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Forms

Monthly Report Forms

Monthly Activity Report (MAR) - English

Monthly Activity Report (MAR) - Spanish

Vehicle Expense Report (VER) - English

Vehicle Expense Report (VER) - Spanish

Request Forms

CCP7 - Child Care Request Form - English

CCP7 - Child Care Request Form - Spanish

CCP8 - CalWORKs Stage One Child Care Authorization Form - English

CCP8 - CalWORKs Stage One Child Care Authorization Form - Spanish

Housing Support Program/Family Stabilization Program Request - English

Housing Support Program/Family Stabilization Program Request - Spanish

WTW Participant Request for Car Repairs - English

WTW Participant Request for Car Repairs - Spanish

Program Notice (Form WTW 5) - English

Program Notice (Form WTW 5) - Spanish

Release of Information Forms

WTW Release of Information - English

WTW Release of Information - Spanish

Contact Us

  1. Tamaran Cook

    Tamaran Cook

    Program Manager
    Email Tamaran
    More Information

  2. Employment Services

    Email Employment Services

    Physical Address
    988 McCourtney Road
    Grass Valley, CA 95949


    988 McCourtney Road Grass Valley CA 95949
    Directions

    Phone: : 530-265-1760
    Fax: : 530-274-1049

    Hours
    Monday - Friday
    8 a.m. - 5 p.m.

    Directory

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  1. How to Complete the MAR/VER
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Cash Benefits
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211/Community Resources
  1. Nevada County California HHS

Contact Us

  1. Ryan Gruver
    Director of Health and Human Services Agency

  2. 950 Maidu Avenue, Suite 120

  3. Nevada City, CA 95959

  4. Hours: 8 a.m. - 5 p.m. Monday-Friday

  5. Phone: 530-265-1627


  6. Fax: 530-265-9860

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