Application Caregiver Form With Child In Oakland

State:
Multi-State
County:
Oakland
Control #:
US-00458BG
Format:
Word; 
Rich Text
Instant download

Description

The Application Caregiver Form with Child in Oakland serves as a formal agreement between a client and a caregiver, outlining the terms of employment and specifying the assistance provided. It includes essential details such as caregiver responsibilities in assisting with daily living activities, managing medication schedules, and accompanying clients on errands. Users can customize the agreement by establishing a work schedule, which requires prior notice for any changes. The form allows for termination by either party with a written notice. Legal provisions are included for disputes, emphasizing the independence of the caregiver as a contractor rather than an employee. This form is particularly beneficial for attorneys, partners, owners, associates, paralegals, and legal assistants as it provides a clear contractual framework that outlines rights and obligations, helping clients understand their choices in caregiver services. The straightforward structure and clarity of language ensure accessibility for users with varying levels of legal expertise, facilitating efficient use and edits as needed.
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  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent

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FAQ

Submit a completed and signed Application for In-Home Supportive Services SOC 295 to: IHSSSOC295Apps@acgov.

Contact IHSS at (408) 792-1600 or fill out the application and submit using one of the options below. Mail. In-Home Supportive Services. PO Box 11018. San Jose, CA 95103-1018.

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.

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.

A county social worker will interview to determine your eligibility and need for IHSS. You must have a physician or other licensed health care professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized.

In-Home Supportive Services (IHSS) Program You must also be a California resident. You must have a Medi-Cal eligibility determination. You must live at home or an abode of your own choosing (acute care hospital, long-term care facilities, and licensed community care facilities are not considered "own home").

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.

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Application Caregiver Form With Child In Oakland