Service Provider Forms

Please review the DDS Guidelines for Vendorization and Rates Frequently Asked Questions .

For information regarding services, becoming a provider and/or a vendor application, please contact the appropriate Resource Coordinator.

SDRC Community Services

For information regarding services, becoming a provider and/or a vendor application, please contact the appropriate Resource Coordinator

Miguel Larios

Community Services Director

Saralynn Keenan

Community Services Manager

Tiffany Swan

Community Services Manager

Erik Peterson

Community Services Manager

Brian U ribe

Community Resource Development Manager

Julie Martinez

Family Home Agencies (FHA)

Wenddy Baca

Liliana Calderon

Intermediate Care Facilities (ICF)

Raquel Zaragoza

Supported Living (SLS)

Independent Living (ILS)

Coordinated Family Supports (CFS)

Personal Assistance (PA)

Kristen VandenBroek

Early Start Services

Sandra Bishop

Rosalie Goulding

Michelle Flores

Paid Internship Program

Gwen Noll

Participant Directed Services

Rosanne Serrano

Jesus Espinosa

Naomi Carpenter

Lourdes Delatorre

Todd Lordson

Jorge Malone

Juan Gonzalez

Health & Safety Waiver Specialist

Amy Mackenzie

Anna Keller

Lindsay Reyes

Maricela Giron

Sarah Pierce

Albert Noriega

Patent Preparation and Prosecution

Breach Incident Report

If information about an individual a vendor serves is ever lost, stolen or received by anyone who is not that person or that persons legally authorize representative, the California Department of Developmental Services (DDS) considers that a “security breach.” Anytime there is a security breach of information possessed by a vendor, DDS requires the vendor to both notify the person whose information was breached (or their legally authorized representative) by letter, as well as the Regional Center using form DS 5340B. The letter sent to the individual needs to be sent within 60 days of the discovery of the breach and a copy needs to be sent to the Regional Center. Vendor breaches also need to be reported to the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) online here .

If you have any questions, please contact Seth Mader , San Diego Regional Center’s Information Security Officer.