Protective supervision 24 hour a day coverage plan example 2025

1. Click ‘Get Form’ to open the Protective Supervision 24-Hours-A-Day Coverage Plan in the editor.
2. Begin by entering the full name of the IHSS recipient in the designated field. This ensures that the plan is accurately associated with the correct individual.
3. Next, input the recipient’s telephone number and home address where care will primarily be provided. This information is crucial for effective communication and coordination.
4. Identify and enter the name of the primary contact responsible for coordinating care, along with their telephone number and relationship to the recipient. This establishes a clear point of contact.
5. List up to three care providers responsible for delivering 24-hour coverage, including their contact numbers. If more providers are involved, you can attach an additional sheet.
6. In the section describing the implementation of the coverage plan, outline how care will be provided throughout the day. Be as detailed as possible to ensure clarity.
7. Finally, have both the primary contact and IHSS social worker sign and date the form to finalize it. Ensure a copy is retained for records.

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