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

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Be Prepared California
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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

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

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

DS 1967 - Request for Rate Adjustment -- Staffing Change.

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

Last Updated: 3/2/2018