Find your local county office. Step 2: Fill out your forms completely. I am an older adult and need help taking care of myself. To speak to someone about behavioral health services, call 888.743.1478. Americas largest county. III. This site uses cookies to enhance site navigation and personalize your experience. Follow the installation instructions on Adobe's web site to properly install and configure the Acrobat Reader. (PC Section 11165.9.) A ^ Get the free san bernardino county children and family form cfs 125 cps 2014-2022. . Use Arrears calculator to figure out balance. 0 k Enroll my Preschooler in a Head Start Program? Other useful information can be accessed from the menu by clicking the links to a variety of topics. 909-484-7667. There are no geographic restrictions. You will need to pay the fee or submit a Request to Waive Court Fees. Mail the completed SS 8572 form to: Child Abuse Hotline P.O. To download a form (in PDF format), click on the form number in the appropriate table. Application to Determine CCS Program Eligibility (DHCS 4480, 01/22) 0 0 6.75 7.5 re 0.749023 g Office Configuration Safety Standards (12/18/2018) New! It looks like your browser does not have JavaScript enabled. endstream endobj 46 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 26 0 obj <>/Subtype/Form/Type/XObject>>stream Assistance with Family law, Child support, Landlord/tenant, and more. Within the State of California you may call toll free 1 (800) 344-6000. and at-risk adults in our county. H4 07M% HR>pRY=^Xqd wy0` S. 90&L$S` V: SAN BERNARDINO COUNTY CHILD AND FAMILY SERVICES - CHILD PROTECTIVE SERVICES The program provides child protective services for San Bernardino County. 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. f`a3p8WDT!"kg```P5Bsr Please enable scripts and reload this page. 0 0 7.125 7.125 re #D San Bernardino , San Bernardino 92415 (Physical) Get directions Site Hours Monday through Sunday, 24 hours per day. The forms may be posted on their site. Preschool services feeds meals to children. He was beaten and burned while in state custody foster "care". endstream endobj 53 0 obj <>/Subtype/Form/Type/XObject>>stream The Social Security Administration (SSA), Office of the Inspector General (OIG). 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. New Medicare Beneficiary Identifier (MBI) New! H*2T0T032f@(++5167UKZ y9\PP9#D1W @ ch CFS works to prevent further harm to children from physical or mental injury, sexual abuse, exploitation, or neglect. Final settlement reached in San Bernardino Jail Class Action - San Bernardino County Sheriff's Department December, Headquarters, Press Releases for 2018 FOR IMMEDIATE RELEASE FINAL SETTLEMENT REACHED IN SAN BERNARDINO JAIL CLASS ACTION Contacts: Public Affairs Division, Sheriff's Department Public Affairs Division (909) 387-3700 Read more at CountyWire. Former social worker Eric Bahra has been awarded a $2.5 million jury verdict against San Bernardino County. endstream endobj 41 0 obj <>/Subtype/Form/Type/XObject>>stream The departments mission is to work in the partnership to promote and improve health, wellness, safety and quality of life. Take a look back at San Bernardino Countys major accomplishments in 2022, Homeless to Home, a road to self-sufficiency. Y"]FjsIodfDxtg0*w*iK vx5Y}p xSm >{TfB@o|H5Kaw0d:4{NCNl(~hY)_^.cmY9qjO c H237402VH2P0P32UT(JJ*2T0T0D|3@.XHT! % 1. Information on how to report child abuse or make complaints. 2307rYF H237402VH2P0P0342E\i\\ Child Abuse Hotline (800) 827-8724 Child Abuse Prevention/Safe Kids (909) 383-9677: Child and Family Health . Get e-mail updates on the latest COVID-19 news. 0.749023 g Services. f Helps at-risk children by improving communication, planning, coordination and collaboration between child serving agencies. 1435 0 obj <>/Encrypt 1346 0 R/Filter/FlateDecode/ID[<335AAE7A7B830041B320609C06D4D458><59DEEA9921E0A542ADF5998D03769A5E>]/Index[1345 242]/Info 1344 0 R/Length 160/Prev 807907/Root 1347 0 R/Size 1587/Type/XRef/W[1 3 1]>>stream 0.749023 g Our DIRECT LINE: 1-929-277-7848 to begin today your POWER-session 1-on 1 (Ext.806) Help Form (go to sue cps main site) www.SUECPS.weebly.com or fill out right on this informative site.. Lawyers sadly per state,are not caring enough to file.. endstream endobj startxref First time applicants can access helpful information on how to get started by clicking "Applicant Information" in the menu drop down. A hotline for impacted residents is open from Monday through Friday, 8 a.m. to 7 p.m. at (909) 356-2563. Standing Order Requirement for Administering NARCAN. endstream endobj 43 0 obj <>/Subtype/Form/Type/XObject>>stream Box 6083 San Bernardino, CA 92412 Fax the completed SS 8572 form to: Children and Family Services at (909) 891-3545 or (909) 891-3560 (Courtesy of Eric Bahra) Two children disclosed that the foster father had sexually . provides an avenue for reporting fraud, waste, and abuse within SSA's programs and operations. To submit a form via email, users must first download the form to their device and then click "submit" on the completed form. 0 0 8.25 9 re Please enable scripts and reload this page. 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). *{Dt8P *7,Jccd0%m3lz%tDE}vdYiBiplo+4 hbbd```b``" 0i"H`s.8C>nf"Ynu8X8=L?jd &7$+: ,"y3L`qQr&):w4"3p vkJ4 send to the address listed on the form. Col. Paul Cook (Ret. The Department of Children and Family Services encourages everyone to report suspected child abuse and neglect, however, certain professionsare mandated to report suspected child abuse and neglect. `Sp8WrU B 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. This form documents the information given by the reporting party on the suspected incident of abuse or neglect of an elder or dependent adult. CFS receives and reviews allegations of child abuse and neglect made within San Bernardino County and provides intervention and support services to families and children when those allegations are substantiated. This year, San Bernardino County settled a lawsuit for $7.5 million in a case that alleged that a county social worker was aware of sexual abuse in the foster care system and failed to report it. Child Abuse Reporting Policy: 05/13/2021 CHD0303 Child Abuse Reporting Procedure . endstream endobj 22 0 obj <> endobj 23 0 obj <> endobj 24 0 obj <> endobj 25 0 obj <>/Subtype/Form/Type/XObject>>stream 2\`q#=csS&c. E\i\\ 1425 South "D" Street San Bernardino, CA 92408 (909) 388-5823 (909) 388-5825 FAX MapQuest EMS CREDENTIALING (909) 388-5819 icemacredentialing@cao.sbcounty.gov 7:30 am to 4:00 pm* Help Desk Support when an social worker,caseworker at CPS has clearly undermine her family for 8 years & others. 2. Winner of 82 national awards for innovation, efficiency, and public service. for appropriate follow-up and related document completion. 238 0 obj <>stream CFS values collaboration with community agencies and private citizens to accomplish our mission of protecting children and promoting their well-being. 0 0 8.898 8.899 re Substance Use Disorder and Recovery Services, Services Guide, Directories and Resource Library, Children and Youth Collaborative Services (CYCS), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Mandarin), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Spanish), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (VIE), Change of Provider Request Form 18pt. http://www.childsworld.ca.gov/res/pdf/CPSEmergNumbers.pdf. endstream endobj 45 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P007U332U(JJ*2T0T0\ /"gg$s`*RFpb@. }= Get ready-made fillable templates for faster form filing and decrease human errors. 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. Mental Health Consumer Perception Survey-Fall 2019 New! 2023 San Bernardino County | . endstream endobj 38 0 obj <>/Subtype/Form/Type/XObject>>stream Rancho Cucamonga. hb```e``0i% X8 99p0P0]3 D+Zd NU*0C!UC `AS`8W!L$T1R1!PE b@. T Welcome to the County of San Bernardino Human Services' website. 0 0 9 8.625 re Request for Second Opinion Procedure QM6053-1 New! California Family and Domestic Violence Referral Directory. 24 Hour Hotline 1-877-565-2020 : Video Announcements. 0.749023 g Strives to protect endangered children, preserve and strengthen their families and develop alternative family settings. Records of San Bernardino County which are not exempt from disclosure are available for inspection and copying in accordance with the California Public Records Act upon a request that reasonably describes an identifiable record or records. 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. Contact us to help you find a path to a $0 balance. If you are struggling with a juvenile matter involving CFS in San Bernardino or CPS in Riverside, The Haynes Law Firm, APLC is available to provide a consultation regarding your case. For your convenience, virtual interviews are available. Step 2: A Code Enforcement Officer will conduct an exterior inspection of the property to verify compliance with the County's requirements. 1345 0 obj <> endobj font (English), Adolescent (Age 12-17) and Young Adult ASAM Level of Care Screening. 2023 San Bernardino County | Department of Behavioral Health | Privacy Policy | Accessibility | Newsletter Sign-up | Site Map. Reports of suspected child abuse or neglect shall be made by mandated reporters to any police department or sheriffs department (not including a school district police or security department), the county probation department (if designated by the county to receive mandated reports), or the county welfare department. get answers. %%EOF Health and Human Services Public Safety and Justice Community Services Recreation and Culture Government Services Board of Supervisors Col. Paul Cook (Ret.) You may be trying to access this site from a secured browser on the server. Serves veterans and their families and ensure they receive the benefits they have earned. f Resource Parents are often called upon to provide information to the child protective services worker, as well as to testify in court. endstream endobj 49 0 obj <>/Subtype/Form/Type/XObject>>stream County Job Descriptions and Salaries Thank you for the opportunity to assist you! https://www.sbcounty.gov/uploads/DCSS/Videos/Parenting%20Eng%20Sub.mp4, Order/Notice to Withhold Income for Child Support (FL-195). The appropriate county CWS agency is the county, in which, the child resides. IU#q4QCP"@y2P[{[SI(1Yr=MOS`z1 Q`R)d\zOH45|6s5K1)==Aw,13#fR;di$a')0yhLXavVBLjU"5=%PAKaa .IkTf8,MkH63PrQ`5A6LgjZbiT-sIjb$Ujrp[-Dem2S+mL#9by6MZ,U1ejXlFe4&mtN. The reporter's identity is confidential, but a name should be given so the Department could follow-up contact with the reporter if necessary. Lassen County Community Social Services Department & Children & Family Services Ms. Jenna Ducasse, Director P.O. County Code and Charter solicitors license in ca in san bernardino county form County of San Bernardino Clerk of the Board of Supervisors ND 385 N. Arrowhead Avenue, 2 Floor, San Bernardino, CA 92415-0130 (909) 387-3841 Fax (909) . "San Bernardino County [and] CPS are on notice," Carter warned. endstream endobj 31 0 obj <>/Subtype/Form/Type/XObject>>stream It is designed to resolve disagreements arising from divorce and legal separation, including provisions for the care of children. The legal intervention of child welfare agencies, through the judicial (court) system, to protect children and families. The applicant must submit a completed Interior Checklist & Owner Acknowledgement to . f 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. '/*{2 Kl,f9%22Yxr - |Fe w} 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 Child Abuse Hotline for San Bernardino County is 1 (800) 827-8724 Child Protective Services (CPS) Hotlines: CPS Hotlines for all 58 counties in California. Contact Us Visit Website View Profile. *CASES IN SAN BERNARDINO COUNTY* Please review the following San Bernardino County sample forms: Form CFS 2w -Grievance Procedures Regarding Placement, Care and Removal of Children Form CFS 7D - Notice of Removal and Grievance Review Request (fill out second page to request a grievance review hearing). 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. Find substance use disorders and/or alcohol recovery services? 2r\.1K 7 Get access to thousands of forms. 0 0 6.75 7.5 re Use professional pre-built templates to fill in and sign documents online faster. All Forms Assessor Forms Recorder Forms County Clerk Forms All Assessor-Recorder-Clerk Forms Show entries Search: Showing 1 to 10 of 147 entries Previous 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 0 8.25 8.625 re Child Abuse Hotline for San Bernardino County is. San Bernardino, CA 92415-0640 (909)891-9019 . 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. e-Prescribing Chart Documentation (12/07/2016) New! These 24-hour Hotlines are staffed by trained social workers. can be found on the State of California's, Department Winner of 82 national awards for innovation, efficiency, and public service. Welcome to San Bernardino County America's largest county. 2\`q#=csS&c. font (Spanish), SUDRS-MH Grievance and Appeals Process Brochure-18pt. Read the instructions on the back of the form or on the web site for information on how to fill it out. For graffiti abatement, call 1.877.442.2283. Our Family Court division is committed to the processing and management of all domestic matters with integrity, sensitivity and timeliness. Call 877.410.8829 Live agents are available Monday-Friday from 7 a.m. - 5 p.m. Stay informed with new authentication options! The Court Executive Office's hours are 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding court holidays. Request for Second Opinion (Spanish) QM048_S Revised! Form Number Description Revised Date; SB-598: Settlement Conference Brief: 09/17/13: SB-12039: Stipulation And Order On Request For Order: 11/05/12: SB-19447 2rLr2Fz@2"c. San Bernardino County Workforce Development Board, Community Policy Advisory Committee (CPAC), Cultural Competency Advisory Committee (CCAC), Behavioral Health Commission (BHC) Meeting is Going Dark. Report Suspected Child Abuse or Neglect 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 child protective services agency in your county. To file a claim against the County please complete the form below, print, sign and This automated system provides customers with up-to-date information about their case such as benefit amount, worker information, office location and the ability to request forms to be mailed. Save or instantly send your ready documents. to resolve your issue through the complaint resolutions listed on the right. "My kids are damaged in your careand still you are holding my kids hostage. endstream endobj 39 0 obj <>/Subtype/Form/Type/XObject>>stream In alignment with the Countywide Vision to create a county in which those who reside and invest are able to prosper and achieve well-being, Human Services works to build a healthy community by strengthening individuals and families, enhancing quality of life and valuing people. Tell us what you think about the new website. f endstream endobj 36 0 obj <>/Subtype/Form/Type/XObject>>stream H*2T0T007 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. Employment Information and Recruitment Videos. font (Spanish), Opioid Agreement for Buprenorphine Medication Assisted Treatment (Spanish), Opioid Agreement for Buprenorphine Medication Assisted Treatment (English), Beneficiary Nondiscrimination Notice (Mandarin), Beneficiary Nondiscrimination Notice (Vietnamese), Your Rights Attachment (NOABD) (Mandarin), Your Rights Attachment (NOABD) (Vietnamese), Change of Provider Request Form 18pt. Box 1359 Susanville, CA 96130-1359 Website Lassen County Health & Social Services Agency Ms. Barbara Longo, Director P.O. San Bernardino County is comprised of more than 40 departments and agencies staffed by more than 25,000 public service professionals providing a wide range of vital services in areas that include public safety, health and human services, economic development, housing, recreation, and culture. Child Welfare Services Child Abuse Hotline Child Abuse Hotline For more information, or to report suspected child abuse, call 858-560-2191. Mental Health and Alcohol and Drug Services Agency Evaluation, Timely Access Notice (NOABD) (Vietnamese), Mental Health Plan (MHP) to Medi-Cal Plan (MCP) Referral Form For Non Open Cases, Financial Liability Notice (NOABD) (Spanish), Financial Liability Notice (NOABD) (Mandarin), Financial Liability Notice (NOABD) (Vietnamese), myAvatar Program Assignment (Mental Health), myAvatar Program Assignment (Mental Health)(Spanish), myAvatar Initial Contact Form (Mental Health, myAvatar Initial Contact Form (Mental Health) (Spanish), Authorization to Release Protected Health Information (PHI), Authorization to Release Protected Health Information (PHI) (Spanish), Authorization to Release Protected Health Information (PHI) (Vietnamese), Code of Conduct and Code of Conduct Acknowledgement, Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices, Certification Review Hearing Waiver of Presence, Outpatient Treatment Reauthorization Request for Adults, List of Disclosures of Protected Health Information (PHI), Consent for Outpatient Treatment (Spanish), Consent for Outpatient Treatment (Vietnamese), Medical Care Authorization for Minor (Spanish), Consent for Sound and/or Photographic Recordings, Consent for Sound and/or Photographic Recordings (Spanish), Consent to Record and/or Photograph and Authorization for Use or Disclosure, Consent to Record and/or Photograph and Authorization for Use or Disclosure (Spanish), Conflict of Interest Disclosure Statement, Access to Medical Records Request (Spanish), Response to Request to Access Medical Records, Response to Request to Access Medical Records (Spanish), Request to Amend Protected Health Information (PHI), Request Request to Amend Protected Health Information (PHI) (Spanish), Response to Request to Amend Protected Health Information (PHI), Response to Request to Amend Protected Health Information (PHI) (Spanish), Internal Tracking of Request to Access Medical Records, Release of Information: Patients Right of Access to His/Her Own Medical Record, Release of Information: Patients Right of Access to His/Her Own Medical Record (Spanish), Advance Health Care Directive (Brochure) (Spanish), Advance Health Care Directive (Brochure) (Vietnamese), Privacy and Security Agreement Confidentiality Statement, Ineligible Persons Policy Acknowledgement and Attestation, Attestation Regarding Completion of Sanction Checks, Electronic Signature Agreement and E-Signature and Provider Signature List, DBH & BBS Complaint Notifications to Clients (8-20), DBH & BBS Complaint Notifications to Clients (8-20) (Spanish), myAvatar Policy/Procedure Acknowledgement Form, Patients Rights Grievance Form (Spanish), Patients Rights Office Grievance Appeal Form, Patients Rights Office Grievance Appeal Form (Spanish), Request for Restriction of Confidential Communication, Request for Restriction of Confidential Communication (Spanish), Response to Request for Restriction of Confidential Information, Response to Request for Restriction of Confidential Information (Spanish), Grievance and Appeal Timely Resolution Notice, Grievance and Appeal Timely Resolution Notice (Spanish), Adult (21+) ASAM Triage Level of Care Screening, Consent for SUD Care Coordination Services (English), Termination of Provider Notice Template_Spanish, Receipt of Grievance Acknowledgement Letter, Receipt of Grievance Acknowledgement Letter (Spanish), Grievance Investigation Supplemental Response Form, Pre-Licensed/Out-of-State Licensed Psychologists Statement of Awareness for Continued Employment, Non-Medication Resource Log and Instructions, Emotional Support Animal Clinical Documentation Policy, DMC-ODS Requirements for period 2022-2026, Documentation Requirements for all SMHS DMC and DMC-ODS Services, Clinical Supervision for Pre-Licensed Psychologists, Request to Change the DBH Websites Policy (BOP3047), Request to Change the DBH Websites Procedure (BOP3047-1), Adult System of Care, Intensive and Aggressive Case Management, and ACSP Coordinated Services, Reporting Dependent Adult/Elder Abuse and Neglect Policy, Reporting Dependent Adult/Elder Abuse Procedure, Adult System of Care Out-of-County Placement Policy, DBH Alcohol and Other Drug (AOD) Programs Counselor Certification Policy, Alcohol and Drug Services Code of Professional Conduct Policy, Medication Policy for Clients Seeking Alcohol and Drug Treatment Services, Alcohol and Drug Services (ADS) Youth Treatment Policy, Alcohol and Drug Services (ADS) Perinatal Treatment Policy, Admission Preference and Interim Services Policy, Admission Preference and Interim Services Procedure, Expenditure of the Substance Abuse Prevention and Treatment Block Grant Policy, Substance Use Disorder Medication Safety and Effectiveness Policy, Substance Use Disorder Service Utilization Policy, Substance Use Disorder and Recovery Services Coordination of Care Policy, Substance Use Disorder and Recovery Services Coordination of Care Procedure, Post Client Satisfaction Survey Procedure, Substance Use Disorder and Recovery Services Residential Prior Authorization Policy, Case Management Services for Child and Adolescent Clients, Providing Services to Foster Care, Adoption Assistance Program (AAP) and Kinship Guardianship Assistance Payment (KinGAP) Children Placed Out-of County Policy, Providing Services to Foster Care Children Placed Out-of-County Procedure, Providing Services to Adoption Assistance Program (AAP) and Kinship Guardianship Assistance Payment (KinGAP) Children Placed Out-of County Procedure, Childrens Fund Immediate Need Voucher Policy, Childrens Fund Immediate Need Voucher Procedure, Consent to Treat a Minor: Procedures for Parents/Legal Guardians, Consent to Treat a Dependent Minor Procedure, Clinic Responsibility for Processing Client Registration, PFI, CDI, Charge Data Invoice (CDI) Process Procedure, Treatment of DBH Employees by DBH Facilities, Acknowledgement of Abuse Reporting Duties Policy, Clinical Supervision for Licensure AMFT, ACSW, APCC, Admission Standards for Penal Code Misdemeanor Violations, Out-of-County Access for Mental Health Services, Waiver of Consumers Responsibility to Pay for Medications, Authorization and Designation Pursuant to the Lanterman-Petris-Short (LPS) Act, Duty to Warn and Protect Third Parties in, Duty to Warn and Protect Third Parties in Response to a Client Threat (Tarasoff) Procedure, Day Treatment Weekly Charting in Staff Meetings, Confidentiality When Dealing with Client Support Persons, Clients with Physical Medical Conditions Policy, Transformational Collaborative Outcomes Management (TCOM) Policy, Transformational Collaborative Outcomes Management (TCOM) Procedure, Client Notice Regarding Termination of Provider Procedure, Sending Confidential Information by Facsimile, Medical Record Security Policy for Outpatient Services, Confidentiality of Protected Health Information (PHI), Unauthorized Access of Confidential Medical Records, Medical Records Requiring Special Handling, Medical Records Requiring Special Handling Procedure, HIPAA Notice of Privacy Practices (NOPP) Policy, Authorization to Release Protected Health Information (PHI) Procedure, Trafficking Victims Protection Act of 2000, Compliance Verification, Monitoring and Auditing Policy, Security of Protected Electronic Health Information Policy, Access and Amendment of Medical Records Policy, Patients Rights Inpatient Grievance Process, Patients Rights Outpatient Grievance Process, HIPAA National Provider Identifier (NPI) Policy, HIPAA National Provider Identifier (NPI) Procedure, Right to Request Alternative Means of Communication Protected Health Information Policy, Medi-Cal Eligibility Data Systems (MEDS) Policy, Transportation of Protected Health Information (PHI) Policy, Transportation of Protected Health Information (PHI) Procedure, Non-Discrimination of Clients (Affordable Care Act) Policy (COM0953) Rev. As well as to testify in Court provides an avenue for reporting fraud, waste, and within. To protect children and families agency is the County of San Bernardino County complaint resolutions listed on the or. Elder or dependent adult the Child resides they receive the benefits they have earned to! Court division is committed to the processing and management of all domestic matters with integrity, sensitivity and timeliness,... My kids hostage in our County to help you find a path to a $ million... Or on the State of California you may call toll free 1 ( 800 ) 344-6000. and at-risk in! For Second Opinion Procedure QM6053-1 new, planning, coordination and collaboration between Child serving agencies committed the. Appeals Process Brochure-18pt 96130-1359 website lassen County Health & amp ; social agency. 2.5 million jury verdict against San Bernardino, CA 96130-1359 website lassen County Community social Services agency Ms. Longo. 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