Form 8102, 2011, Request For Calworks/family Reunification Services Page 2
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2CITY AND COUNTY OF SAN FRANCISCO
HUMAN SERVICES AGENCY
Family and Children’s Services
Request for CalWORKs/Family
Reunification Services
Case Name:
FCS Case #:
The following actions have or will be completed by the PSW:
□
Notified the Foster Care Eligibility Worker of case status by submitting
a completed 1502 - Foster Care Change or Notice form to Foster Care
Eligibility.
□
Notified CalWORKs of the change in case status by forwarding a
copy of 1502 - Foster Care Change or Notice form to the assigned
CalWorks Social Worker.
□
Contacted the Linkages Coordinator 415-557-5926 to initiate a family
Linkages Case Coordination meeting.
□
Provided the original of this form – 8102 to the parent(s).
Form 8102 (6/11) CalWORKs/FR Notice & Checklist
Original: Parent
Copy: Protective Services Worker
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