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This version of the form is not currently in use and is provided for reference only. Download this version of
Form SOC2255
for the current year.
Form SOC2255 In-home Supportive Services (Ihss) Program Provider Workweek & Travel Time Agreement - California
What Is Form SOC2255?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is SOC2255?
A: SOC2255 is a form used for the In-home Supportive Services (Ihss) Program Provider Workweek & Travel Time Agreement in California.
Q: What is the In-home Supportive Services (Ihss) Program?
A: The In-home Supportive Services (Ihss) Program is a California state program that provides assistance to eligible individuals with disabilities or older adults who need help with daily activities in their own homes.
Q: What is the purpose of the SOC2255 form?
A: The purpose of the SOC2255 form is to establish an agreement between the IHSS program provider and the recipient regarding the provider's workweek schedule and travel time.
Q: Who needs to fill out the SOC2255 form?
A: Both the IHSS program provider and the recipient need to fill out the SOC2255 form.
Q: What information is required in the SOC2255 form?
A: The SOC2255 form requires the provider's name, provider number, recipient's name, recipient's case number, and details about the workweek schedule and travel time.
Q: Are there any deadlines for submitting the SOC2255 form?
A: The deadlines for submitting the SOC2255 form may vary depending on the county. It is advisable to contact your local IHSS office for specific information.
Q: Can the SOC2255 form be modified or canceled after submission?
A: Yes, the SOC2255 form can be modified or canceled after submission. It is important to notify your local IHSS office about any changes or cancellations.
Q: What happens after submitting the SOC2255 form?
A: After submitting the SOC2255 form, it will be reviewed by the IHSS program staff. If approved, the agreement will go into effect and the provider will follow the agreed-upon workweek schedule and travel time.
Q: What should I do if I have questions or need assistance with the SOC2255 form?
A: If you have questions or need assistance with the SOC2255 form, you can contact your local county IHSS office for guidance and support.
Form Details:
- Released on November 1, 2015;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form SOC2255 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form SOC2255 In-home Supportive Services (Ihss) Program Provider Workweek & Travel Time Agreement - California
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