Form Cw 2189 - Notice Of Your Calworks Time Limit - 42nd Month On Aid
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2STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COUNTY
CASE NAME
NOTICE OF YOUR CalWORKs TIME LIMIT
-42
MONTH ON AID
OTHER ID NO.
CASE NO.
ND
WORKER NAME
Questions? Ask your worker.
THIS NOTICE GIVES YOU INFORMATION ABOUT YOUR CalWORKs 48-MONTH TIME CLOCK.
As of _____________________ , the County has found that you, ___________________________,
(DATE)
(NAME)
have received a total of 42 months of your lifetime 48-month time limit of CalWORKs cash aid. You may
be eligible to receive aid for 6 more months from that date.
CONTACT YOUR WORKER RIGHT AWAY IF YOU:
Need more information about the number of months that were counted toward your 48-month time
clock.
Are or were exempt from the CalWORKs 48-month time limit and you have not requested
the exemption. An exemption stops your time clock by not counting certain months against your
lifetime limit on aid.
Do not agree with the county’s time limit count.
Need more information about the CalWORKs 48-month time limit requirements, or exemptions, or how
to ask for a time limit exemption.
THE 48-MONTH TIME LIMIT WILL NOT AFFECT YOUR ELIGIBILITY FOR CALFRESH OR
MEDI-CAL.
You will also receive a Notice of Action to tell you when you have used your lifetime 48-months of
CalWORKs cash aid.
CONTACT YOUR WORKER IF YOU THINK THIS NOTICE IS WRONG. YOU MAY ALSO ASK FOR A
STATE HEARING. “YOUR HEARING RIGHTS” FORM ON THE BACK SIDE OF THIS PAGE TELLS HOW
TO ASK FOR A STATE HEARING.
CW 2189 (3/15) REQUIRED FORM - NO SUBSTITUTE PERMITTED
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