CalWORKs Verification Chart

This chart only provides a verification summary and is not intended to be all-inclusive. Before eligibility can be cleared, the Social Services Benefits Specialist (SSBS) 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 approval 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 approval	For each adult applicant: Documentation of all Out of State TOA information.
Income Refer to Evidence of Income.	Unearned	Prior to approval	Checks or copies of checks Award letters Veterans Benefits Verification and 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 approval	Client will provide the SSBS with verification to document the actual cost if it is less than the CalWORKs in-kind chart value.
	Earned	Prior to approval	Paycheck stubs Statement from employer Request for Employment Information (SCD 549-A) IEVS abstract Truv report GEN 853 if unable to obtain other verification. Important: For all Assistance Unit (AU) and non-AU members whose income must be counted, a 3-month The Work Number (TWN) report must be requested and saved to the case file, whether or not income and employment are reported, or relevant verification is submitted by the AU. Refer to Common Place Handbook The Work Number (TWN) and Truv.
Deprivation Refer to Deprivation.	Deceased	Prior to approval	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 approval 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 approval	Child/Medical Support Packet. Refer to Common Place Handbook Required Forms. If questionable, obtain a written statement from the Absent Parent (A/P) or other persons with prior knowledge of the marriage relationship, or Document evidence of the client's actions that indicate absence.
	Unemployment	Prior to approval Aid shall not be granted until verification is on file. Refer to Definitions for exceptions.	Request for Information on Termination of Employment (SCD 549-B), or statement from employer providing hours worked, last day of work, reason for termination, and any work offered. Notice of Computation, UIB (DE 429D) Notice of Unemployment Insurance Award (DE 429Z) IEVS Abstract/UIB Match.
Property Refer to Property - General.	Real property	Prior to approval	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 approval	Self-Certification Form for Motor Vehicles - CalWORKs (CW 80). Refer to Vehicles.
Personal Property	Other personal property	Prior to approval	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 approval 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.
Pregnancy Refer to Pregnancy Special Needs.		Prior to approval	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	Exemption	Eligibility clear and prior to approval	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 approval until date physician specifies	Special Diet Request (CSF 25) Statement from physician Statement of Facts - Homeless Assistance (CW 42).
Special Needs	Nonrecurring	Prior to approval	Special Needs Requisition (SCD 414).

CalWORKs Verification Chart

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