STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES DATA SYSTEMS AND SURVEY DESIGN BUREAU

Annual Recipient Report on CalWORKs, Foster Care (FC), Social Services, Nonassistance Food Stamps (NAFS), Welfare to Work (WTW), Refugee Cash Assistance (RCA), and the Cash Assistance Program for Immigrants (CAPI) Ethnic Origin and Primary Language ABCD 350

DOWNLOAD REPORT FORM FROM:

http://www.cdss.ca.gov/research
E-MAIL COMPLETED REPORT FORM AS AN ATTACHMENT TO:

[email protected]

COUNTY NAME

VERSION

REPORT MONTH

REPORT YEAR

Select County Name

PART A. ETHNIC ORIGIN

Select Version
NUMBER OF CASES

July 2012

C O D E

CalWORKs

WTW TANF Timed-Out Cases a/ (D)

1 65

ETHNIC ORIGIN

Two Parent a/ (A)

1 1

Zero Parent a/ (B)

1

All Other Families a/ (C)

Safety Net Cases a/ (E)

81

FC

Social Services

NAFS

Two Parent d/ (I)

129 145

All Other Families e/ (J)

161

RCA

CAPI

b/ (F)
97

c/ (G)
113

f/ (K)
177

(H)

(L)

1 White
2 18 34 50 66 82 98 114 130 146 162 178

2 Hispanic 3 Black Other Asian or 4 Pacific Islander American Indian or 5 Alaska Native 7 Filipino
7 23 39 55 71 87 103 119 135 151 167 183 3 19 35 51 67 83 99 115 131 147 163 179 4 20 36 52 68 84 100 116 132 148 164 180

21

37

53

69

85

101

117

133

149

165

181

22

38

54

70

86

102

118

134

150

166

182

C Chinese
8 24 40 56 72 88 104 120 136 152 168 184

H Cambodian
9 25 41 57 73 89 105 121 137 153 169 185

J Japanese
10 26 42 58 74 90 106 122 138 154 170 186

K Korean
11 27 43 59 75 91 107 123 139 155 171 187

M Samoan
12 28 44 60 76 92 108 124 140 156 172 188

N Asian Indian
13 29 45 61 77 93 109 125 141 157 173 189

P Hawaiian
14 30 46 62 78 94 110 126 142 158 174 190

R Guamanian
15 31 47 63 79 95 111 127 143 159 175 191

T Laotian
16 32 48 64 80 96 112 128 144 160 176 192

V Vietnamese
193 194 195 196 197 198 199 200 201 202 203 204

Total
COMMENTS

a/

Total CalWORKs Two Parent, Zero Parent, All Other Families, TANF Timed-Out Cases, and Safety Net Cases must equal the corresponding case totals on the CA 237 CW, Part B, Item 8.

b/ Total FC must equal the total cases on the CA 237 FC, Part B, Item 3. c/ e/ f/ Total NAFS cases must equal the total cases on the DFA 296, Item 8, NAFS column. Total CalWORKs WTW All (Other) Families cases must equal the total enrollees on the WTW 25, Part A, Item 1. Total CAPI cases must equal the total recipients reported on the CA 1037, Part C, Item 10. d/ Total CalWORKs WTW Two Parent cases must equal the total enrollees on the WTW 25A, Part A, Item 1.

Note: Total in each column of page 1 of this report must equal the total in the corresponding column on page 2.

ABCD 350 (7/12) Electronic Form Updated 7/12/12

Page 1 of 23

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES DATA SYSTEMS AND SURVEY DESIGN BUREAU

COUNTY NAME

REPORT MONTH

REPORT YEAR

Select County Name

PART B. PRIMARY LANGUAGE SPOKEN
NUMBER OF CASES

July 2012

C O D E

CalWORKs

WTW TANF Timed-Out Cases a/ (D)

292 321

LANGUAGE

Two Parent a/ (A)

Zero Parent a/ (B)

234 263

All (Other) Families a/ (C)

Safety Net Cases a/ (E)

350

FC

Social Services

NAFS

Two Parent d/ (I)

437 466

All (Other) Families e/ (J)

495

RCA

CAPI

b/ (F)
379

c/ (G)
408

f/ (K)
524

(H)

(L)

American Sign Language

205

206

235

264

293

322

351

380

409

438

467

496

525

1 Spanish
207 236 265 294 323 352 381 410 439 468 497 526

2 Cantonese
208 237 266 295 324 353 382 411 440 469 498 527

3 Japanese
209 238 267 296 325 354 383 412 441 470 499 528

4 Korean
210 239 268 297 326 355 384 413 442 471 500 529

5 Tagalog Other Non6 English (specify) 7 English Other Sign A Language B Mandarin Other Chinese C Languages D Cambodian

211

240

269

298

327

356

385

414

443

472

501

530

212

241

270

299

328

357

386

415

444

473

502

531

213

242

271

300

329

358

387

416

445

474

503

532

214

243

272

301

330

359

388

417

446

475

504

533

215

244

273

302

331

360

389

418

447

476

505

534

216

245

274

303

332

361

390

419

448

477

506

535

217

246

275

304

333

362

391

420

449

478

507

536

E Armenian
218 247 276 305 334 363 392 421 450 479 508 537

F Ilocano
219 248 277 306 335 364 393 422 451 480 509 538

G Mein
220 249 278 307 336 365 394 423 452 481 510 539

H Hmong
221 250 279 308 337 366 395 424 453 482 511 540

I Lao
222 251 280 309 338 367 396 425 454 483 512 541

J Turkish
223 252 281 310 339 368 397 426 455 484 513 542

K Hebrew
224 253 282 311 340 369 398 427 456 485 514 543

L French
225 254 283 312 341 370 399 428 457 486 515 544

M Polish
226 255 284 313 342 371 400 429 458 487 516 545

N Russian
227 256 285 314 343 372 401 430 459 488 517 546

P Portuguese
228 257 286 315 344 373 402 431 460 489 518 547

Q Italian
229 258 287 316 345 374 403 432 461 490 519 548

R Arabic
230 259 288 317 346 375 404 433 462 491 520 549

S Samoan
231 260 289 318 347 376 405 434 463 492 521 550

T Thai
232 261 290 319 348 377 406 435 464 493 522 551

U Farsi
233 262 291 320 349 378 407 436 465 494 523 552

V Vietnamese
553 554 555 556 557 558 559 560 561 562 563 564

Total
CONTACT PERSON TELEPHONE EXTENSION FAX

TITLE/CLASSIFICATION

E-MAIL

DATE SUBMITTED

Note: Total in each column of page 2 of this report must equal the total in the corresponding column on page 1.

ABCD 350 (7/12) Electronic Form Updated 7/12/12

Page 2 of 23

Annual Recipient Report on CalWORKs, Foster Care (FC), Social Services, Nonassistance Food Stamps (NAFS), Welfare to Work (WTW), Refugee Cash Assistance (RCA), and the Cash Assistance Program for Immigrants (CAPI) Ethnic Origin and Primary Language (ABCD 350)
PART A. ETHNIC ORIGIN (TOTAL) CELL 193:

VALIDATION RULES AND EDITS

Cell 193 must be equal to the sum of (Cell 1 plus Cell 2 plus Cell 3 plus Cell 4 plus Cell 5 plus Cell 6 plus Cell 7 plus Cell 8 plus Cell 9 plus Cell 10 plus Cell 11 plus Cell 12 plus Cell 13 plus Cell 14 plus Cell 15 plus Cell 16) Cell 194 must be equal to the sum of (Cell 17 plus Cell 18 plus Cell 19 plus Cell 20 plus Cell 21 plus Cell 22 plus Cell 23 plus Cell 24 plus Cell 25 plus Cell 26 plus Cell 27 plus Cell 28 plus Cell 29 plus Cell 30 plus Cell 31 plus Cell 32) Cell 195 must be equal to the sum of (Cell 33 plus Cell 34 plus Cell 35 plus Cell 36 plus Cell 37 plus Cell 38 plus Cell 39 plus Cell 40 plus Cell 41 plus Cell 42 plus Cell 43 plus Cell 44 plus Cell 45 plus Cell 46 plus Cell 47 plus Cell 48) Cell 196 must be equal to the sum of (Cell 49 plus Cell 50 plus Cell 51 plus Cell 52 plus Cell 53 plus Cell 54 plus Cell 55 plus Cell 56 plus Cell 57 plus Cell 58 plus Cell 59 plus Cell 60 plus Cell 61 plus Cell 62 plus Cell 63 plus Cell 64) Cell 197 must be equal to the sum of (Cell 65 plus Cell 66 plus Cell 67 plus Cell 68 plus Cell 69 plus Cell 70 plus Cell 71 plus Cell 72 plus Cell 73 plus Cell 74 plus Cell 75 plus Cell 76 plus Cell 77 plus Cell 78 plus Cell 79 plus Cell 80) Cell 198 must be equal to the sum of (Cell 81 plus Cell 82 plus Cell 83 plus Cell 84 plus Cell 85 plus Cell 86 plus Cell 87 plus Cell 88 plus Cell 89 plus Cell 90 plus Cell 91 plus Cell 92 plus Cell 93 plus Cell 94 plus Cell 95 plus Cell 96) Cell 199 must be equal to the sum of (Cell 97 plus Cell 98 plus Cell 99 plus Cell 100 plus Cell 101 plus Cell 102 plus Cell 103 plus Cell 104 plus Cell 105 plus Cell 106 plus Cell 107 plus Cell 108 plus Cell 109 plus Cell 110 plus Cell 111 plus Cell 112) Cell 200 must be equal to the sum of (Cell 113 plus Cell 114 plus Cell 115 plus Cell 116 plus Cell 117 plus Cell 118 plus Cell 119 plus Cell 120 plus Cell 121 plus Cell 122 plus Cell 123 plus Cell 124 plus Cell 125 plus Cell 126 plus Cell 127 plus Cell 128) Cell 201 must be equal to the sum of (Cell 129 plus Cell 130 plus Cell 131 plus Cell 132 plus Cell 133 plus Cell 134 plus Cell 135 plus Cell 136 plus Cell 137 plus Cell 138 plus Cell 139 plus Cell 140 plus Cell 141 plus Cell 142 plus Cell 143 plus Cell 144) Cell 202 must be equal to the sum of (Cell 145 plus Cell 146 plus Cell 147 plus Cell 148 plus Cell 149 plus Cell 150 plus Cell 151 plus Cell 152 plus Cell 153 plus Cell 154 plus Cell 155 plus Cell 156 plus Cell 157 plus Cell 158 plus Cell 159 plus Cell 160) Cell 203 must be equal to the sum of (Cell 161 plus Cell 162 plus Cell 163 plus Cell 164 plus Cell 165 plus Cell 166 plus Cell 167 plus Cell 168 plus Cell 169 plus Cell 170 plus Cell 171 plus Cell 172 plus Cell 173 plus Cell 174 plus Cell 175 plus Cell 176) Cell 204 must be equal to the sum of (Cell 177 plus Cell 178 plus Cell 179 plus Cell 180 plus Cell 181 plus Cell 182 plus Cell 183 plus Cell 184 plus Cell 185 plus Cell 186 plus Cell 187 plus Cell 188 plus Cell 189 plus Cell 190 plus Cell 191 plus Cell 192)

CELL 194:

CELL 195:

CELL 196:

CELL 197:

CELL 198:

CELL 199:

CELL 200:

CELL 201:

CELL 202:

CELL 203:

CELL 204:

PART B. PRIMARY LANGUAGE SPOKEN (TOTAL) CELL 553: Cell 553 must be equal to the sum of (Cell 205 plus Cell 206 plus Cell 207 plus Cell 208 plus Cell 209 plus Cell 210 plus Cell 211 plus Cell 212 plus Cell 213 plus Cell 214 plus Cell 215 plus Cell 216 plus Cell 217 plus Cell 218 plus Cell 219 plus Cell 220 plus Cell 221 plus Cell 222 plus Cell 223 plus Cell 224 plus Cell 225 plus Cell 226 plus Cell 227 plus Cell 228 plus Cell 229 plus Cell 230 plus Cell 231 plus Cell 232 plus Cell 233) Cell 554 must be equal to the sum of (Cell 234 plus Cell 235 plus Cell 236 plus Cell 237 plus Cell 238 plus Cell 239 plus Cell 240 plus Cell 241 plus Cell 242 plus Cell 243 plus Cell 244 plus Cell 245 plus Cell 246 plus Cell 247 plus Cell 248 plus Cell 249 plus Cell 250 plus Cell 251 plus Cell 252 plus Cell 253 plus Cell 254 plus Cell 255 plus Cell 256 plus Cell 257 plus Cell 258 plus Cell 259 plus Cell 260 plus Cell 261 plus Cell 262) Cell 555 must be equal to the sum of (Cell 263 plus Cell 264 plus Cell 265 plus Cell 266 plus Cell 267 plus Cell 268 plus Cell 269 plus Cell 270 plus Cell 271 plus Cell 272 plus Cell 273 plus Cell 274 plus Cell 275 plus Cell 276 plus Cell 277 plus Cell 278 plus Cell 279 plus Cell 280 plus Cell 281 plus Cell 282 plus Cell 283 plus Cell 284 plus Cell 285 plus Cell 286 plus Cell 287 plus Cell 288 plus Cell 289 plus Cell 290 plus Cell 291) Cell 556 must be equal to the sum of (Cell 292 plus Cell 293 plus Cell 294 plus Cell 295 plus Cell 296 plus Cell 297 plus Cell 298 plus Cell 299 plus Cell 300 plus Cell 301 plus Cell 302 plus Cell 303 plus Cell 304 plus Cell 305 plus Cell 306 plus Cell 307 plus Cell 308 plus Cell 309 plus Cell 310 plus Cell 311 plus Cell 312 plus Cell 313 plus Cell 314 plus Cell 315 plus Cell 316 plus Cell 317 plus Cell 318 plus Cell 319 plus Cell 320) Cell 557 must be equal to the sum of (Cell 321 plus Cell 322 plus Cell 323 plus Cell 324 plus Cell 325 plus Cell 326 plus Cell 327 plus Cell 328 plus Cell 329 plus Cell 330 plus Cell 331 plus Cell 332 plus Cell 333 plus Cell 334 plus Cell 335 plus Cell 336 plus Cell 337 plus Cell 338 plus Cell 339 plus Cell 340 plus Cell 341 plus Cell 342 plus Cell 343 plus Cell 344 plus Cell 345 plus Cell 346 plus Cell 347 plus Cell 348 plus Cell 349) Cell 558 must be equal to the sum of (Cell 350 plus Cell 351 plus Cell 352 plus Cell 353 plus Cell 354 plus Cell 355 plus Cell 356 plus Cell 357 plus Cell 358 plus Cell 359 plus Cell 360 plus Cell 361 plus Cell 362 plus Cell 363 plus Cell 364 plus Cell 365 plus Cell 366 plus Cell 367 plus Cell 368 plus Cell 369 plus Cell 370 plus Cell 371 plus Cell 372 plus Cell 373 plus Cell 374 plus Cell 375 plus Cell 376 plus Cell 377 plus Cell 378) Cell 559 must be equal to the sum of (Cell 379 plus Cell 380 plus Cell 381 plus Cell 382 plus Cell 383 plus Cell 384 plus Cell 385 plus Cell 386 plus Cell 387 plus Cell 388 plus Cell 389 plus Cell 390 plus Cell 391 plus Cell 392 plus Cell 393 plus Cell 394 plus Cell 395 plus Cell 396 plus Cell 397 plus Cell 398 plus Cell 399 plus Cell 400 plus Cell 401 plus Cell 402 plus Cell 403 plus Cell 404 plus Cell 405 plus Cell 406 plus Cell 407)

CELL 554:

CELL 555:

CELL 556:

CELL 557:

CELL 558:

CELL 559:

ABCD 350 (7/12)

Page 3 of 23

CELL 560:

Cell 560 must be equal to the sum of (Cell 408 plus Cell 409 plus Cell 410 plus Cell 411 plus Cell 412 plus Cell 413 plus Cell 414 plus Cell 415 plus Cell 416 plus Cell 417 plus Cell 418 plus Cell 419 plus Cell 420 plus Cell 421 plus Cell 422 plus Cell 423 plus Cell 424 plus Cell 425 plus Cell 426 plus Cell 427 plus Cell 428 plus Cell 429 plus Cell 430 plus Cell 431 plus Cell 432 plus Cell 433 plus Cell 434 plus Cell 435 plus Cell 436) Cell 561 must be equal to the sum of (Cell 437 plus Cell 438 plus Cell 439 plus Cell 440 plus Cell 441 plus Cell 442 plus Cell 443 plus Cell 444 plus Cell 445 plus Cell 446 plus Cell 447 plus Cell 448 plus Cell 449 plus Cell 450 plus Cell 451 plus Cell 452 plus Cell 453 plus Cell 454 plus Cell 455 plus Cell 456 plus Cell 457 plus Cell 458 plus Cell 459 plus Cell 460 plus Cell 461 plus Cell 462 plus Cell 463 plus Cell 464 plus Cell 465) Cell 562 must be equal to the sum of (Cell 466 plus Cell 467 plus Cell 468 plus Cell 469 plus Cell 470 plus Cell 471 plus Cell 472 plus Cell 473 plus Cell 474 plus Cell 475 plus Cell 476 plus Cell 477 plus Cell 478 plus Cell 479 plus Cell 480 plus Cell 481 plus Cell 482 plus Cell 483 plus Cell 484 plus Cell 485 plus Cell 486 plus Cell 487 plus Cell 488 plus Cell 489 plus Cell 490 plus Cell 491 plus Cell 492 plus Cell 493 plus Cell 494) Cell 563 must be equal to the sum of (Cell 495 plus Cell 496 plus Cell 497 plus Cell 498 plus Cell 499 plus Cell 500 plus Cell 501 plus Cell 502 plus Cell 503 plus Cell 504 plus Cell 505 plus Cell 506 plus Cell 507 plus Cell 508 plus Cell 509 plus Cell 510 plus Cell 511 plus Cell 512 plus Cell 513 plus Cell 514 plus Cell 515 plus Cell 516 plus Cell 517 plus Cell 518 plus Cell 519 plus Cell 520 plus Cell 521 plus Cell 522 plus Cell 523) Cell 564 must be equal to the sum of (Cell 524 plus Cell 525 plus Cell 526 plus Cell 527 plus Cell 528 plus Cell 529 plus Cell 530 plus Cell 531 plus Cell 532 plus Cell 533 plus Cell 534 plus Cell 535 plus Cell 536 plus Cell 537 plus Cell 538 plus Cell 539 plus Cell 540 plus Cell 541 plus Cell 542 plus Cell 543 plus Cell 544 plus Cell 545 plus Cell 546 plus Cell 547 plus Cell 548 plus Cell 549 plus Cell 550 plus Cell 551 plus Cell 552)

CELL 561:

CELL 562:

CELL 563:

CELL 564:

ABCD 350 (7/12)

Page 4 of 23

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell
Two Parent a/ (A) Zero Parent a/ (B)

PART A. ETHNIC ORIGIN

1. White CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalW

17

33

49

65

81

97

113

129

145

161

177

ect County Name

PART B. PRIMARY LANGUAGE SPOKEN

O. American Sign Language (ASL)

Program Item Name Data Cell
Two Parent a/ (A) Zero Parent a/ (B)

CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalW

205

234

263

292

321

350

379

408

437

466

495

524

206

ect County Name

0
H. Hmong

PART B. PRIMARY LANGUAGE SPOKEN Program Item Name Data Cell

Two Parent a/ (A) Zero Parent a/ (B)

CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalW

220

249

278

307

336

365

394

423

452

481

510

539

221

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

JulyPART A. ETHNIC ORIGIN 2012

Program Item Name Data Cell

2. Hispanic CalWORKs WTW

TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B)

Zero Parent a/ (B)

All Others a/ (C)

18

34

50

66

82

98

114

130

146

162

178

19

ect County Name

PART B. PRIMARY LANGUAGE SPOKEN

0
1. Spanish

Program Item Name Data Cell

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B)

235

264

293

322

351

380

409

438

467

496

525

207

236

ect County Name

PART B. PRIMARY LANGUAGE SPOKEN

0
I. Lao

Program Item Name Data Cell

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B)

250

279

308

337

366

395

424

453

482

511

540

222

251

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

3. Black CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

4. O WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C)

35

51

67

83

99

115

131

147

163

179

20

36

ect County Name

0
2. Cantonese

PART B. PRIMARY LANGUAGE SPOKEN Program Item Name Data Cell

CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C)

265

294

323

352

381

410

439

468

497

526

208

237

266

ect County Name

0
J. Turkish

PART B. PRIMARY LANGUAGE SPOKEN Program Item Name Data Cell

CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C)

280

309

338

367

396

425

454

483

512

541

223

252

281

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

PART A. ETHNIC ORIGIN July

2012
Program Item Name Data Cell

4. Other Asian or Pacific Islander CalWORKs

TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H)

5. American In WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D)

52

68

84

100

116

132

148

164

180

21

37

53

ect County Name

PART B. PRIMARY LANGUAGE SPOKEN

0
3. Japanese

4 WTW CalWORKs
RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Program Item Name Data Cell

CalWORKs
TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G)

295

324

353

382

411

440

469

498

527

209

238

267

296

ect County Name

PART B. PRIMARY LANGUAGE SPOKEN

0
K. Hebrew

L WTW CalWORKs
RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Program Item Name Data Cell

CalWORKs
TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G)

310

339

368

397

426

455

484

513

542

224

253

282

311

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
CalWORKs Program
Item Name Data Cell

PART A. ETHNIC ORIGIN

5. American Indian or Alaska Native WTW

Safety Net a/ (E) FC b/ (F) Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

7. Filipino CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E)

69

85

101

117

133

149

165

181

22

38

54

70

ect County Name

0
4. Korean

PART B. PRIMARY LANGUAGE SPOKEN

5. Tagalog WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

CalWORKs Program
Item Name Data Cell
Safety Net a/ (E) FC b/ (F) Social Services (G)

325

354

383

412

441

470

499

528

210

239

268

297

326

ect County Name

0
L. French

PART B. PRIMARY LANGUAGE SPOKEN

M. Polish WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

CalWORKs Program
Item Name Data Cell
Safety Net a/ (E) FC b/ (F) Social Services (G)

340

369

398

427

456

485

514

543

225

254

283

312

341

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

ETHNIC ORIGIN

July 2012
Program Item Name Data Cell

7. Filipino WTW
FC b/ (F) Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

C. Chinese CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

86

102

118

134

150

166

182

23

39

55

71

87

ect County Name

0
5. Tagalog

Y LANGUAGE SPOKEN Program Item Name Data Cell

FC b/ (F) Social Services (G) NAFS c/ (H)

6. Other Non-English (specif WTW

Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

355

384

413

442

471

500

529

211

240

269

298

327

356

ect County Name

0
M. Polish

0
N. Russian

Y LANGUAGE SPOKEN Program Item Name Data Cell

FC b/ (F) Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

370

399

428

457

486

515

544

226

255

284

313

342

371

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

C. Chinese WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

H. Cambodian CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

103

119

135

151

167

183

24

40

56

72

88

ect County Name

0
6. Other Non-English (specify)

0
7. English

PART B. PRIMARY LANGUAGE SPOKEN Program Item Name Data Cell

Social Services (G) NAFS c/ (H)

WTW
Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

385

414

443

472

501

530

212

241

270

299

328

357

ect County Name

N. Russian
Program Item Name Data Cell

PART B. PRIMARY LANGUAGE SPOKEN

P. Portuguese WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Social Services (G)

400

429

458

487

516

545

227

256

285

314

343

372

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

NIC ORIGIN

July 2012
Program Item Name Data Cell

H. Cambodian WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

J. Japanese CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

104

120

136

152

168

184

25

41

57

73

89

ect County Name

7. English
Program Item Name Data Cell

NGUAGE SPOKEN

A. Other Sign Language WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Social Services (G)

386

415

444

473

502

531

213

242

271

300

329

358

ect County Name

P. Portuguese
Program Item Name Data Cell

0
Q. Italian

NGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

401

430

459

488

517

546

228

257

286

315

344

373

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

J. Japanese WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

K. Korean CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

105

121

137

153

169

185

10

26

42

58

74

90

ect County Name

A. Other Sign Language
Program Item Name Data Cell

0
B. Mandarin

PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

387

416

445

474

503

532

214

243

272

301

330

359

ect County Name

Q. Italian
Program Item Name Data Cell

0
R. Arabic

PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

402

431

460

489

518

547

229

258

287

316

345

374

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

NIC ORIGIN

July 2012
Program Item Name Data Cell

K. Korean WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

M. Samoan CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

106

122

138

154

170

186

11

27

43

59

75

91

ect County Name

B. Mandarin
Program Item Name Data Cell

NGUAGE SPOKEN

C. Other Chinese Languages WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Social Services (G)

388

417

446

475

504

533

215

244

273

302

331

360

ect County Name

R. Arabic
Program Item Name Data Cell

0
S. Samoan

NGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

403

432

461

490

519

548

230

259

288

317

346

375

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

M. Samoan WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

N. Asian Indian CalWORKs

Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

107

123

139

155

171

187

12

28

44

60

76

92

ect County Name

0
C. Other Chinese Languages

PART B. PRIMARY LANGUAGE SPOKEN

D. Cambodian WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Program Item Name Data Cell

Social Services (G)

389

418

447

476

505

534

216

245

274

303

332

361

ect County Name

S. Samoan
Program Item Name Data Cell

0
T. Thai

PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

404

433

462

491

520

549

231

260

289

318

347

376

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

NIC ORIGIN

July 2012
Program Item Name Data Cell

N. Asian Indian WTW

Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

P. Hawaiian CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

108

124

140

156

172

188

13

29

45

61

77

93

ect County Name

D. Cambodian
Program Item Name Data Cell

0
E. Armenian

NGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

390

419

448

477

506

535

217

246

275

304

333

362

ect County Name

T. Thai
Program Item Name Data Cell

0
U. Farsi

NGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

405

434

463

492

521

550

232

261

290

319

348

377

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

P. Hawaiian WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

R. Guamanian CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

109

125

141

157

173

189

14

30

46

62

78

94

ect County Name

E. Armenian
Program Item Name Data Cell

0
F. Ilocano

PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

391

420

449

478

507

536

218

247

276

305

334

363

ect County Name

U. Farsi
Program Item Name Data Cell

PART B. PRIMARY LANGUAGE SPOKEN

V. Vietnamese WTW CalWORKs

RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J)

Social Services (G)

406

435

464

493

522

551

233

262

291

320

349

378

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

ORIGIN

July 2012
Program Item Name Data Cell

R. Guamanian WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

T. Laotian CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

110

126

142

158

174

190

15

31

47

63

79

95

ect County Name

F. Ilocano
Program Item Name Data Cell

0
G. Mein

UAGE SPOKEN

PART B. PRIMARY LANGUAGE S

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

392

421

450

479

508

537

219

248

277

306

335

364

ect County Name

V. Vietnamese
Program Item Name Data Cell

0
Total

UAGE SPOKEN

PART B. PRIMARY LANGUAGE S

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A)

CalWORKs
Zero Parent a/ (B) All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

407

436

465

494

523

552

553

554

555

556

557

558

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

T. Laotian WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B)

CalWORKs

111

127

143

159

175

191

16

32

ect County Name

G. Mein
Program Item Name Data Cell

0
PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L)

393

422

451

480

509

538

ect County Name

Total
Program Item Name Data Cell

0
PART B. PRIMARY LANGUAGE SPOKEN

WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L)

CONTACT PERSON

TITLE/CLASSIFICATION

559

560

561

562

563

564

ect County Name

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

V. Vietnamese CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F) Social Services (G)

48

64

80

96

112

ect County Name

Program Item Name Data Cell

ect County Name

Program Item Name Data Cell

E-MAIL

TELEPHONE

EXTENSION

FAX

DATE SUBMITTED

ect County Name

1/0/1900

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July V. Vietnamese 2012

Program Item Name Data Cell
NAFS c/ (H) Two Parent d/ (I)

WTW
All Others e/ (J) RCA (K)

128

144

160

176

ect County Name

Program Item Name Data Cell

ect County Name

Program Item Name Data Cell

COMMENTS

REPORT MONTH REPORT YEAR

VERSION (Initial or Revised)

ect County Name

July

2012

Select Version

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell
CAPI f/ (L) Two Parent a/ (A) Zero Parent a/ (B)

PART A. ETHNIC ORIGIN

Total CalWORKs
All Others a/ (C) TANF a/ (D) Safety Net a/ (E) FC b/ (F)

192

193

194

195

196

197

198

ect County Name

Program Item Name Data Cell

ect County Name

ELECTRONIC FORM UPDATED DATE (This cell added to Electronic Form's Back Page, and Workbook's County B4 sheet and Edits Sheet on 7/22/10)

Program Item Name Data Cell

ect County Name

7/12/12

Annual Recipient Report on CalWORKs, FC, Social Services, NAFS, WTW, RCA, and CAPI Ethnic Origin and Primary Language (ABCD 350) ELECTONIC FORM's CDSS ONLY BACK PAGE

July 2012
Program Item Name Data Cell

PART A. ETHNIC ORIGIN

Total WTW
Social Services (G) NAFS c/ (H) Two Parent d/ (I) All Others e/ (J) RCA (K) CAPI f/ (L)

199

200

201

202

203

204

ect County Name

Program Item Name Data Cell

ect County Name

Program Item Name Data Cell

ect County Name