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STATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCYCALIFORNIA DEPARTMENT OF SOCIAL SERVICES000000003SOC 2261 (7/15)INHOME SUPPORTIVE SERVICES (IHSS) INDIVIDUAL PROVIDER TIMESHEETINHOME SUPPORTIVE.

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If you were convicted within the last 10 years of elder / dependent adult abuse, child abuse or fraud against a government health care or supportive services program you are not eligible to be an IHSS provider. Find applicant live scan (fingerprinting) in your area: locations and hours of operation.

• Ensure a completed IHSS Individualized Back-up Plan and Risk. Assessment (SOC 864) that indicates the steps the recipient must take in the event of an emergency, is in OnBase and print a copy to give to the client at the home visit. • Print out a Needs Assessment Form (SOC 293) from CMIPS II.

• This form allows the IHSS applicant/recipient or his/her legal representative to. choose an Authorized Representative for the IHSS program and identifies the functions the Authorized Representative may perform on his/her behalf. This form is only for the IHSS program.

IHSS rules describe paramedical tasks as: Administration of medications, Puncturing the skin, Inserting a medical device into an opening in the body, Activities requiring sterile procedures, or. Other activities requiring judgement based on training given by a licensed health care professional.

For this purpose, a legal representative is a court-appointed guardian or conservator, or for a recipient who is a minor, the parent or other individual who is the legally authorized decision maker for the minor. To do so, the recipient or their legal representative must complete the SOC 839 Form Part C.

SOC 846 IHSS Program Provider Enrollment Agreement.

Completing the paramedical services form Sometimes, doctors will request assistance from parents in filling out the paramedical services form (SOC 321).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232