Welcome to the California Department of Developmental Services
DDS Logo California Department of Developmental Services
1600 9th Street
P. O. Box 944202
Sacramento, CA 94244-2020

Info: (916) 654-1690
TTY: (916) 654-2054

Quick Links

DDS YouTube Channel
Be Prepared California
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Documents identified by PDF (Portable Document Format) requires the Adobe Acrobat Reader to be viewed and printed. If you do not already have the Adobe Reader, it can be downloaded for free from Adobe.

Work Services Cost Statement Forms

The forms below are for work service (formerly Habilitation) providers to report all revenue and expenses biennially to the Department.

The Excel forms can be downloaded and completed using the Microsoft Excel spreadsheet program. For further information, please read the instructions accompanying each form.

DS 1950 - Habilitation Services Cost Statement Forms
Description of Form.

DS 1950 (3/05) (Microsoft Excel Spreadsheet with formulas)
DS 1950 (3/05) (Microsoft Excel Spreadsheet without formulas)

DS 1966 - Request for Rate Adjustment -- Occupancy Change
Description of Form.

DS 1966 (3/05) (Microsoft Excel Spreadsheet)

DS 1967 - Request for Rate Adjustment -- Staffing Change
Description of Form.

DS 1967 (3/05) (Microsoft Excel Spreadsheet)

 
 
Last Updated: 11/4/2014