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Click ‘Get Form’ to open the inland respite indio in the editor.
Begin by entering the month and year of your leave period. Ensure you circle the correct pay period ending date.
Fill in your Employee Name and Employee I.D. # accurately to avoid any processing issues.
Record the dates of your leave in the DATE section, using the MM/DD/YY format. Make sure to circle AM or PM for both TIME FROM and TIME TO fields.
Calculate and enter TOTAL HOURS worked during your leave, rounding to the nearest quarter hour as specified.
Select a reason for your leave from the provided options by circling one that applies.
Sign and date the form at the bottom, certifying that all information is correct before submission.

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Who qualifies for respite care in California?

Members are eligible for Respite Services if they live in the community and are compromised in their Activities of Daily Living (ADLs) and are therefore dependent upon a qualified caregiver who provides most of their support, and who require caregiver relief to avoid institutional placement are eligible for Respite

How much does it cost for respite?

Paying for respite care According to the UK care guide, respite care costs on average 700 to 800 a week. It can be as much as 1,500 a week, for emergency respite care, live-in care, or staying in a care home. There are 2 main ways of getting help with the costs of respite care: from the council.

Does Medicaid pay for respite care in Illinois?

Individuals who are 60 years and older and eligible for Medicaid can receive coverage for respite care through Illinois waiver program.

How much is respite care per hour in California?

Average base salary The average salary for a respite worker is $19.93 per hour in California. 54 salaries taken from job postings on Indeed in the past 36 months (updated September 12, 2025).

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