Forms & Documents > Adult Services > Public Authority (IHSS Providers) Forms

Name Description Type Action
IHSS-PA-100-Caregiver-Registry-Application-and-Instructions File Download
IHSS-PA-100-Caregiver-Registry-Application-and-Instructions-(Sp) File Download
PA Eform Online Form View
SOC-846-IHSS-Provider-Enrollment-Agreement SOC 846 IHSS Provider Enrollment Agreement File Download
SOC-846-SP-IHSS-Provider-Enrollment-Agreement SOC 846 SP IHSS Provider Enrollment Agreement File Download
SOC-426-IHSS-Provider-Enrollment-Form SOC 426 IHSS Provider Enrollment Form File Download
SOC-426-SP-IHSS-Provider-Enrollment-Form SOC 426 SP IHSS Provider Enrollment Form File Download
SOC-341A-Mandated-Reporter-Acknowledgement SOC 341A Mandated Reporter Acknowledgement File Download
SOC-341A-SP-Mandated-Reporter-Acknowledgement SOC 341A SP Mandated Reporter Acknowledgement File Download
SOC-2255-Provider-Workweek-and-Travel-Time-Agreement SOC 2255 Provider Workweek and Travel Time Agreement File Download
SOC-2255-SP-Provider-Workweek-and-Travel-Time-Agreement SOC 2255 SP Provider Workweek and Travel Time Agreement File Download
SOC-2256-IHSS-Program-Recipient-and-Provider-Workweek-Agreement SOC 2256 IHSS Program Recipient and Provider Workweek Agreement File Download
SOC-2256-SP-IHSS-Program-Recipient-and-Provider-Workweek-Agreement SOC 2256 SP IHSS Program Recipient and Provider Workweek Agreement File Download
SOC-2279-Live-In-Family-Care-Provider-Overtime-Exemption SOC 2279 Live-In Family Care Provider Overtime Exemption File Download
SOC-2279-SP-Live-In-Family-Care-Provider-Overtime-Exemption SOC 2279 SP Live-In Family Care Provider Overtime Exemption File Download
Provider-2nd-Violation-Self-Certification-Instructional-Review-Materials Provider 2nd Violation Self-Certification Instructional Review Materials File Download
Provider-2nd-Violation-Self-Certification-Instructional-Review-Materials-SP Provider 2nd Violation Self-Certification Instructional Review Materials SP File Download

Contact Social Services

Child and Adult Hotline Information:

  • If you suspect there is an emergency requiring immediate intervention, call 911
  • To report suspected child abuse or neglect call the 24 hour Child Abuse Hotline at (805) 781-KIDS (5437) or toll free 1-800-834-KIDS (5437)
  • To report suspected elder abuse or neglect call the Adult Services Hotline at (805) 781-1790 during regular business hours, or after business hours call (844) 729-8011