Form Sr 10 PDF Details

In the intricate landscape of financial accountability and reporting within the realm of California's social services, particularly those involving group homes and foster family agencies, the SR 10 form emerges as a pivotal document. Stemming from the directives of the California Department of Social Services, this form serves as a certification of audited cost data, mandating a thorough examination by a Certified Public Accountant (CPA) of the financial audit reports submitted by these organizations. It is designed to ensure that all cost data reports, crucial for the financial integrity and transparency of such agencies, have been meticulously audited and confirmed to be accurately represented, reflecting the true financial condition of the entity in question. The completion and submission of the SR 10 form, therefore, are not mere bureaucratic steps but integral components of the financial oversight mechanism put in place by the state's health and human services agency. By requiring that this form, along with supplementary cost data reports, be sent to the Program and Financial Audits Bureau, California underscores its commitment to upholding the highest standards of financial reporting and accountability. Furthermore, this form aligns with the principles outlined in the Manual of Policies and Procedures, underscoring the state's proactive approach to preventing financial misrepresentation and fostering an environment of trust and integrity among social service providers.

QuestionAnswer
Form NameForm Sr 10
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescalifornia sr 10, how to ca sr 10, form sr 10 printable, california sr10

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

CERTIFICATION OF

AUDITED COST DATA

The Group Home or Foster Family Agency corporation should have their Certified Public Accountant (CPA) complete and submit this form as part of the required financial audit if the CPA has not otherwise provided written documentation which clearly shows that the required cost data reports were audited and that the information was fairly stated in all material respects in relation to the basic financial statements taken as a whole.

Please have the completed and signed form sent to:

California Department of Social Services

Program and Financial Audits Bureau

ATTENTION: Financial Audits Unit Manager

744 P Street, MS 9-23

Sacramento, California 95814.

GROUP HOME OR FOSTER FAMILY AGENCY CORPORATE NAME

PROGRAM NUMBERS(S)

STREET ADDRESS

PROGRAM FISCAL YEAR (MO/YR-MO/YR)

CITY, STATE, AND ZIP CODE

PROVIDER PHONE NUMBER

The attached supplementary cost data reports are presented for the purposes of additional analysis and are not a required part of the basic financial statements but are required as supplementary information by the California Department of Social Services in accordance with Manual of Policies and Procedures Section 11-405.214. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements, and in our opinion, is fairly stated in all material respects in relation to the basic fianancial statements taken as a whole.

Check only the forms which apply:

SR 3___ SR 4___ FCR 12FFA___

In compliance with the False Claims Act (31 U.S.C. §3729-3733), I certify that the information on this form is true and correct.

PRINTED NAME OF CPA

SIGNATURE OF CPA

DATE

ADDRESS

CITY, STATE AND ZIP CODE

SR 10 (2/06)

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Writing segment 2 of sr 10 cost

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