Get Soc 871 - California Department Of Social Services - State Of ... - Cdss Ca

Filling out the SOC 871 form is an essential step in the process of managing general exception appeals within the California In-Home Supportive Services program. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently.

Follow the steps to complete the SOC 871 form.

1. Click the ‘Get Form’ button to access the SOC 871 form and open it in the filling interface.
2. In the 'General Exception Appeal Information' section, enter the legal case number, which should be between 9 to 11 digits. Then, input the date the appeal request was received and the date on which the acknowledgment letter was sent to the applicant provider.
3. In the same section, indicate the due date for the Statement of Facts (SOF) and select the county where the applicant is applying to be an IHSS provider. Lastly, enter the name of the county contact.
4. Proceed to the 'General Exception Applicant Provider Information' section. Fill in the name of the applicant provider in the format of last name, first name, and middle initial. Ensure to provide the correct address, city, ZIP code, and telephone number.
5. In the 'Type of Action Requested' section, mark the option for either 'General Exception Denial' or 'General Exception Rescission', depending on the action you wish to take.
6. In the 'CBCB GEU Information' section, fill out the contact information for the CBCB GEU analyst, including their name, telephone number, and mail station. Then, provide the same details for the analyst’s manager.
7. Ensure to obtain the required signatures and dates for both the manager and the bureau chief in the respective fields.
8. In the 'Comments' section, summarize the reasons that support the denial of the general exception request. Include factors considered, such as rehabilitation efforts, and other relevant documentation.
9. After completing all fields, you can save changes, download the form, print it for your records, or share it as needed.

Complete the SOC 871 form online today to ensure your appeal is processed smoothly.