Documents and Forms

In addition to all the basic demographic documents, the following completed forms and documents must be processed and filed in the Kin-GAP case file by the intake worker. Many of the forms or documents may be retrieved from the prior Foster Care or CalWORKs case.

 

  • SAWS 2 Plus
  • KG 1
  • KG 2
  • KG 3
  • SOC 369
  • SOC 369A
  • Legal Guardianship Letter
  • 366.26 Court Order
  • SCD 441
  • Immunization Record (based on age)
  • CW 2.1 and CW 2.1Q or CW 51
  • SCD 1383 FC
  • SOC 158A
  • Supporting Title IV-E Findings
  • GEN 1365 
  • SCD 2339
  • Occasionally, SCZ 1590 and SCZ 1591
  • SCD 1948

SAWS 2 Plus

All Kin-GAP applicants must have completed an “Application for CalFresh, Cash Aid, and/or Medi-Cal" (SAWS 2 Plus), while in Foster Care or CalWORKs.

A SAWS 2 Plus is required for all Kin-GAP applications, inter-county program transfers, restorations, and inter-program transfers from the existing cash programs (FC or CalWORKs). Request a copy of the SAWS 2 Plus from the Foster Care or CalWORKs case. If there is more than one calendar month break-in-aid a new SAWS 2 Plus will be required.

The SAWS 2 Plus replaces the SAWS 2 and combines the program rules, many of the rights and responsibilities, the SAWS 1, the Statement of Facts, and appendices to collect additional ACA-required information where applicable.

Statement of Facts Supporting Eligibility for Kinship Guardianship Assistance Payment Program (KG 2)

The “Statement of Facts Supporting Eligibility for Kinship Guardianship Assistance Payment Program (KG 2) must be completed by the legal guardian when applying for a Kin-GAP child. The KG 2 is required for all:

  • Applications,
  • Restorations,
  • Redetermination, and
  • Initial Intra-Program Transfer.

Agency-Relative Guardianship Disclosure (SOC 369)

The SOC 369 form is used to inform foster parents of the funding options available if legal guardianship is established. This form is completed by the SW/PO. A copy of the SOC 369 is required in the eligibility case file.

Kin-GAP Program Agreement Amendment (SOC 369A)

The SOC 369A is used to negotiate the payment with the guardian. This form is completed by the SW/PO during their assessment and it is forwarded to the FC eligibility for the case file.

Legal Guardianship Letter

Also known as the Letters of Guardianship. The court document verifies the guardianship to the caregiver.

Note: For CalSAWS data-entry purposes, the Kin-GAP guardianship Begin Date is the date the Legal Guardian is appointed by the court.

366.26 Court Order

Minute order reflecting the dismissal of the child’s dependency status.

Kin-GAP Information Sheet (SCD 21)

County created form used to assist in the communication between DFCS and the FC bureau for new Kin-GAP cases. This form is not required and should be considered optional.

School Attendance Verification (SCD 441)

Required for Kin-GAP children ages 6-18 for school attendance verification. There is no penalty applied to children or youth under the age of 18.

Immunization Record

Required for all children under the age of 6. Proof of immunization must be in the eligibility case file. The “Immunization Assessment Form” (SCD 832) must be used to verify the immunizations are current. There is no penalty applied for lack of immunizations.

Foster Care Caretaker Relative Documentation Chart (SCD 1383 FC)

The sworn statement to establish the caretaker guardian’s relationship to the eligible child.

Note: This document is not required for fictive relatives.

Supporting Title IV-E Documents

To verify a foster child’s eligibility for Title IV-E foster care benefits, eligibility documentation must include the FC 2, FC 3, FC 3A, and/or SOC 158A. The documents may come from the FC case file and findings must be documented in a CalSAWS Journal.

Notice of Language Services (GEN 1365)

When state or county-specific correspondence is not available in the client’s language of preference, the multilingual Notice of Language Services (GEN 1365) is to be included with the English correspondence. The GEN 1365 informs the client to contact their worker if they do not understand the information in their correspondence and that they have the right to interpreter services provided by the county at no cost to the client.

Reinstatement of Kin-GAP (SCZ 1590)

The SCZ 1590 is a Department of Family and Children's Services (DFCS) form that verifies that DFCS has assessed the legal guardian(s), confirmed that the legal guardianship is intact and that new KG 2 and SOC 369A forms have been completed.  This form is used when restoring Kin-GAP benefits.

Important - Non-Minor youth do not need the home or LG to be assessed when restoring benefits. However, the Social Worker must verify that the guardianship is still intact and new KG 2 and KG3 forms are completed.

Successor Guardian Assessment (Kin-GAP) (SCZ 1591)

The SCZ 1591 is a DFCS form used to verify that all requirements have been met to establish a successor guardian case.

SCD 1948 Direct Deposit Enrollment Form

Required when an applicant chooses to enroll in Direct Deposit.

 

 

 

Kinship Guardianship Assistance Payment Program