Soc 2279-2026

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The document outlines the requirements and conditions for Live-In Family Care Providers under the In-Home Supportive Services (IHSS) program in California. It specifies that providers can work up to 90 hours per week if they meet certain criteria, including providing services to multiple recipients, living with them, and being related to them. The document also includes sections for provider and recipient information, as well as a declaration of compliance with the exemption requirements.

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Click ‘Get Form’ to open the SOC 2279 in the editor.
In Part A, review the provider requirements carefully. Ensure you meet all three conditions for the overtime exemption before proceeding.
Move to Part B and enter your residential address in the designated field. Make sure this is accurate as it will be used for verification.
Next, fill in your mailing address. This should be where you receive correspondence related to your IHSS services.
Complete the recipient information chart by entering each recipient's name, case number, and your relationship to them. Indicate whether they live with you by answering Yes or No.
Finally, read through the declaration statement at the bottom of the form. Sign and date it to confirm that all information provided is true and correct.

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2016	4.8 Satisfied (165 Votes)

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soc 2279

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