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.
Application Caregiver Form With Child In Suffolk
Category:
State:
Multi-State
County:
Suffolk
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
Description
Free preview
Form popularity
FAQ
The Local Welfare Assistance Scheme (LWAS) helps those experiencing financial hardship. There are lots of reasons why you may be in hardship and if you are eligible, we can provide financial help. To receive help from LWAS you must: Be able to demonstrate you are in financial hardship.
Go there to ask for an application for Non-Public Assistance Food Stamps, or telephone the office at (516) 227-8523 and ask them to mail one to you. If you reside in Suffolk County, there are four Department of Social Services Centers where you can apply: Riverhead (893 E. Main St, 631-852-3560)
SWEP. The Suffolk Works Employment Program (SWEP) helps Temporary Assistance applicants and recipients obtain the skills they need to find employment. Once employed, families can receive help with childcare and other work-related expenses.
Children's Single Point of Access (C-SPOA) The program serves Suffolk County residents, ages 5 to 21 years, and their families. All C-SPOA programs are voluntary for both the youth and their family. This application is for accessing CSPOA in-home services and supports, including preventive and intensive services.
Who Can Apply for a Child Care Voucher? Your family may qualify for child care assistance if your family's income falls below 85% of the State Median Income and you have an approved reason for seeking child care ("reason for care"). This reason must be at least one of the following: You work 10+ hours per week.
Income Requirements Family SizeAnnual Income LimitMonthly Income Limit 2 $73,869.56 $6,155.80 3 $91,250.63 $7,604.22 4 $108,631.70 $9,052.64 5 $126,012.77 $10,501.062 more rows
Day Care Center AgeWeeklyDaily Under 1 ½ $406.00 $80.00 1 ½ – 2 $370.00 $75.00 3-5 $325.00 $67.00 6-12 $300.00 $60.00