This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Application Caregiver Form Without Experience In Alameda
Category:
State:
Multi-State
County:
Alameda
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
Description
Free preview
Form popularity
FAQ
MY PHONE: Call 510-577-1800 weekdays from AM - 12 Noon or - PM. Once you dial, when prompted, press “1” for English and then “1” for applying for IHSS and “1” a third time to speak with an intake screener. 2. BY MAIL: Request an application to be mailed to client's home.
Eligibility. To become an IHSS Provider, you must: Complete and sign all mandatory forms included in the IHSS Program Provider Enrollment Packet and return it to the County IHSS Office. Be fingerprinted and go through a criminal background check by the California Department of Justice (DOJ).
How to Become an IHSS Provider Go to an IHSS Provider Orientation given by the county. Complete, sign and return the IHSS Program Provider Enrollment Form (SOC 426) directly to the County IHSS Office or IHSS Public Authority. Complete and sign the IHSS Provider Enrollment Agreement (SOC 846) .
Under the law, you are ineligible to work in the IHSS program ONLY if you have been convicted within the last 10 years of: 1) fraud against a government health care or supportive services program; 2) child abuse; or 3) abuse of an elder or dependent adult.
Submit a completed and signed Application for In-Home Supportive Services SOC 295 to: IHSSSOC295Apps@acgov.
To be eligible for IHSS, an individual must be Medi-Cal eligible or must be receiving Supplemental Security Income (SSI) benefits. The IHSS program provides payment for non-medical in-home care for qualified individuals who are unable to remain safely in their homes without this assistance.
Attend 2-hour, group Orientation in San Francisco Valid state or U.S. government-issued photo ID. Original Social Security card. A Work Authorization (required only if your Social Security card states "Valid for work only with DHS or INS authorization") Completed the IHSS Provider Packet (including SOC 426A).
The basic requirements are: To be able to pass an enhanced DBS check as our carers look after vulnerable people. To be able to use a mobile phone and our simple care app. To have positive references. To be physically fit, for example to be able to bend and kneel for some time.
Qualifications of a Caregiver A valid driver's license. Bilingual in a language spoken in your region. CPR certification. CNA certification. Ability to pass a background check. Ability to assist with ADLs (assisting with eating, toileting, bathing, dressing)
To become a caregiver in California, meet state requirements (work authorization, background check, good health), complete a Home Care Aide certification course and provide proof of vaccinations and a negative TB test.