Form Pa 481 PDF Details

Navigating the avenues of public assistance in Los Angeles County is made simpler with the introduction of the PA 481 form, a document designed to ensure that individuals can engage with the Department of Public Social Services in a language they are most comfortable with. This Language Designation Form plays a crucial role in breaking down language barriers, offering a choice between several languages for both spoken and written communication. Applicants can designate their preference for interactions in languages including, but not limited to, Armenian, Cambodian, Cantonese, English, Korean, Mandarin, Russian, Spanish, Tagalog, and Vietnamese. Moreover, the form extends the facility for applicants to receive written documents in their preferred language, acknowledging that effective communication is key to accessing services. The form also addresses situations where the desired written language may not be available, ensuring that verbal translations can be arranged. The thoughtful design of the PA 481 form reflects a commitment to inclusivity and accessibility, underscoring the importance of understanding and meeting the diverse needs of the community. By ensuring language is not a barrier to service, the form facilitates a smoother, more effective interaction between the public and social services.

QuestionAnswer
Form NameForm Pa 481
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespa 167 form la county, pa 167 la county, pa 167 calfresh, county of los angeles pa 167 form

Form Preview Example

COUNTY OF LOS ANGELESDEPARTMENT OF PUBLIC SOCIAL SERVICES

LANGUAGE DESIGNATION FORM

CASE NAME: ----------- CASE NUMBER:

FREE INTERPRETER SERVICES ARE AVAILABLE

(please ask your worker)

A.SPOKEN LANGUAGE DESIGNATION

I speak the language checked below. I prefer to speak/talk about my case or related matters with staff from the Department of Public Social Services in the language selected below. This designation takes the place of any choices made before.

D Armenian

D Cambodian

D Cantonese

D English

D Korean

D Mandarin

D Russian

D Spanish

D Tagalog

D Vietnamese

D Other (Specify)

_

B.WRITTEN LANGUAGE DESIGNATION

D I prefer to get written letters, notices, forms and other communication in English.

OR

D I prefer that written communications and forms be sent or given to me, if available, in the

language specified below (Chinese is the written language for those who speak Cantonese and Mandarin). In addition, I understand that if written communications from

the Department of Public Social Services are not available in the language specified below, I can receive a verbal translation by contacting my case worker.

D Armenian

D Cambodian

D Chinese

 

D English

D Korean

D Russian

D Spanish

D Tagalog

D Vietnamese

D Other (Specify)

_

APPLICANT'S/PARTICIPANT'S

SIGNATURE (OR MARK)

 

DATE

D I hereby verify that the applicant's/participant's above choices are reflected on LEADER and/or GEARS and/or CMIPS and/or any other computer program used to manage eligibility issues.

CASE CARRYING WORKER'S SIGNATURE

FILE NUMBER

DATE

SUPERVISOR'S INITIALS

DATE

 

 

FILING INSTRUCTIONS:

 

BWS/BSO: Documentation/Activity Folder

PA 481 Eng. (REV. 7-10)

Retention: Permanent

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part 1 to filling in pa 167 form

Complete the specified, In addition, D I prefer that written, in the those who speak language if, D Cambodian D Korean D Vietnamese, I can receive a verbal translation, D Chinese D Russian D Other Specify, D Spanish, I understand that, language for, APPLICANTSPARTICIPANTS, SIGNATURE OR MARK, DATE, D I hereby verify that the, and above choices are reflected on fields with any particulars that are asked by the software.

Completing pa 167 form step 2

In the SUPERVISORS INITIALS, PA Eng REV, DATE, FILING INSTRUCTIONS, BWSBSO DocumentationActivity, and Folder area, highlight the relevant details.

stage 3 to completing pa 167 form

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