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 With Child In Fairfax
Category:
State:
Multi-State
County:
Fairfax
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
Description
Free preview
Form popularity
FAQ
Calling your case worker directly or calling the Customer Call Center at 703-324-7500, Monday–Friday, 8 a.m.– p.m.
Call Fairfax County's Child Protective Services (CPS) hotline 703-324-7400. You may give your name or remain anonymous.
Two ways to apply for the Child Care Subsidy Program Apply online, or screen for eligibility through CommonHelp, a self-service portal available 24 hours a day, 7 days a week. Submit a Child Care Service Application and Redetermination Form to your local department of social services.
Anyone can report suspected child abuse or neglect to a local department of social services or to the CPS Hotline. Callers will be asked to provide as much information as possible about the child, the alleged abuser and the incident.
Call 703-324-7500. Download an application for SNAP, TANF, General Relief and more (English, Spanish).
Call Fairfax County's Child Protective Services (CPS) hotline 703-324-7400. You may give your name or remain anonymous.
As a licensed provider, you have a competitive advantage over unlicensed and unregistered providers. Your licensed program is held to a higher standard that provides accountability to health and safety standards enforced by the Commonwealth of Virginia.
Head Start and Early Head Start. Prekindergarten programs. School-age child care programs.
If you would like personal assistance in finding child care, contact Child Care Aware of Virginia at 866-543-7852.