Forms

The forms below are used to monitor compliance and participation in the Vocational Services activities.

SCD 523 - Vocational Services Cooperation Agreement

The form SCD 523 is provided to participants during the individual orientation and initial assessment interview. The participant must agree to cooperate and abide by Vocational Services Program requirements.

VS 30 - Vocational Services Schedule and Appointment

The purpose of the VS 30 form is to keep track of the next scheduled appointment date.

The EC:

Provides VS 30 to participants at every return appointment
Reminds participants of future activity due dates.
Informs the participant to obtain a date stamp from GA clerical staff on the VS 30 when submitting required documents, to be used as a receipt.

VS 9 - Vocational Services Activity Time Sheet

The purpose of the VS 9 is to inform participants of their assigned workfare details. Participants must provide work site supervisors with this form to be signed. Once assignment is complete, the participant must submit the completed VS 9 to VS staff, so the number of hours worked can be entered into VSAS for monitoring participant compliance.

EC
1. Provides participants with a VS 9.
Participant
1. Submits the VS 9 form to the designated VS clerk by the due date, but no later than the last business day of the month.
Clerical
1. Receives the VS 9 from the participant.
  1. Review the VS 9 for completion, including the correct number of hours
  2. Date stamps the VS 9.
2. If VS 9 is complete
  1. Enters the date the VS 9 was received and records the hours the participant worked into VSAS Activity Data Entry window
  2. Forwards the VS9 to Imaging
3. If the VS 9 is Incomplete or late
  1. Has the participant sign the OD log
  2. Calls the EC Officer of the Day (OD) for a "good cause" determination
    1. NOTE: If the participant refuses to meet with the OD, then clerical will stamp the form with office stamp "Declined to see OD" and cause determination is not made.
The EC OD:
1. Reviews and discusses the "incomplete/late" form with the participant.
2. Requests for verification and determines good cause as appropriate.
3. If good cause is grant, enters information into VSAS.
4. If good cause is not granted, informs the participant that benefits may be discontinued and Fair Hearing appointment will be mailed.
5. Adds Journal entries in CalSAWS and in VSAS [Narrative] tab.
6. Forwards form to clerical for data entry along with any supporting documents to IDM.

VS 1527 - Vocational Services Job Search Verification

The form VS 1527 is used to monitor the required number of job searches.

VS Clerical
1. Upon receiving the form from the participant:
  1. Date stamps the VS 1527
  2. Reviews for completion and accuracy, including the correct number of job search contacts.
  3. Checks for EDD contacts.
2. Enters the following information into VSAS:
  1. The date the form was submitted, and
  2. The number of contacts reported.
  3. If Job Search requirements are met, then the VS 1527(s) is scanned to Imaging.
  4. If Job Search requirements are not met, and/or the VS1527 is submitted late, then the VS 1527 must be given to the EC OD for a good cause determination.
EC OD
1. Reviews and discusses the form with the participant.
2. Requests verification and determines good cause as appropriate.
3. If good cause is granted, enters information in VSAS.If good cause is not granted, informs the participant that benefits may be discontinued and Fair Hearing appointment will be mailed.
4. Forwards form to clerical for data entry, and any supporting documents to Imaging.

VS 68 - Monthly Attendance Report

This form must be submitted on a monthly basis (by the fifth working day of the following month) to Vocational Services for Education and Vocational Training activities. This form is obtainable through the VSAS application.

CSF 152 - General Assistance/General Relief (GA/GR) Supportive Services

Participant receiving transportation payment must be provided with a “General Assistance/General Relief (GA/GR) Supportive Services Notice” (CSF 152) with every transportation allowance issued. This form is obtainable through CalSAWS.

SCD 2570 - Vocational Services - Supportive Services Payment Related Expense Certification

The form SCD 2570 explains the purpose of the payment issuance and certifies that the participant must use the payment for its intended purpose. The SCD 2570 must be signed by the participant prior to the payment issuance. A copy of the signed form must be issued to the participant and sent for Imaging.

SCD 1400 - General Assistance Program - Request For Medical Information

This form is provided to participants who are unable to work and need exemption from participation in Vocational Services activities. The participant must have the SCD 1400 completed and signed by the health care provider. The form must be returned to the Eligibility Worker by the due date.

Note: The SCD 1400 replaces the "Appointment Notice for Medical Verification" form (GA 919).

VS 001 - Vocational Services Appointment Notice

This form VS 001 is to be provided to participants with information on their next appointment with Vocational Services. The form indicates the type of appointment and the documentation required (if any).

GA 53 - Eligibility Worker/Vocational Services Communication

This form GA 53 is used by Eligibility Workers and Vocational Services Employment Counselors as a way of communicating information pertinent to the participant in common. The forms must be scanned in IDM.

GA 40 - General Assistance Administrative Review by Director

This form GA 40 is completed by Vocational Services participants to request an Administrative Review when they disagree with the decision made by the Fair Hearing Officer. The request must be filed within 15 days after notification of the decision made by the Fair Hearing Officer.