To speak to someone about behavioral health services, call 888.743.1478. . The Adult Protective Services (APS) program is mandated by the State of California. County Operator General County Information Telephone: Toll Free (888) . font (English), Adolescent (Age 12-17) and Young Adult ASAM Level of Care Screening. Help Count the Unsheltered and Make a Difference. endstream endobj 40 0 obj <>/Subtype/Form/Type/XObject>>stream Former social worker Eric Bahra has been awarded a $2.5 million jury verdict against San Bernardino County. 2. Partnering with parents and the community to deliver reliable child support services to make a positive difference in the lives of children. 0.749023 g If you suspect that a child's health or safety is jeopardized due to abuse or neglect by parents or other caretaker who has custody of the child, contact the appropriate Emergency Response Hotline Number For County Child Protective Services to report the details. %%EOF Request for Second Opinion (Spanish) QM048_S Revised! Requests may be submitted by completing the Request for Judicial Administrative Records Form and sending it to the Court by e-mail or U.S. Mail. 0 0 8.25 9 re Step 2: Fill out your forms completely. Get CA CFS 125 CPS - San Bernardino County 2013-2022 Get form. If not, the site will list the address and phone number of your local courthouse. Network Adequacy Requirements and Deadline (03/01/2018), Updated Authorization to Release Protected Health Info, Child and Adolescent Needs and Strengths (CANS)(PSC-35), UCLA Treatment Perceptions Survey Information (9/20/18), Mental Health Consumer Perception Survey Fall 2018. http://www.childsworld.ca.gov/res/pdf/CPSEmergNumbers.pdf. Enroll my Preschooler in a Head Start Program? Child Protective Services. Helps at-risk children by improving communication, planning, coordination and collaboration between child serving agencies. Read more at CountyWire. Services are provided in person, by phone, online, and by email. The applicant must submit a completed Interior Checklist & Owner Acknowledgement to . Child Welfare Services Child Abuse Hotline Child Abuse Hotline For more information, or to report suspected child abuse, call 858-560-2191. 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). DV, child abuse, sex offender classes Youth Hope, Inc. 255 N. "D" St, Suite 302 San Bernardino 92401 (909)567-2808 Family Service Agency 1661 North "E" Street San Bernardino 92405 (909) 886-6737 Adult classes now offered $20 per class *Contact if Bilingual Services needed Precious Life CES 445 S. Arrowhead Ave Ste. 0 `$ Step 2: A Code Enforcement Officer will conduct an exterior inspection of the property to verify compliance with the County's requirements. Complete the CPS Records Request Form below and fill it out with as much information as possible. 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. Consolidation of Electronic Signature (E-Signature). 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. Disaster Response Requirements (02/01/2017) New! endstream endobj 27 0 obj <>/Subtype/Form/Type/XObject>>stream To submit a form via email, users must first download the form to their device and then click "submit" on the completed form. Standing Order Requirement for Administering NARCAN. Within the State of California you may call toll free 1 (800) 344-6000. Winner of 82 national awards for innovation, efficiency, and public service. Americas largest county. endstream endobj 28 0 obj <>/Subtype/Form/Type/XObject>>stream Box 1409 San Bernardino, CA 92408. However. Assistance with Family law, Child support, Landlord/tenant, and more. The Hotline is contacted when a member of the community has a concern regarding potential abuse or neglect of a child. Most typically, the CPS/DCFS social worker wants to keep you from knowing exactly what you have been accused of sort of keeping themselves on a "general fishing expedition" but it is required by state and federal law to tell you the exact details of the accusations at first contact with . endstream endobj 37 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 31 0 obj <>/Subtype/Form/Type/XObject>>stream Preschool services feeds meals to children. endstream endobj 44 0 obj <>/Subtype/Form/Type/XObject>>stream You will need to pay the fee or submit a Request to Waive Court Fees. endstream endobj 41 0 obj <>/Subtype/Form/Type/XObject>>stream 90&L$S` V: San Bernardino Independent: 36: 150 E Holt Blvd, 3rd Floor, Ontario, CA 91762: 909-458-1637: 909-986-2970: San Diego Independent: 37: 0 0 8.25 8.625 re cps report form san bernardino county. San Bernardino County size in square miles, Incorporated cities in San Bernardino County, Auditor-Controller/Treasurer/Tax Collector, George Air Force Base: Commemorating Its Legacy 30 Years Later Exhibit. 2r\.1K 7 endstream endobj 22 0 obj <> endobj 23 0 obj <> endobj 24 0 obj <> endobj 25 0 obj <>/Subtype/Form/Type/XObject>>stream Box 1359 Susanville, CA 96130-1359 Website Lassen County Health & Social Services Agency Ms. Barbara Longo, Director P.O. He was beaten and burned while in state custody foster "care". Rancho Cucamonga. H*2T0T037U03U(J Please turn on JavaScript and try again. 123 0 obj <>/Filter/FlateDecode/ID[<4E5FEE2E7615B60FE59503200306F587>]/Index[21 218]/Info 20 0 R/Length 225/Prev 152285/Root 22 0 R/Size 239/Type/XRef/W[1 2 1]>>stream Phone : 800.722.3181 Your computer must have the Adobe Acrobat Reader installed in order to view any of these documents.You will need todownload Adobe Acrobat Readerfrom Adobe's website. CFS values collaboration with community agencies and private citizens to accomplish our mission of protecting children and promoting their well-being. endstream endobj 53 0 obj <>/Subtype/Form/Type/XObject>>stream San Bernardino County - Local Forms Downloading & Viewing Directions Your computer must have the Adobe Acrobat Reader installed in order to view any of these documents.You will need to download Adobe Acrobat Reader from Adobe's website. To file a claim against the County please complete the form below, print, sign and H*2T0T007U0332U(J Step 1: Apply online through the County's Portal, and submit the $667 initial application fee. Vice Chairman/Supervisor First District Jesse Armendarez You may be trying to access this site from a secured browser on the server. f If you are interested becoming a volunteer and working with social workers at CFS, please apply at: http://hss.sbcounty.gov/VIP/default.asp VIP CFS brochure 2019.pdf f It is designed to resolve disagreements arising from divorce and legal separation, including provisions for the care of children. )Vice Chairman/SupervisorFirst District, Jesse ArmendarezSupervisorSecond District, Goals and Objectives H*2T0T032U0W(J Call the child abuse hotline at 909-384-9233 (San Bernardino area) or 1-800-827-8724 (outside of San Bernardino). to anonymously report if they suspect a child is being abused. Phone : 909.384.9233 Phone : 800.827.8724 Code Enforcement Hotline The Code Enforcement Division of the Land Use Services Department receives complaints regarding land use, zoning, housing, public nuisances, vehicle abatement, and vegetation or fire hazard abatement. Please enable scripts and reload this page. Substance Use Disorder and Recovery Services, Services Guide, Directories and Resource Library, Children and Youth Collaborative Services (CYCS), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Mandarin), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Spanish), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (VIE), Change of Provider Request Form 18pt. H237402VH2P0P If you do not see the form you need, please check if it can be ordered through the Children's Medical Services Catalog or contact us and we will try to accommodate your request.. 2023 San Bernardino County | . Missing payments increase your amount owed. San Bernardino County Workforce Development Board, Community Policy Advisory Committee (CPAC), Cultural Competency Advisory Committee (CCAC), Behavioral Health Commission (BHC) Meeting is Going Dark. Save or instantly send your ready documents. Information on California Workers' Compensation rights and responsibilities H237402VH2P0P007U332U(JJ*2T0T0\ /"gg$s`*RFpb@. }= Lassen County Community Social Services Department & Children & Family Services Ms. Jenna Ducasse, Director P.O. endstream endobj 38 0 obj <>/Subtype/Form/Type/XObject>>stream 909-484-7667. Get e-mail updates on the latest COVID-19 news. endstream endobj 32 0 obj <>/Subtype/Form/Type/XObject>>stream 21 0 obj <> endobj endstream endobj 47 0 obj <>/Subtype/Form/Type/XObject>>stream Use professional pre-built templates to fill in and sign documents online faster. H*2T0T007 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. 0 0 9 8.625 re endstream endobj startxref endstream endobj 46 0 obj <>/Subtype/Form/Type/XObject>>stream A hotline for impacted residents is open from Monday through Friday, 8 a.m. to 7 p.m. at (909) 356-2563. H*2T0T0342E\\y\FPn.6RBVT+ ,&?(bYY Vb4*LgPr`2GH X, 9974|3/ Wy8L@O q][Wk9URk#w+mr5A! 1425 South "D" Street San Bernardino, CA 92408 (909) 388-5823 (909) 388-5825 FAX MapQuest EMS CREDENTIALING (909) 388-5819 icemacredentialing@cao.sbcounty.gov 7:30 am to 4:00 pm* Help Desk Support This site uses cookies to enhance site navigation and personalize your experience. Below are a few helpful hints on how to navigate . 2. 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. 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