The following “Commonly Used Recipient and Provider State Forms” is available on the California Department of Social Services website at: http://www.cdss.ca.gov/inforesources/Forms-Brochures/Forms-Alphabetic-List/Q-T#soc.
- Application for In-Home Supportive Services - SOC 295
- Recipient Responsibility Checklist - SOC 332
- Provider Enrollment - SOC 426
- Recipient Designation of Provider - SOC 426A
- Provider Direct Deposit Enrollment - SOC 829
- Recipient Request for Provider Assigned Hours - SOC 838
- Recipient or Provider Change of Address and/or Telephone Number - SOC 840
- Provider Enrollment Agreement - SOC 846
- Health Certification - SOC 873
- Provider Workweek and Travel Time Agreement - SOC 2255
- Provider Live-In Certification - SOC 2298
- Provider Live-In Cancellation - SOC 2299
- Provider Paid Sick Leave Request - SOC 2302
The following are Riverside County’s “Commonly Used IHSS Forms”.
Example: Live Scan Forms for Riverside County IHSS must include the information below