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Click ‘Get Form’ to open the soc 2248 in the editor.
Begin by entering the provider relationship to the recipient, followed by the county where services are provided.
Fill in the IHSS recipient's name, Social Security Number (SSN), date of birth (DOB), and address. Repeat this for the IHSS provider.
Indicate whether the complaint is against the recipient, provider, or both by checking the appropriate boxes.
In section A, provide your details as the reporting party including your name, email, phone number, and relationship to the IHSS participant.
For section B, check all applicable reasons for your complaint and provide any necessary details such as dates or names of facilities.
Use section C to narrate any observations related to your complaint. Be specific about actions observed and dates.
Complete sections D through G as required for case file information and determinations. Ensure all necessary enclosures are attached before submission.

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How do I file a complaint with IHSS in California?

How can I report a concern and/or complaint? calling 805-654-3416. -2320 (TTY) or turn in a complaint intake form online at: .dfeh.ca.gov/complaint-process/file-a- complaint/.

Does IHSS do investigations?

If you are reported for IHSS fraud, an investiga- tion will be conducted. Fraud will be prosecuted. If information is found that you are defrauding by withholding income information to another program a referral will be sent to the appropriate agency.

What is form soc 864?

Ensure a completed IHSS Individualized Back-up Plan and Risk. Assessment (SOC 864) that indicates the steps the recipient must take in the event of an emergency, is in OnBase and print a copy to give to the client at the home visit. Print out a Needs Assessment Form (SOC 293) from CMIPS II.