Research, Automation, and Data Division
Report Form and Instructions
This webpage contains downloadable Excel automated report forms that allow county offices and designated agencies to electronically transmit their statistical data via email.
Contact the report email address to request an older automated form version for revisions.
CalFresh Programs
| Automated Form |
Letters and Notices |
Contact Information |
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CF 18: CalFresh Churn Monthly Report
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admCF18@dss.ca.gov
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CF 296: CalFresh Monthly Caseload Movement Statistical Report
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admCF296@dss.ca.gov
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CF 256: Food Stamp Program Participation and Benefit Issuance Report
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admDFA256@dss.ca.gov
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CF 358F: CalFresh Participants by Race/Ethnicity (Federal Only and Combined Households)
CF 358S: CalFresh Participants by Race/Ethnicity (State Only)
- CF358FS Automated Form (Updated 08/30/22)
- Effective July 2021 and July 2022 report month
- Automated form combines the CF 358F and CF 358S reports
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admCF358FS@dss.ca.gov
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STAT 47: Non-Assistance CalFresh Work Registrants, Able-Bodied Adults without Dependents (ABAWD), and Employment and Training (E&T) Program Quarterly Statistical Report
- STAT47 Automated Form (Updated 03/25/22)
- Effective October - December 2014 through April - June 2024 report quarters
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admSTAT47@dss.ca.gov
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WINS 2: Work Incentive Nutritional Supplement (WINS) Monthly Caseload Report
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admWINS2@dss.ca.gov
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CalWORKs Programs
| Automated Form |
Letters and Notices |
Contact Information |
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Cal-OAR: CalWORKs Outcomes and Accountability Review
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admCalOAR19@dss.ca.gov
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CA237CW: Cash Grant Caseload Movement Report
CA253CW: Report on Reasons for Discontinuances of Cash Grant
CA255CW: Report on Reasons for Denials and Other Non-Approvals of Applications for Cash Grant
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DSSDB@dss.ca.gov
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CA237HA: Homeless Assistance Program Monthly Statistical Report
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admCA237HA@dss.ca.gov
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CCB18: Emergency Child Care Bridge Program for Foster Children (Bridge Program)
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admCCB18@dss.ca.gov
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CW115: Child Care Monthly Report (CalWORKs Families)
CW115A: Child Care Monthly Report (Two-Parent Families)
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admCW115@dss.ca.gov
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FSP14: Family Stabilization Program
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admFSP14@dss.ca.gov
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HSP14: Housing Support Program (HSP)
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HVP19: Home Visiting Program (HVP)
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admHVP19@dss.ca.gov
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STAT45: Teen Parent Cal-Learn Program
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admSTAT45@dss.ca.gov
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TEMP2220: Children Aged 5-17 in Families Receiving CalWORKs Exceeding Poverty Level during October
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admTEMP2220@dss.ca.gov
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WTW25: Welfare-to-Work (All Other Families)
WTW25A: Welfare-to-Work (Two-Parent Families)
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admWTW25@dss.ca.gov
admWTW25A@dss.ca.gov
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Child Welfare Programs
Disability and Adult Programs
| Automated Form |
Letters and Notices |
Contact Information |
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CA1037: Cash Assistance Program for Immigrants
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admCA1037@dss.ca.gov
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GR237: General Relief and Interim Assistance to Applicants for SSI/SSP Monthly Caseload and Expenditure Report
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admGR237@dss.ca.gov |
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SOC242: Adult Protective Services and County Services Block Grant Monthly Report
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admSOC242@dss.ca.gov
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SOC808: Quarterly Report of Overpayments and Collections for the Cash Assistance Program for Immigrants (CAPI)
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admSOC808@dss.ca.gov
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Fraud Programs
| Automated Form |
Letters and Notices |
Contact Information |
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CA812: Quarterly Report of Overpayments and Collections (CalWORKs)
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admCA812@dss.ca.gov
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DPA482: Income and Eligibility Verification System (IEVS) Management Report
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admDPA482@dss.ca.gov
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DSS466: Fraud Investigations Activity Report
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admDSS466@dss.ca.gov
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Immigration Programs
Multiple Programs
| Automated Form |
Letters and Notices |
Contact Information |
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ABCD350: Annual Recipient Report on CalWORKs, Foster Care, Social Services, Non-Assistance CalFresh, CalWORKs Welfare-to-Work, Refugee Cash Assistance, and the Cash Assistance Program for Immigrants Ethnic Origin and Primary Language Report
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admABCD350@dss.ca.gov
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