CalWORKs Policy - Department of Public Social Services

Declaration of Paternity, the EW must ensure
that the following is completed:
1. Instruct both parents to complete Section A
and B. Both sections must be legible and
completed in black or blue ink.
2. The EW must complete Section C in black or
blue ink (if not previously witnessed).
3. Print and enter: Los Angeles County, DPSS,
District Location and address including zip
code.
4. Photocopy the completed CS 909 and file on
the left side of the Documentation/Activity
folder. The parents will be given the yellow
and pink copy.
5. Within three (3) workdays of the parent’s
signature, forward the white original and
green copy to the ES.
6. Ensure that the action taken is documented
in “Case Comments”.
ES
1. Ensure the CS 909 is complete and legible.
Within four (4) workdays of the parent’s
signature, forward the original and third copy
of the CS 909 to CSSD Case Initiation
Division, 5701 S. Eastern Avenue
Commerce, Ca 90040, 2nd Floor, Attn: Irma
Rios.
CW 82-510.4 – Non-
Cooperation
How does the CSSD staff inform the EW
when the applicant/participant has not
cooperated?
CSSD staff will update CCSAS when the
participant has not cooperated with a child
support enforcement activity. The information
will be received electronically by LEADER from
CCSAS as follows:
• Approved cases - For approved cases, the
non-cooperation information will be received
by LEADER from CCSAS once CSSD staff
updates CCSAS with the information.