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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.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

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.
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.
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).
IHSS program at-a-glance A Provider can be a family member, a friend or anyone who has completed the enrollment process through the Public Authority. 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.
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) .
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.
Postal service: IHSS, PO Box 11018 San Jose, CA 95103-1018. Fax: (408) 792-1601. In-person: 353 W. Julian Street, San Jose.
Apply for In-Home Supportive Services Gather important information. You will need your contact information, date of birth, social security number, and Medi-Cal number. Apply for IHSS. Turn in a completed IHSS application by email, fax, mail, or in-person. Home visit. Service approval. Hire provider(s).