California Department of Social Services Forms

This form is used for confirming the enrollment of recipients of In-Home Supportive Services (IHSS) or Waiver Personal Care Services (WPCS) in the Electronic Timesheet Service or Telephone Timesheet System in California.

This form is used for notifying applicants of their application confirmation number for the In-home Supportive Services Program in California.

This form is used for the In-home Supportive Services (IHSS) Program in California. It is a response letter to a provider, rescinding a third or fourth violation for exceeding workweek and/or travel time limits.

This form is used for reporting on contract mode services in the state of California.

This form is used for the In-home Supportive Services Program in California. It is a notice to the recipient acknowledging the provider's request for a review of county violation for exceeding workweek and/or travel time limits.

This form is used for acknowledging the receipt of a county violation review in the In-home Supportive Services Program in California.

This form is used for notifying the provider in California's In-home Supportive Services Program about their right to dispute a violation regarding exceeding workweek and/or travel time limits.

This form is used for notifying the service provider in the In-home Supportive Services Program in California about their failure to complete the workweek and travel agreement.

This form is used for notifying recipients of the In-home Supportive Services Program in California about their failure to complete the Workweek Agreement (Soc 2256).

This document is used for providing notice to In-home Supportive Services (IHSS) providers in California regarding the cancellation of an alternate schedule due to a recurring event.

This form is used for the In-home Supportive Services Program in California. It is a notice to the recipient informing them of the cancellation of an alternate schedule due to a recurring event.

This form is used for notifying providers in California's In-home Supportive Services program about the approval to work an alternate schedule due to a recurring event.

This form is used for recipients of the In-home Supportive Services (IHSS) program in California to approve their provider to work an alternate schedule due to a recurring event.

This form is used for the In-home Supportive Services Program in California to notify a provider of the denial of their request to exceed weekly hours.

This form is used for providing a notice to the recipients of the In-home Supportive Services Program in California regarding the denial of their request to exceed the weekly hours limit.

This type of document is used in California for notifying recipients of the In-home Supportive Services Program about a provider's fourth violation within a one-year period. The violation refers to exceeding workweek and/or travel time limits, resulting in a one-year period of ineligibility.

This form is used for notifying providers in California of their fourth violation in exceeding workweek and/or travel time limits within a one-year period. The violation results in a one-year period of ineligibility for the In-home Supportive Services Program.

This form is used for notifying recipients of the In-home Supportive Services Program in California about a provider's third violation, which results in a 90-day suspension of eligibility. The violation pertains to exceeding workweek and/or travel time limits.

This form is used for notifying providers in California's In-home Supportive Services Program of their third violation, resulting in a 90-day suspension of eligibility. The violations may include exceeding workweek and/or travel time limits.

This form is used for the In-home Supportive Services program in California. It notifies the provider of their second violation for exceeding workweek and/or travel time limits.

This Form is used for the In-home Supportive Services Program in California to provide a notice to a provider of a second violation with no record of completion of review of instructional materials.

This Form is used for notifying recipients in the In-Home Supportive Services Program in California about their provider's first or second violation for exceeding workweek and/or travel time limits.

This form is used for filing an appeal with the California Cannabis Control Commission (CCI).

This Form is used for applying for qualified agency certification in California. It is necessary for agencies who wish to provide services to the state government.

This document is a checklist used for the application process to become a qualified agency in California. It ensures that all necessary requirements are met before submitting the application.

This Form is used for reporting findings in the IHSS (In-Home Supportive Services) program in California. It is used to document information about the care provided to IHSS recipients and to evaluate their eligibility for benefits.