Caregiver Form Printable With Holidays In Riverside
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
Who is it For: 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").
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.
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) .
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"). You must submit a completed Health Care Certification form.
To apply for IHSS over the phone, contact Riverside's HOME Call Center at (888) 960-4477. Phones are answered Monday – Friday from AM to PM Pacific time, excluding County holidays.
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.
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) .
