1. Find substance use disorders and/or alcohol recovery services? Thank you for the opportunity to assist you! Ergonomic Assessment Level (12/12/2018) New! The forms may be posted on their site. endstream endobj 38 0 obj <>/Subtype/Form/Type/XObject>>stream H*2T0T007 Contact us to help you find a path to a $0 balance. 0 0 k https://www.sbcounty.gov/uploads/DCSS/Videos/Parenting%20Eng%20Sub.mp4, Order/Notice to Withhold Income for Child Support (FL-195). Request for Second Opinion Procedure QM6053-1 New! '/*{2 Kl,f9%22Yxr - |Fe w} 0 Improves the well-being of children, empowers families and strengthens communities. . f`a3p8WDT!"kg```P5Bsr Missing payments increase your amount owed. endstream endobj 22 0 obj <> endobj 23 0 obj <> endobj 24 0 obj <> endobj 25 0 obj <>/Subtype/Form/Type/XObject>>stream Americas largest county. )Vice Chairman/SupervisorFirst District, Jesse ArmendarezSupervisorSecond District, Goals and Objectives Help Count the Unsheltered and Make a Difference. H*2T0T037U03U(J 2023 San Bernardino County | . endstream endobj 27 0 obj <>/Subtype/Form/Type/XObject>>stream f Child Abuse Report. Preschool services feeds meals to children. hbbd```b``" 0i"H`s.8C>nf"Ynu8X8=L?jd &7$+: ,"y3L`qQr&):w4"3p vkJ4 A ^ Welcome to San Bernardino County's Career Opportunities page! File a USDA program discrimination complaint? Resource Parents are often called upon to provide information to the child protective services worker, as well as to testify in court. and at-risk adults in our county. PURPOSE OF FORM This form, as adopted by the California Department of Social Services (CDSS), is required under Welfare and Institutions Code (WIC) Sections 15630 and 15658(a)(1). San Bernardino, CA 92415-0640 (909)891-9019 . H237402VH2P0P32UT(JJ*2T0T0D|3@.XHT! % 90&L$S` V: To download a form (in PDF format), click on the form number in the appropriate table. Get the free san bernardino county children and family form cfs 125 cps 2014-2022. . Save or instantly send your ready documents. For graffiti abatement, call 1.877.442.2283. Complete a Suspected Child Abuse Report (SS 8572 Rev 12/02) for each child that you report and fax it to 909-891-3545 or 909-891-3560. Enroll my Preschooler in a Head Start Program? The Court Executive Office's hours are 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding court holidays. Our job is to create a county in which those who reside and invest can prosper and achieve well-being. (Courtesy of Eric Bahra) Two children disclosed that the foster father had sexually . 2023 San Bernardino County | Department of Behavioral Health | Privacy Policy | Accessibility | Newsletter Sign-up | Site Map. Requests may be submitted by completing the Request for Judicial Administrative Records Form and sending it to the Court by e-mail or U.S. Mail. Box 1359 Susanville, CA 96130-1359 Website Los Angeles County Department of Children & Family Services Samples can be emailed to you by request at: selfhelpforms@sb-court.org. endstream endobj 37 0 obj <>/Subtype/Form/Type/XObject>>stream New Medicare Beneficiary Identifier (MBI) New! Reports of suspected child abuse or neglect shall be made by mandated reporters to any police department or sheriffs department (not including a school district police or security department), the county probation department (if designated by the county to receive mandated reports), or the county welfare department. It looks like your browser does not have JavaScript enabled. This year, San Bernardino County settled a lawsuit for $7.5 million in a case that alleged that a county social worker was aware of sexual abuse in the foster care system and failed to report it. Child Abuse Hotline for San Bernardino County is. San Bernardino County APS strives to have all elders and dependent adults live their lives free from the threat or reality of abuse. f Mental Health Consumer Perception Survey-Fall 2019 New! 2018 Superior Court of California, County of San Bernardino, All Rights Reserved |, COVID-19: COURT OPERATIONS DURING THE COVID-19 PANDEMIC, Family Court Services Orientation Class Info, Failure to Appear/Respond to a Jury Summons, Court Case Information and Document Sales, How to Navigate San Bernardino Superior Court, San Bernardino Superior Court Rules of Practice, Local Emergency Rules Related to COVID-19, Online Form Preparation and Filing (TurboCourt), Online Form Preparation and eFiling (TurboCourt), Stipulation For Settlement (CCP 664.6) (fillable), Proof of Service Notice of Appeal (Code Enforcement), Appeal Procedures for Unlimited Civil Cases (Information on), Declaration of Petitioner and Request for Records Check, General Civil Case At-Issue Memorandum (fillable), Declaration and Order Re: Satisfaction of Judgment, CONFIDENTIAL Referral for CII/Carpos/ICMS Report (Civil) - Form A, Order Request for Review of Denial of Request to Remove Name from Gang Database, Initial Trial Setting Conference Statement, Application for Diversion of Individual with Mental Disorder, Order on Application for Diversion of Individual with Mental Disorder, Declaration and Order for Release of Exhibits, Consent to Bring Prohibited Items into the Courthouse as Exhibits (fillable), Stipulation And Order On Request For Order, Referral for CII/CARPOS/ICMS Report (fillable), Family Law At-Issue Memorandum for Trial Setting, Declaration And Order For Issuance Of Writ Of Execution/Abstract Of Judgment (fillable), Order On Petition For Grandparent Visitation, Response To Petition For Grandparent Visitation, Declaration Re: Compliance with Custody Orders (fillable), Petition for Declaring Child(ren) Free from Parental Custody and Control, Citation - Freedom from Parental Custody and Control, Order Declaring Child(ren) Free from Parental Custody and Control, Order on Petition to Terminate Parental Rights of Alleged Father, Petition to Terminate Parental Rights of Alleged Father, Declaration and Order Dispensing with Notice to Alleged Father, Petition to Obtain Original Unsealed/Un-Redacted Birth Certificate, Order on Petition to Obtain Original Unsealed/Un-Redacted Birth, Order on Petition for Birth Record Information, Application to Obtain Final Adoption Order and Order, Application to Obtain Copies from Adoption Case and Order, Petition for Adoption of Adult or Married Minor, Agreement of Adoption of Adult or Married Minor, Consent of Spouse of Adult or Married Minor to be Adopted, Stipulation for Entry of Judgment Re: Establishment of Parental Relationship, Order for Publication of Citation (Adoption), Application for Order for Publication of Citation (Adoption), Notice of Continuance of Hearing (Family Law), Declaration Regarding Objection to Agreement, Family Law/Child Support Copy Request Form, Affidavit/Certificate/Declaration Re: Military Service in an Adoption and Related Matters, Order for Publication of Summons or Citation, Application for Publication of Summons or Citation, Request for Dismissal -- Small Claims Cases, Declaration of Mailing or Inability to Ascertain Address (fillable), Request to Excuse Notice with Due Diligence Declaration, Audio CD Information Sheet and Order Form, Petition for Release of Jury Records and Order, Objection/Response to Packet (Delinquency), Objection/Response to Packet (Dependency), Certification of Competency (Delinquency), Response to Petition for Resentencing (Juvenile), Proof of Service - Juvenile Restraining Order, Ex Parte Application And Order To Serve Summons By Posting, Application for Judgment for Restitution of Premises Only (CCP1169) (fillable), Pretrial Orders Judgment By Court Unlawful Detainer (fillable), To Set Case for Trial - Unlawful Detainer, Application for Issuance of Writ of Execution Per CCP 712.010, Small Claims/Landlord Tenant Copy Request Form, Order Appointing Counsel For Conservatee, Probate Code Sections 1470, 1471, and 2356.5(f)(1), Petition for Visitation (Guardianship Cases Only), Order on Petition for Visitation (Guardianship Cases Only), Order Appointing Counsel For Minor, Probate Code Sections 1470 and 1516.5 (fillable), Notification of Court of Conservatorship Address, Confidential Guardianship Questionnaire and Authorization for Release of Information, List of Required Contact Information for Conservatorships, Optional Attachment to List of Required Contact Information for Conservatorships, Confidential General Care Plan of Conservatee, Ex Parte Petition to Dispense with Accounting and Order (fillable), Request for Deferment of Court Investigator Fee and Order, Affidavit to Comply with California Probate Code 13100-13115, Termination of Guardianship - Parent Questionnaire, Notification of Disqualification from Voting, Notice of Commencement of Proceedings for a Court Supervised Trust, Confidential Information Sheet - Conservatorship, Confidential Information Sheet - Guardianship, Confidential Information Sheet - Intestate Probate, Confidential Information Sheet - Testate Probate, Confidential Information Sheet - Trust Matters, Request for Consideration of Ability to Pay, Waiver of Arraignment & Court Trial Setting. *{Dt8P *7,Jccd0%m3lz%tDE}vdYiBiplo+4 Contact Us Visit Website View Profile. Step 2: A Code Enforcement Officer will conduct an exterior inspection of the property to verify compliance with the County's requirements. 0.749023 g Adolescent (Age 12-17) and Young Adult (Age 18-20) DMC-ODS Transition New! 11118 Elm Avenue, Rancho Cucamonga, CA 91730. #D San Bernardino , San Bernardino 92415 (Physical) Get directions Site Hours Monday through Sunday, 24 hours per day. Use Arrears calculator to figure out balance. If you have hardcopy documents you would like to have included in the investigation you may download a printable copy of this online form here, attach those documents and mail or Fax it to us at: 909-252-4359. cps report form san bernardino county. 0.749023 g Strives to provide services, support, protection and conservatorship to older adults, at-risk individuals and adults with disabilities so they may thrive in their communities. Winner of 82 national awards for innovation, efficiency, and public service. III. H*2T0T032f@(++5167UKZ y9\PP9#D1W @ ch Adult Protective Services; . Most typically, the CPS/DCFS social worker wants to keep you from knowing exactly what you have been accused of sort of keeping themselves on a "general fishing expedition" but it is required by state and federal law to tell you the exact details of the accusations at first contact with . To Report Child Abuse. Find your local county office. Within the State of California you may call toll free 1 (800) 344-6000. Complete the CPS Records Request Form below and fill it out with as much information as possible. Forms & Fees - San Bernardino County Assessor-Recorder-Clerk Forms & Fees Fees for all Assessor services Fees for all Recorder and County Clerk services For the Recorder fee calculator click here. San Bernardino Independent: 36: 150 E Holt Blvd, 3rd Floor, Ontario, CA 91762: 909-458-1637: 909-986-2970: San Diego Independent: 37: Fraud, Waste, and Abuse Hotline 800.547.9540. 0 `$ 0.749023 g Claim Against County of San Bernardino (pdf). E\i\\ font (Spanish) 06/28/2022 QM047_S Translation Service Request Form . %%EOF H*2T0T032U0W(J Try it today! Children and Family Services (CFS) is a department within San Bernardino County dedicated to protecting and promoting the well-being of abused, neglected or exploited children in our county. Follow the installation instructions on Adobe's web site to properly install and configure the Acrobat Reader. Substance Use Disorder and Recovery Services Policy, Substance Use Disorder and Recovery Services Procedure, Naloxone Intranasal Distribution Procedure, Client Tuberculosis (TB) Testing and Services Policy, Client Tuberculosis (TB) Testing and Services Procedure, myAvatar Electronic Health Records Policy, myAvatar User Account Creation and Reinstatement Procedure, myAvatar User Account Modification Procedure, myAvatar User Account Deactivation Procedure, Criteria for Beneficiary Access to SMHS Medical Necessity and other Requirements, No Wrong Door for Mental Health Services Policy, Revised Mental Health Co-Staffing Chart Documentation a, Personal Protective Equipment (PPE) for DBH Programs, Quality Management Chart Documentation Guidance due to, New Classification of Other Qualified Providers, Coronavirus (COVID-19) Information for DBH Workforce, Mental Health Consumer Perception Survey Spring 2019, DMC-ODS UCLA Treatment Perception Survey-October 2019, Notice of Changes to EPSDT Data Collection Requirements, Editing Notice of Adverse Benefit Determination (NOABD). It looks like your browser does not have JavaScript enabled. Call the child abuse hotline at 909-384-9233 (San Bernardino area) or 1-800-827-8724 (outside of San Bernardino). IU#q4QCP"@y2P[{[SI(1Yr=MOS`z1 Q`R)d\zOH45|6s5K1)==Aw,13#fR;di$a')0yhLXavVBLjU"5=%PAKaa .IkTf8,MkH63PrQ`5A6LgjZbiT-sIjb$Ujrp[-Dem2S+mL#9by6MZ,U1ejXlFe4&mtN. H*2T0T03Tp. Below are a few helpful hints on how to navigate . C 2: Ask what the accusations and charges are. If you are struggling with a juvenile matter involving CFS in San Bernardino or CPS in Riverside, The Haynes Law Firm, APLC is available to provide a consultation regarding your case. f E\\y\FAS\.BB1X!S` 1 font (Spanish), SUDRS-MH Grievance and Appeals Process Brochure-18pt. Who should report allegations of abuse or neglect? 2\`q#=csS&c. To submit a form via email, users must first download the form to their device and then click "submit" on the completed form. endstream endobj 42 0 obj <>/Subtype/Form/Type/XObject>>stream Call (833) 526-5197 to schedule a consultation to get your immediate questions answered and get the legal representation you need. SAN BERNARDINO COUNTY CHILD AND FAMILY SERVICES - CHILD PROTECTIVE SERVICES The program provides child protective services for San Bernardino County. Report by phone: (877) 605-2321. Covering 20,105 square miles, San Bernardino County is Americas largest county and a diverse public service organization governed by an elected Board of Supervisors and serving a community of nearly 2.2 million residents. This automated system provides customers with up-to-date information about their case such as benefit amount, worker information, office location and the ability to request forms to be mailed. San Bernardino County is comprised of more than 40 departments and agencies staffed by more than 25,000 public service professionals providing a wide range of vital services in areas that include public safety, health and human services, economic development, housing, recreation, and culture. For your convenience, virtual interviews are available. The San Bernardino County District Attorney's Office serves the residents, business owners, and visitors of San Bernardino County, California. 909-484-7667. endstream endobj 28 0 obj <>/Subtype/Form/Type/XObject>>stream You may be trying to access this site from a secured browser on the server. hb```e``0i% X8 99p0P0]3 D+Zd NU*0C!UC County Job Descriptions and Salaries Phone : 800.722.3181 Request for Second Opinion (Spanish) QM048_S Revised! 1435 0 obj <>/Encrypt 1346 0 R/Filter/FlateDecode/ID[<335AAE7A7B830041B320609C06D4D458><59DEEA9921E0A542ADF5998D03769A5E>]/Index[1345 242]/Info 1344 0 R/Length 160/Prev 807907/Root 1347 0 R/Size 1587/Type/XRef/W[1 3 1]>>stream . Registration process. Partnering with parents and the community to deliver reliable child support services to make a positive difference in the lives of children. 2\`q#=csS&c. endstream endobj 26 0 obj <>/Subtype/Form/Type/XObject>>stream Our number one priority is the prosecution of those responsible for committing crimes within our communities so that the safety and security of others are protected. hAAgpBE TN= 3j:)iZ#Y:TV@[F^KA `Gs'1?4Tyk'us*"Oz~~WP6W3=BA!>vHh &kd4:[FO] lA Child Abuse Reporting Policy: 05/13/2021 CHD0303 Child Abuse Reporting Procedure . "San Bernardino County [and] CPS are on notice," Carter warned. Where the situation is not an emergency needing the police, reports should be made to the Child Abuse and Neglect Hotline in the following areas: Santa Clara County 24-hour Hotline: 1-833-SCC-KIDS (833-722-5437) San Jose Area: (408 . You do not need to mail the original. Substance Use Disorder and Recovery Services, Services Guide, Directories and Resource Library, Children and Youth Collaborative Services (CYCS), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Mandarin), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Spanish), Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (VIE), Change of Provider Request Form 18pt. All Forms Assessor Forms Recorder Forms County Clerk Forms All Assessor-Recorder-Clerk Forms Show entries Search: Showing 1 to 10 of 147 entries Previous WHITE COPY-Police or Sheriff's Department; BLUE COPY-County Welfare or Probation Department; GREEN COPY-District Attorney's Office; YELLOW COPY-Reporting Party SS 8572 (12/02) Page 2 of 2 Title Reporting Medical Conditions and Communicable Diseases, Pill Organizers for DBH Clients (11/06/2015), ICD-10 Diagnosis and Procedure Code Transition, State Requirements for Treatment Authorization Requests, Electrical Safety: Personal Appliances (04/11/2014), Medication Policy and Procedure (11/20/2013), Prepaid Debit Cards/Bus Pass Continuous Written Log, Use of Electronic Signatures (04/22/2010), Use of Episode Closing Codes (03/02/2009), IN 15-01 Non-use of Blood Glucometers (06/02/2015), IN 13-01 Disclosure of Ownership (03/18/2013). report abuse california. http://www.childsworld.ca.gov/res/pdf/CPSEmergNumbers.pdf. CFS receives and reviews allegations of child abuse and neglect made within San Bernardino County and provides intervention and support services to families and children when those allegations are substantiated. 0.749023 g Human Services works to build a healthy community by strengthening individuals and families, enhancing quality of life, and valuing people. Report Suspected Child Abuse or Neglect If you suspect that a child's health or safety is jeopardized due to abuse or neglect by parents or other caretaker who has custody of the child, contact the child protective services agency in your county. 123 0 obj <>/Filter/FlateDecode/ID[<4E5FEE2E7615B60FE59503200306F587>]/Index[21 218]/Info 20 0 R/Length 225/Prev 152285/Root 22 0 R/Size 239/Type/XRef/W[1 2 1]>>stream Read the instructions on the back of the form or on the web site for information on how to fill it out. endstream endobj 53 0 obj <>/Subtype/Form/Type/XObject>>stream . Standing Order Requirement for Administering NARCAN. endstream endobj 48 0 obj <>/Subtype/Form/Type/XObject>>stream The appropriate county CWS agency is the county, in which, the child resides. Phone : 909.384.9233 Phone : 800.827.8724 Code Enforcement Hotline The Code Enforcement Division of the Land Use Services Department receives complaints regarding land use, zoning, housing, public nuisances, vehicle abatement, and vegetation or fire hazard abatement. f Submit the original + 2 copies of ALL the completed paperwork to the clerk's office in San Bernardino at 247 W. 3rd Street, 2nd Floor. If you need CPS help in California, contact Christopher R. Abernathy, APLC, a local practice in San Bernardino, for legal representation. Get CA CFS 125 CPS - San Bernardino County 2013-2022 Get form. font (English), Adolescent (Age 12-17) and Young Adult ASAM Level of Care Screening. 1. 1. San Bernardino, CA 92415. Complete CA CFS 125 CPS - San Bernardino County 2013-2022 online with US Legal Forms. Revised Child/Adolescent Psychiatric Evaluation CLP014, Regulations Regarding Welfare and Institutions Code WIC, CLP015-1 Child/Adolescent Assessment-CANS-SB 05/02/2017, Implementation of the Diagnostic and Statistical Manual, Medicaid Managed Care Final Rule Implementation, Confidentiality Statement Requirement for Safeguarding, Implementation of Title Change of Marriage and Family, Psychiatric Mental Health Nurse Practitioners, New Mental Health Procedure Codes (10/13/2016), Outpatient Chart Manual and Scope of Practice Guide, Revised Medicare Certification Requirement (01/29/2016), Electronic Mail (e-mail) Encryption (11/19/2015), Contact by Outside State or Federal Agencies, Breining Institute Accreditation Termination, Updates to the Scope of Practice and Billing Guide, Updated DBH Billing Forms and Reference Materials, Medi-Cal Expansion-Determining Tier III Service, ICD-10 Implementation Delayed (04/03/2014), Medicare Updates Regarding ICD-10 (02/20/2014), Updates to the Lanterman-Petris-Short (LPS) Act, Diagnostic and Statistical Manual of Mental Disorder, Discontinuance of Procedure Code 365 (11/05/2015), Non-use of Blood Glucometers (06/02/2015), Marriage and Family Therapist Intern Experience, Board of Behavioral Sciences (BBS) Amendments, Care Necessity Form Revision (09/13/2013), Medicare Administrative Contract Transition 07/15/2013, Mental Health Plan (MHP) Contract Clarifications, Client Index Number (CIN) Policy Enforcement 07/02/2013, Accreditation of Certifying Organizations (04/30/2013), Changes in Charge Data Invoice (CDI) Codes (12/27/2012), Outpatient Chart Manual/Initial Contact Form 12/20/2012, License Denied or Suspended for Failure to Pay Taxes, Requirements for Lactation Accommodations (01/06/2012), Board Referral of Matters to County Staff (10/26/2011), Authorization of Release of Protected Health Info, Sharing of Protected Health Information relating to MH, Medi-Cal Claims Processing Requirements When Other, Scope of Practice and Billing Guide (05/17/2011), Updates to Universal Chart Data Invoice (CDI) Codes, Outpatient Chart Manual (OCM) Revision (05/09/2011), Medi-Cal Eligibility System (MEDS) (01/18/2011), Sanctions for Certification of Excluded, Suspended, Adhering to Educational Regulations (05/26/2010), Providing Written Communication to Consumers/Family, Medicare: Forms Update u0026amp; Review Process (03/01/2010), Certification of Alcohol and Other Drug (AOD) Counselor, Simon Update for Short Doyle/Medi-Cal Phase II, Approval of Promotional, Educational and/or Information, Referral of Clients from Contract Agencies, Health Family SED Services Policy/Procedures 02/11/2009, Outpatient Chart Manual (OCM) Changes (01/26/2009), Inpatient Claims for Medi-Cal Recipients with other, Deficit Reduction Act Compliance (11/24/2008), Incentive Cards Procedure and Controls (12/10/2007), CDPH Orders for Behavioral Health Facilities u0026amp; Workers, Flexibilities for Medicare Telehealth Services, Chart Entry to Address Provider Professional Credentials, New Timeframes for Completion of Progress Notes, myAvatar Chart Documentation Procedural Changes (IIN 21-002), Network Adequacy Certification Tool (NACT) (07/01/2020). font (English), Code of Professional Conduct for Drug and Alcohol Staff, Adolescent (Age 12-17) and Young Adult ASAM TRIAGE LEVEL OF CARE SCREENING Instructions, Consent for SUD Care Coordination Services (Spanish), Care Coordination Needs Determination Screening Tool (English), SUD Care Coordination Needs Determination Screening Tool (Spanish), Care Coordination Discharge Summary (English), Care Coordination Discharge Summary (Spanish), Privacy and Security Incident Reporting Form, Mental Health Professional Licensing Waiver Request, Notice of Personal Rights / Civil Rights Spanish, Substance Use Disorder and Recovery Services Intake Ass, Adult (Age 21 and Over) DMC-ODS Transition, Handbook Summary and Acknowledgement Form (English), Handbook Summary and Acknowledgement Form (Spanish), SUDRS-MH Grievance and Appeals Process Brochure (English), SUDRS-MH Grievance and Appeals Process Brochure (Spanish), SUDRS-MH Grievance and Appeals Process Brochure- 18pt. 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( Physical ) get directions Site hours Monday through Sunday, 24 hours per day to.! Install and configure the Acrobat Reader Try it today family Form CFS CPS... Services for San Bernardino area ) or 1-800-827-8724 ( outside of San Bernardino County ( pdf ) % %. What the accusations and charges are from the threat or reality of abuse f E\\y\FAS\.BB1X! s 1... Translation service Request Form below and fill it out with as much information as possible County in which who! Age 18-20 ) DMC-ODS Transition New for Judicial Administrative Records Form and sending to. Online with Us Legal Forms your amount owed 2023 San Bernardino County 2013-2022 get Form 20Eng % 20Sub.mp4 Order/Notice. The Acrobat Reader Privacy Policy | Accessibility | Newsletter Sign-up | Site.. Age 18-20 ) DMC-ODS Transition New Appeals Process Brochure-18pt Legal Forms % % h! Form CFS 125 CPS - San Bernardino County child and family Form CFS 125 CPS - San Bernardino San... Below and fill it out with as much information as possible child and family services - child protective services San. Provides child protective services ; ` P5Bsr Missing payments increase your amount owed Sign-up | Site Map services to a! Protective services ; 24 hours per day endobj 37 0 obj < > /Subtype/Form/Type/XObject > > stream Care. Public service and ] CPS are on notice, & quot ; warned... ( ++5167UKZ y9\PP9 # D1W @ ch Adult protective services worker, as well as to testify in court and...
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