Instructions:
• Complete, sign, and return this report by the 5th of the month following the report month. EXAMPLE: turn in October report by November 5th.
• Complete all sections for each date that you participate in an Employment Services activity. This will be
used to determine your eligibility for transportation and child care costs in addition to verifying your
participation.
• Mandatory ES participants who do not participate as required in Employment Services activities may
have their cash aid reduced or discontinued. CalFresh benefits may also be changed. Voluntary ES
participants who do not participate as agreed may be dis-enrolled from the Employment Services program.
• Employment Services supportive services such as child care, transportation, or ancillary payments may
be delayed, changed, denied or stopped if you fail to participate or provide proof of participation in your
Employment Services activities. If you have a change in your need for supportive services, contact your ES Counselor.
Activities:
• When you receive CalWORKs, unless you are exempt, you are required to participate in Employment Services activities each month.
• You agreed to and were scheduled to participate in Employment Services activities. If your activity has
ended and you haven't talked to your ES Counselor about starting another approved activity, contact your ES Counselor immediately.
Hours of Participation:
• One parent families - If you are the adult in a one parent CalWORKs household, you are required to participate in your assigned Employment Services activities for a total of at least 32 hours a week.
• Two parent families - If you are an adult in a two parent CalWORKs household, you and/or the other
parent are required to participate in your assigned Employment Services activities for a total of at least 35 hours a week. Of the 35 hours required, one parent must participate for at least 20 hours a week.
Good Cause/Exemptions:
• If you are not participating in Employment Services activities because you have a good reason, you may qualify for an exemption from participation or good cause for not participating, contact your
ES Counselor.