cp 49-055 benefit determinations - Department of Public Social ...

conducted by the district of application can meet CAPI’s face-to-face
requirement, provided the applicant presented acceptable
permanent identification at application. Otherwise, the applicant is to
come into the Wilshire Special District for the eligibility determination
unless physically or mentally unable to do so.
Home calls
Home calls are to be conducted whenever a participant is
homebound or in a residential care facility and unable to come to the
district office. The District Director has the latitude to allow home
calls in other exceptional situations.
Which forms are used to determine CAPI eligibility?
The application forms used to determine CAPI eligibility include:
SAWS 1/
CA 1
MC 210
SOC 451 LA
SOC 453
APPLICATION FOR CASH AID, FOOD STAMPS,
AND/OR MEDI-CAL/STATE CMSP (CW 1)
(English and Spanish versions of this form are user
initiated on LEADER. Other languages are out of
drawer, manually generated.)
STATEMENT OF FACTS (MEDI-CAL)
(English and Spanish versions of this form are user
initiated on LEADER. Other languages are out of
drawer, manually generated.)
CAPI SUPPLEMENTAL APPLICATION
(INCLUDES AN INTERIM ASSISTANCE
REIMBURSEMENT AUTHORIZATION AND A
SHEET ADVISING OF REPORTING
REQUIREMENTS)
(Out of drawer form.)
STATEMENT OF LIVING ARRANGEMENT AND
HOUSEHOLD EXPENSES
(The English and Spanish versions of these forms
are user initiated on LEADER. Other languages are
out of drawer.)
G-845 USCIS - DOCUMENT VERIFICATION REQUEST
(Out of drawer form.)
G-845 USCIS - DOCUMENT Supplement
VERIFICATION REQUEST
(Out of drawer form.)
PA 481
PRIMARY LANGUAGE
(User initiated on LEADER form.)