Nevada State Funded - Sierra Regional Center (SRC) 2026

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The document is an intake form for enrolling support service professionals (SSPs) in a worker self-direction program. It collects personal and employment-related information from the SSP, outlines the responsibilities of common law employers, and details the mandatory criminal background checks required for hiring. The form emphasizes that completion does not guarantee employment and includes terms of agreement regarding confidentiality, eligibility, and compliance with laws.

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Click ‘Get Form’ to open the Nevada State Funded - Sierra Regional Center (SRC) form in our editor.
Begin by filling out the 'Participant and Common Law Employer Information' section. Enter the participant's name and ID, followed by the employer's name and ID.
Next, complete the 'Support Service Professional (Applicant) Information' section. Fill in your first name, middle name, last name, date of birth, gender, and social security number.
Indicate whether you share a residence with the participant and if you are related by blood or marriage. Provide details as necessary.
Fill in your physical address and mailing address if different. Include your contact numbers and preferred method of communication.
In the 'Enrollment Preference' section, select how you would like to continue the enrollment process—either online or via email/mail.
Complete all required background information fields on the next page to ensure compliance with program requirements.

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Where does regional center funding come from?

Funding for regional centers comes from the California General Fund and the federal Medicaid program. The Lanterman Act also created Area Boards and the State Council on Developmental Disabilities. There are 13 Area Boards, located in different regions throughout the state.

Who funds Harbor Regional Center?

Our center opened its doors in 1973 and served 397 individuals. We currently serve over 19,000 individuals. Our major source of funding is a combination of state and federal government programs and, we also receive funding for specific projects or purposes from foundations, businesses, and individuals.

What does San Andreas Regional Center do?

The San Andreas Regional Center is one of 21 Regional Centers for people with developmental disabilities in the State of California. These centers were originally established to assist people with intellectual disabilities and their families in locating and developing services and programs within their communities.

How to apply for DRC Las Vegas?

How to Apply? To apply, contact a Regional Center near you: Southern Nevada - Desert Regional Center (702) 486-7850. Rural Nevada - Rural Regional Center (775) 687-5162.

Who funds San Andreas Regional Center?

San Andreas Regional Center is a community-based, private nonprofit corporation funded by the State of California to serve people with developmental disabilities as required by the Lanterman Developmental Disabilities Act.

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Is the Inland Regional Center federally funded?

Inland Regional Center (IRC), formally Inland Counties Regional Center, Inc., is a government-funded not-for-profit public benefit corporation that provides services and programs to more than 33,000 people with developmental disabilities and their families in Californias San Bernardino and Riverside Counties.

Nevada State Funded - Sierra Regional Center (SRC) 2026

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