CDC

Press "Send" to send ALL Declaration of Compliance Forms or "Cancel" to return. Due Date:

Override ALL forms previously sent and send a new form immediately

CDC

Press "Send" to send a sample Declaration of Compliance form or "Cancel" to return.

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Name:

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When pressing the "Authorize" button ALL Declaration of Compliance Forms will be sent.

Administrator Id:

Administrator Password:

Program Name

When pressing the "Authorize" button a waiver form for this program will be considered submitted.

Program Name

Press "Send" to send this Declaration of Compliance Form or "Cancel" to return. Due Date:

Program Name

Press "Submit" to send this Declaration of Compliance Form or "Cancel" to return.

Feedback Details

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To:

Subject:

Details: 4000 characters maximum

Contractor Profile Updates

Contractor Name

Expiration Date:

Override previous "Send Date" and send this form immediately

Community Program Profile Updates

Program Director Name

Expiration Date:

Site Visit Schedule

Program Name

Date and time previously agreed with

Site Visit Date: Time: Type of Visit:

Medi-Cal Certification

Citywide Fiscal

Eligibility

Joint Fiscal

Monitoring

Technical Assistance

Virtual Monitoring

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Programs Scheduled Site Visits Report

Order by:

Program name
Contractor name
Visit date
Program section

When pressing the "Delete" button this program will be permanently deleted and cannot be recovered.

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Record will be permanently deleted and cannot be recovered.

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_LoginUser

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Mailing Labels To Excel Spreadsheet

Table To Excel Spreadsheet

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Modality Description *

Fields marked with asterisks * are required.

Funding Source *

Program Name

When pressing the "Exclude" button a PDC form for this program will be considered EXCLUDED.

Date:

Time:

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Type:

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Profile Updates Notification

Reminder Settings

Schedule Date:
Frequency:
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A reminder will be sent if profile has not been updated for more than one year

Notification Recipients

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Community Programs
Organizational Management

Version 2.9.0 (https://www.old.bocc-pcs.net) October 24, 2025

54.81.112.180

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