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.
Care Caregiver Form Application With Database Example In Riverside
Category:
State:
Multi-State
County:
Riverside
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
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. Obtain a criminal record clearance.
Apply for services or become a caregiver by calling the IHSS Home Line and Public Authority at (888) 960-4477. Click here to visit our Riverside IHSS website for specific IHSS support for clients and providers.
You are blind, live with a disability or are 65 years of age or older. You must live at home in Santa Clara County. You must have Medi-Cal. Apply for Medi-Cal.
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) .
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.
Home Care Aide Application Process Access the Guardian Applicant Portal at . Create an Account by clicking “Register as a new user.” A temporary password will be sent to your email account. Enter Application Information. Retrieve the Live Scan Form.
Verify Caregiver Registration Click here to go to the state's Home Care Aide Registry search page. Enter the caregiver's first name, last name and PER ID#. Click "search". Check the "Status" column to determine if your caregiver has registered and been cleared (passed the DOJ and FBI background check) to provide care.
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.
Apply for services or become a caregiver by calling the IHSS Home Line and Public Authority at (888) 960-4477. Click here to visit our Riverside IHSS website for specific IHSS support for clients and providers.