Strives to protect endangered children, preserve and strengthen their families and develop alternative family settings. Former foster youth perseveres, becomes veterinarian. endstream endobj 48 0 obj <>/Subtype/Form/Type/XObject>>stream E\\y\Fz0\.S=3H!C 9 Request for Second Opinion (Spanish) QM048_S Revised! f 9445 Fairway View Place, Suite 110 Rancho Cucamonga, CA 91730 909-948-6200. It looks like your browser does not have JavaScript enabled. endstream endobj 51 0 obj <>/Subtype/Form/Type/XObject>>stream If you have hardcopy documents you would like to have included in the investigation you may download a printable copy of this online form here, attach those documents and mail or Fax it to us at: 909-252-4359. Step 2: Fill out your forms completely. Thank you for the opportunity to assist you! endstream endobj 31 0 obj <>/Subtype/Form/Type/XObject>>stream . The San Bernardino County Department of Child Support Services determines paternity, establishes and enforces child support orders, and secures payments to assist the financial and medical needs of their children. First 5 San Bernardino (909) 387-7706 Fishing (909) 38-PARKS: Fleet Management (909) 387-7870: Flies . get answers. Covering 20,105 square miles, San Bernardino County is Americas largest county and a diverse public service organization governed by an elected Board of Supervisors and serving a community of nearly 2.2 million residents. endstream endobj 33 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 49 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 47 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 43 0 obj <>/Subtype/Form/Type/XObject>>stream As a team, Human Services departments collaborate with community partners to provide a wide range of quality programs and services that address the changing and emerging needs of county residents. 2: Ask what the accusations and charges are. WHITE COPY-Police or Sheriff's Department; BLUE COPY-County Welfare or Probation Department; GREEN COPY-District Attorney's Office; YELLOW COPY-Reporting Party SS 8572 (12/02) Page 2 of 2 Title Ergonomic Assessment Level (12/12/2018) New! endstream endobj 50 0 obj <>/Subtype/Form/Type/XObject>>stream 0.749023 g endstream endobj 32 0 obj <>/Subtype/Form/Type/XObject>>stream CFS values collaboration with community agencies and private citizens to accomplish our mission of protecting children and promoting their well-being. Request Public Records Preschool services feeds meals to children. 0 If you feel you have a claim against the County, we encourage you to first attempt Enhances the quality of life in the community by administrating support programs to persons in need of financial, nutritional and/or medical assistance while working with families and individuals to attain self-sufficiency. http://www.childsworld.ca.gov/res/pdf/CPSEmergNumbers.pdf. 0 0 7.125 7.125 re 1. This site uses cookies to enhance site navigation and personalize your experience. If you suspect that a child has been, or is in danger of, abuse or neglect , contact the county Children's Protective Services 24-hour emergency response phone. DCS 125 CPS (7/04) Author: L1634 Try it now! Phone : 800.722.3181 2018 Superior Court of California, County of San Bernardino, All Rights Reserved |, COVID-19: COURT OPERATIONS DURING THE COVID-19 PANDEMIC, Family Court Services Orientation Class Info, Failure to Appear/Respond to a Jury Summons, Court Case Information and Document Sales, How to Navigate San Bernardino Superior Court, San Bernardino Superior Court Rules of Practice, Local Emergency Rules Related to COVID-19, Online Form Preparation and Filing (TurboCourt), Online Form Preparation and eFiling (TurboCourt), Stipulation For Settlement (CCP 664.6) (fillable), Proof of Service Notice of Appeal (Code Enforcement), Appeal Procedures for Unlimited Civil Cases (Information on), Declaration of Petitioner and Request for Records Check, General Civil Case At-Issue Memorandum (fillable), Declaration and Order Re: Satisfaction of Judgment, CONFIDENTIAL Referral for CII/Carpos/ICMS Report (Civil) - Form A, Order Request for Review of Denial of Request to Remove Name from Gang Database, Initial Trial Setting Conference Statement, Application for Diversion of Individual with Mental Disorder, Order on Application for Diversion of Individual with Mental Disorder, Declaration and Order for Release of Exhibits, Consent to Bring Prohibited Items into the Courthouse as Exhibits (fillable), Stipulation And Order On Request For Order, Referral for CII/CARPOS/ICMS Report (fillable), Family Law At-Issue Memorandum for Trial Setting, Declaration And Order For Issuance Of Writ Of Execution/Abstract Of Judgment (fillable), Order On Petition For Grandparent Visitation, Response To Petition For Grandparent Visitation, Declaration Re: Compliance with Custody Orders (fillable), Petition for Declaring Child(ren) Free from Parental Custody and Control, Citation - Freedom from Parental Custody and Control, Order Declaring Child(ren) Free from Parental Custody and Control, Order on Petition to Terminate Parental Rights of Alleged Father, Petition to Terminate Parental Rights of Alleged Father, Declaration and Order Dispensing with Notice to Alleged Father, Petition to Obtain Original Unsealed/Un-Redacted Birth Certificate, Order on Petition to Obtain Original Unsealed/Un-Redacted Birth, Order on Petition for Birth Record Information, Application to Obtain Final Adoption Order and Order, Application to Obtain Copies from Adoption Case and Order, Petition for Adoption of Adult or Married Minor, Agreement of Adoption of Adult or Married Minor, Consent of Spouse of Adult or Married Minor to be Adopted, Stipulation for Entry of Judgment Re: Establishment of Parental Relationship, Order for Publication of Citation (Adoption), Application for Order for Publication of Citation (Adoption), Notice of Continuance of Hearing (Family Law), Declaration Regarding Objection to Agreement, Family Law/Child Support Copy Request Form, Affidavit/Certificate/Declaration Re: Military Service in an Adoption and Related Matters, Order for Publication of Summons or Citation, Application for Publication of Summons or Citation, Request for Dismissal -- Small Claims Cases, Declaration of Mailing or Inability to Ascertain Address (fillable), Request to Excuse Notice with Due Diligence Declaration, Audio CD Information Sheet and Order Form, Petition for Release of Jury Records and Order, Objection/Response to Packet (Delinquency), Objection/Response to Packet (Dependency), Certification of Competency (Delinquency), Response to Petition for Resentencing (Juvenile), Proof of Service - Juvenile Restraining Order, Ex Parte Application And Order To Serve Summons By Posting, Application for Judgment for Restitution of Premises Only (CCP1169) (fillable), Pretrial Orders Judgment By Court Unlawful Detainer (fillable), To Set Case for Trial - Unlawful Detainer, Application for Issuance of Writ of Execution Per CCP 712.010, Small Claims/Landlord Tenant Copy Request Form, Order Appointing Counsel For Conservatee, Probate Code Sections 1470, 1471, and 2356.5(f)(1), Petition for Visitation (Guardianship Cases Only), Order on Petition for Visitation (Guardianship Cases Only), Order Appointing Counsel For Minor, Probate Code Sections 1470 and 1516.5 (fillable), Notification of Court of Conservatorship Address, Confidential Guardianship Questionnaire and Authorization for Release of Information, List of Required Contact Information for Conservatorships, Optional Attachment to List of Required Contact Information for Conservatorships, Confidential General Care Plan of Conservatee, Ex Parte Petition to Dispense with Accounting and Order (fillable), Request for Deferment of Court Investigator Fee and Order, Affidavit to Comply with California Probate Code 13100-13115, Termination of Guardianship - Parent Questionnaire, Notification of Disqualification from Voting, Notice of Commencement of Proceedings for a Court Supervised Trust, Confidential Information Sheet - Conservatorship, Confidential Information Sheet - Guardianship, Confidential Information Sheet - Intestate Probate, Confidential Information Sheet - Testate Probate, Confidential Information Sheet - Trust Matters, Request for Consideration of Ability to Pay, Waiver of Arraignment & Court Trial Setting. APS - Central Intake. Once completed, the request form may be emailed (preferred method) as an attachment to CPSGatekeeper@saccounty.gov . endstream endobj 26 0 obj <>/Subtype/Form/Type/XObject>>stream `AS`8W!L$T1R1!PE b@. T endstream endobj 53 0 obj <>/Subtype/Form/Type/XObject>>stream San Bernardino County residents can dial. Tell us what you think about the new website. of Industrial Relations web site. H237402VH2P0P 0 0 8.898 8.899 re Report by phone: (877) 605-2321. Claim Against County of San Bernardino (pdf) County of San Bernardino Employees If you need to file a claim for Workers' Compensation please report to your supervisor for appropriate follow-up and related document completion. The San Bernardino County District Attorney's Office serves the residents, business owners, and visitors of San Bernardino County, California. A hotline for impacted residents is open from Monday through Friday, 8 a.m. to 7 p.m. at (909) 356-2563. San Bernardino, CA 92415. E\i\\ Children and Family Services (CFS) is a department within San Bernardino County dedicated to protecting and promoting the well-being of abused, neglected or exploited children in our county. H*2T0T032U0W(J Box 1409 San Bernardino, CA 92408. Registration process. Change of Provider Request Form - 18pt. Help Count the Unsheltered and Make a Difference. 1. Substance Use Disorder and Recovery Services Policy, Substance Use Disorder and Recovery Services Procedure, Naloxone Intranasal Distribution Procedure, Client Tuberculosis (TB) Testing and Services Policy, Client Tuberculosis (TB) Testing and Services Procedure, myAvatar Electronic Health Records Policy, myAvatar User Account Creation and Reinstatement Procedure, myAvatar User Account Modification Procedure, myAvatar User Account Deactivation Procedure, Criteria for Beneficiary Access to SMHS Medical Necessity and other Requirements, No Wrong Door for Mental Health Services Policy, Revised Mental Health Co-Staffing Chart Documentation a, Personal Protective Equipment (PPE) for DBH Programs, Quality Management Chart Documentation Guidance due to, New Classification of Other Qualified Providers, Coronavirus (COVID-19) Information for DBH Workforce, Mental Health Consumer Perception Survey Spring 2019, DMC-ODS UCLA Treatment Perception Survey-October 2019, Notice of Changes to EPSDT Data Collection Requirements, Editing Notice of Adverse Benefit Determination (NOABD). Complete CA CFS 125 CPS - San Bernardino County 2013-2022 online with US Legal Forms. H237402VH2P0P037U03U(JJ*2T0T0BC#S\.1* e Winner of 82 national awards for innovation, efficiency, and public service. The reporter's identity is confidential, but a name should be given so the Department could follow-up contact with the reporter if necessary. This form documents the information given by the reporting party on the suspected incident of abuse or neglect of an elder or dependent adult. Employment Information and Recruitment Videos. 0 0 6.75 7.5 re However. endstream endobj 40 0 obj <>/Subtype/Form/Type/XObject>>stream Take a look back at San Bernardino Countys major accomplishments in 2022, Homeless to Home, a road to self-sufficiency. You may be trying to access this site from a secured browser on the server. Reports of suspected child abuse or neglect shall be made by mandated reporters to any police department or sheriffs department (not including a school district police or security department), the county probation department (if designated by the county to receive mandated reports), or the county welfare department. Box 1359 Susanville, CA 96130-1359 Website Los Angeles County Department of Children & Family Services endstream endobj 54 0 obj <>/Subtype/Form/Type/XObject>>stream County Budget San Bernardino County Workforce Development Board, Community Policy Advisory Committee (CPAC), Cultural Competency Advisory Committee (CCAC), Behavioral Health Commission (BHC) Meeting is Going Dark. PURPOSE OF FORM This form, as adopted by the California Department of Social Services (CDSS), is required under Welfare and Institutions Code (WIC) Sections 15630 and 15658(a)(1). COVID-19: COURT OPERATIONS DURING THE COVID-19 PANDEMICRevised 5/2/2022 - 9:32 am. 11-22, Affordable Care Act (ACA) 1557 Grievance Procedure, Behavioral Health Services for Clients/Family, Field Testing of Written Materials Policy, Field Testing of Written Materials Procedure, Providing Interpretation Services Procedure, Providing Written Communications in Threshold/Primary Languages for Consumers/Family Members Policy, Incorporated Employees Fiscal Control Procedures, Guidelines For Psychiatrists Assigned to Outpatient Clinics, Deviation from Standard of Practice of Medicine, Control, Access and Accountability of Medications and Medical Supplies Policy, Control, Access and Accountability of Medications and Medical Supplies Procedure, Controlled Substance Utilization Review and Evaluation System (CURES) Policy, Controlled Substance Utilization Review and Evaluation System (CURES) Procedure, Handling of Contaminated Waste/Needles and Syringes, Consent for Administration of Psychotropic Medication to Minors Policy, Laboratory Services/Physical Assessment Policy, Laboratory Services/Physical Assessment Procedure, Medication Authorization for Dependent Children and Youth Policy, Urgent and Emergency Conditions Procedure, Control and Organization of the Standard Practice Manual (SPM) Policy, Requests to Modify Standard Practice Manual Procedure, Department Vision, Mission and Values Policy, Public Information and Media Release Policy, Reimbursement for Travel and Related Expenses, Use of Supplies and Equipment/Notification of Loss or Damage, Furniture and Equipment Relocation Procedure, Assignment of Pagers to Divisions/Programs and Staff, Facility Physical Security and Access Control Policy, Facility Physical Security and Access Control Procedures, Billing and Collection for Treatment Services Policy, Guidelines for Promotional, Educational, and/or Informational Materials, DBH Review Panel for Promotional, Educations, and/or Informational Materials, Review of Promotional, Educational and/or Informational Materials Procedure, Assignment, Closure, Merger or Relocation of Clinics Policy, Closure of DBH Contract Provider Procedure, Assignment of DBH Contract Provider Procedure, Merger of DBH Contract Provider Procedure, Medi-Cal Claim Certification of Authenticity Policy, Intra-Department Reassignment Policy (Supersedes-Employee Reassignment Requests), Waiver for Pre-Licensed/Out-of-State Licensed Ready Psychologists, Registration and Licensure Requirements for Clinical Therapists, Volunteer Request and Registration Procedure, Non-Discrimination / Equal Employment Opportunity, Time and Attendance Form How to Complete, Position Transfer Reassignment & Borrowing Policy, Position Transfer Reassignment & Borrowing Procedure, Procedure for Purchasing Computer Equipment, Request for Information Technology Support Procedure, Computer and Network Appropriate Use Policy, Superseded by myAvatar User Account Creation and Reinstatement Procedure, QShort-Doyle and Short-Doyle/Medi-Cal Clinic Change of Ownership or Location, Requesting an Initial Choice of Provider or Change of Provider Procedure, Requesting an Initial Choice of Provider or Change of Provider Policy, Quality Management Committee Membership/Participation, Pre State Chart Audit Responsibilities & Procedures, Billing Guidelines for Quality Assurance Activities, Outpatient Chart Audit Site Review Policy, Investigating and Reporting Death of a DBH Client, SAMHSA Block Grant-Annual Program Review Procedure, Standard and Expedited Resolution of Appeals Procedure, Consistency in Inpatient and Outpatient Utilization Review and Authorization Practices Policy, Consistency in Inpatient Utilization Review and Authorization Practices Procedure, Consistency in Outpatient Utilization Review and Authorization Practices Procedure, MHP Point of Authorization Plan for Inpatient Psychiatric Hospitalization Protocol, Selection and Retention of Network Provider Policy, Department Liability for Employees and Volunteers Action Outside Work, Electrical Safety Policy: Personal Appliances, Threats Against Federal or State Officials Policy, Threats and Assault on DBH Staff Procedure, Special Incident Reporting Procedure Client Related, Occupational Injury or Illness Reporting Procedure, Local Community Crisis Incident Response Procedure, Office Ergonomics Intervention Program Policy, Interagency Communication of Unusual Events Procedure. 53 0 obj < > /Subtype/Form/Type/XObject > > stream San Bernardino County residents can dial 2T0T0BC # *. 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