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.
Caregiver Application Form With Insurance In Orange
Category:
State:
Multi-State
County:
Orange
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
Become a Provider Step 1: Set up Your Account. Visit the IHSS enrollment website and. Step 2: Get Fingerprinted. Step 3: Attend the In-Person Orientation. Step 4: Fill Out and Return the SIP Packet. Step 5: Create an Online Account.
Orange County IHSS Public Authority Provider/Caregiver Services Must follow the application process. Attend Registry Orientation. Submit a complete application. Must be willing and able to provide personal care and perform domestic services. Must own an insured and dependable car. Must be able to speak/read/write English.
Home Care Aides (HCA) need 5 hours of initial training and 5 hours of annual training in specific topics which CareAcademy offers. Certified Nursing Assistant (CNAs) need 48 hours of continuing education over 2 years, 24 hours can be obtained through an approved provider like CareAcademy (NAC provider number 7047).
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.
In Los Angeles County, you can apply by phone by calling (888) 944-IHSS (4477) or (213) 744-IHSS (4477) or complete the application SOC 295 - Application For In-Home Supportive Services, available at .
Who is Eligible? To be eligible, a person must meet all of the following requirements: Be disabled, blind, or age 65 years or older. Be unable to live at home safely without help.
120 hour HHA Training Be at least sixteen (16) years of age. Have successfully completed a 120-hour training program approved by The California Department of Public Health, which includes an examination to test the applicant's knowledge and skills related to basic patient care services.
Welcome to the County of Orange Social Services Agency In-Home Supportive Services (IHSS) website. The purpose of the IHSS program is to provide supportive services to persons who are aged, blind, or disabled, and who are limited in their ability to care for themselves and cannot live at home safely without assistance.
You can become a provider by attending an in-person provider orientation or by completing the provider orientation process online. After the orientation you will be required to visit an IHSS office to: Present your photo ID and Social Security card; Complete and return the required enrollment forms; and.