Form Sr 2 Dn - Documentation Needed
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1STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
DOCUMENTATION NEEDED (SR 2-DN)
CHILD CARE & SUPERVISION
CCW:
Verification of Residential Child Care Experience
Verification of Prior Employment. Full or Part-time.
Verification of Education
Degree/Transcript
Timesheet/Timecard
Payroll Register
Fingerprints/Association/Live Scan
Other (List)
SOCIAL WORK
Social Worker:
Verification of Professional Level
Degree/Transcript/Professional License(s)
Timesheet/Timecard
Payroll Register
Proof of Payment
Contract
Direct Contact Contract, if applicable
Fingerprints/Association/Live Scan
Other (List)
MENTAL HEALTH
Mental Health Professional:
Verification of Professional Level
Professional License(s)
Proof of Payment
Other (List)
SIGNATURE
DATE
SR 2-DN (1/03)
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