibility for information on the requirement to verify adult applicants' identity in person or virtually.
Social Security numbers (SSNs) or application for SSNs Refer to Social Security Numbers.		Prior to payment Newborn Exception: Refer to Immediate Medi-Cal Authorization for Newborn.	Social Security card SSA Referral Notice (MC 194) IEVS Abstract Any official notification from Social Security.
Residency Refer to Residence.			Client's written statement. For minor parents, Supplemental Statement of Facts - Minor Parent (CW 25) needed.
Citizenship and/or "qualified non-citizen" status Refer to Citizenship Verification.			For citizenship primary documentation: Birth certificate, baptismal certificate, U.S. passport, or certificate of citizenship or naturalization. For "qualified non-citizen" status: I-94 or I-551 for appropriate "qualified non-citizen" status or proof of "exception criteria" being met. Correspondence from INS. Refer to Qualified Non-Citizens.
Time on Aid (TOA)		Prior to payment	For each adult applicant: Current [TSUM] screen. Current [PTOA] screen. Documentation of all Out of State TOA information.
Income Refer to Evidence of Income.	Unearned	Prior to payment	Checks or copies of checks Award letters Veteran's Benefit Referral (CW 5) IEVS Abstract Signed statement from person or organization providing the income Statement from checking or savings account if income is directly deposited into bank. Sworn Statement (GEN 853) if unable to obtain other verification.
	Income-in-Kind	Prior to payment	Client will provide the EW with verification to document the actual cost if it is less than the CalWORKs in-kind chart value.
	Earned	Prior to payment	Paycheck stubs Statement from employer Request for Information from Employer (SCD 549) IEVS Abstract GEN 853 if unable to obtain other verification.
Deprivation Refer to Deprivation.	Deceased	Prior to payment	Copy of death certificate OASDI award letter Newspaper account of death Other reliable information, such as physician's statement who treated deceased, family Bible records, SSPM signed affidavit, etc.
	Incapacity	Prior to payment OR within 30 days pending medical verification	Authorization to Release Medical Information (CW 61). Written statement from licensed physician, certified psychologist or staff member including diagnosis describing employment and child care limitations and duration. Copy of disability award letter. DM 1 - DM 3 if permanent disability. IEVS Abstract.
	Absence	Prior to payment	Child/Medical Support Packet. Refer to Common Place Handbook Required Forms. If questionable, obtain written statement from Absent Parent (A/P) or other persons with prior knowledge of marriage relationship, or Document evidence of client's actions that indicate absence.
	Unemployment	Prior to payment Aid shall not be granted until a completed SCD 549 is on file. Refer to Definitions for exceptions.	SCD 549, or statement from employer giving hours worked, date, reason for leaving and any work offered. Notice of Computation, UIB (DE 429) Disqualification Notice, DIB (DE 1080) IEVS Abstract.
Property Refer to Property - General.	Real property	Prior to payment	Copy of current county tax statement. Copy of documents showing encumbrances, such as payment books, payment receipts, notes, mortgages, etc. If unwritten encumbrance, copy of sworn statement giving initial and maturity dates, balance owed and signature of both parties. Receipts for expenses on rental property.
Personal Property	Motor vehicles	Prior to payment	Current DMV registration. Documentation of DMV contact. Documentation of evaluation of county property specialist. 3 appraisals by auto dealers, insurance adjustors or property appraisers. Documentation/verification if another method used.
Personal Property	Other personal property	Prior to payment	Bank statements Copies of loan balance statements, credit union statements, purchase contracts, stock certificates, U.S. bonds, etc. Evaluation by county property specialist 3 appraisals by dealers, adjustors, property appraisers, etc. To be used when value is questionable or appreciates. Note: Checkbooks are not acceptable verification.
Age	All children in the AU	Prior to payment Newborn Exception: Refer to Immediate Medi-Cal Authorization for Newborn.	Photocopy of birth certificate or other acceptable evidence of age. Refer to Age, School Attendance and Immunization, for complete list.
Age	School age children	At Intake. At Annual Redetermination. When a child age 6-17 is added to an existing AU. Any time when EW determines that it is necessary to verify school attendance.	School/Educational Institution Attendance Verification (CSF 37).
Pregnancy Refer to Pregnancy Special Needs.		Prior to payment	Written statement from a physician, physician's assistant, state certified nurse midwife, nurse practitioner or by designated medical or clinic personnel with access to the medical record that provides diagnosis and estimated due date. When medical verification cannot be obtained, the verification requirement may be initially satisfied by means of a sworn statement or verbal attestation. However, medical verification must be submitted within 30 working days for the pregnancy special need and/or pregnant person only case to continue.
Work Registration	Informing notice	Eligibility clear and prior to payment	Welfare to Work Core/Non-Core Activities (SCD 298).
Work Registration	Exemption	Eligibility clear and prior to payment	Under 16 16-18 in school Age 60 or older Disabled Non-parent Relative caring for a child who is at risk Cares for ill household member Caretaker of child under 12 months Caretaker for subsequent child Pregnancy.
Special Needs	Recurring	Prior to payment until date physician specifies	Special Diet Request (CSF 25) Statement from physician Statement of Facts - Homeless Assistance (CW 42).
Special Needs	Nonrecurring	Prior to payment	Special Needs Requisition (SCD 414).

CalWORKs Verification Chart

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