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Social Services

County of San Luis Obispo

Home » Departments » Social Services » Forms & Documents » Adult Services » Public Authority (IHSS Providers) Forms

Public Authority (IHSS Providers) Forms

  • IHSS PA 100 Caregiver Registry Application and Instructions (Sp)
  • IHSS PA 100 Caregiver Registry Application and Instructions
  • Provider 2nd Violation Self-Certification Instructional Review Materials
  • SOC 341A Mandated Reporter Acknowledgement
  • SOC 341A (Sp) Mandated Reporter Acknowledgement
  • SOC 426 IHSS Provider Enrollment Form
  • SOC 426 (Sp) IHSS Provider Enrollment Form
  • SOC 846 IHSS Provider Enrollment Agreement
  • SOC 846 (Sp) IHSS Provider Enrollment Agreement
  • SOC 2255 Provider Workweek & Travel Time Agreement
  • SOC 2255 (Sp) Provider Workweek & Travel Time Agreement
  • SOC 2256 IHSS Program Recipient and Provider Workweek Agreement
  • SOC 2256 (Sp) IHSS Program Recipient and Provider Workweek Agreement
  • SOC 2279 Live In Family Care Provider Overtime Exemption
  • SOC 2279 (Sp) Live In Family Care Provider Overtime Exemption
  • SOC 2302 In-Home Supportive Services (IHSS) Program Provider Paid Sick Leave Request Form
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Devin Drake

Director

Take me to:

  • Mandated Reporter Training »
  • Apply for IHSS »
  • APS Multidisciplinary Team Meeting »
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  • Public Authority (IHSS Providers) Forms »
  • Public Authority (IHSS Providers) Information »
  • Public Authority (IHSS Providers) Resources »
  • Public Authority (IHSS Providers) Videos »
  • Provider Enrollment Information »
  • Apply for the Caregiver Registry! »
  • IHSS Provider Benefits »
  • SLO Master Plan »

Contact Social Services

Child 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)
  • After calling the hotline, mandated reporters must fill out the Suspected Child Abuse Report BCIA 8572 and send it to the CWS Social Worker by fax or email.

Adult Hotline Information:

  • If you suspect there is an emergency requiring immediate intervention, call 911
  • 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
  • Mandated Reporter

 

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1055 Monterey Street, San Luis Obispo, CA 93408

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County Phone Directory: 805-781-5000

(Toll free: 800-834-4636)

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