Note: If you can show that you need more hours than what is listed above, you may qualify to get it. Sacramento, CA 94244. As a result, this particular dangerous behavior might not qualify for protective supervision, because it likely does not require 24-hour-a day oversight. Tips for Using Adobe PDF Files, Notice of Action Documents(used by county governments), Copyright 2023 California Department of Social Services, NA Back9 (5/22) - Your Hearing Rights (Full Rights Are Listed in CDSS PUB 412), NA Description Of Services L (3/15) - Description Of services, NA IHSS Back L (3/15) - Your Hearing Rights, NA 200 (12/20) - Notice Of Action - Multipurpose - Include Budget, NA 200 (7/21) - Notice Of Action - Multipurpose - Include Budget, NA 210 (5/20) - Discontinue, Suspend Financial Eligibility, NA 213 (10/21) - Deny - Financial Eligibility, NA 213A (12/20) Notice Of Action Deny Financial Eligibility, NA 213A (7/21) Notice Of Action Deny Financial Eligibility, NA 214 (4/00) - Discontinue, Suspend Transfer of Property, NA 215 (1/00) - Continuation Page, Sponsor Non Citizens Deemed Income, NA 216 (11/99) - Sponsored Non Citizens Property, NA 271 (12/20) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 271 (7/21) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 274 (4/99) - Continuation Page Overpayment Computations (prior to 10-1-89), NA 274B (4/99) - Continuation Page Overpayment Computations (for 10/1/89 to 8/31/91), NA 274C (4/99) - Continuation Page - Overpayment Computations (for 9/1/91 to 8/31/95), NA 274D (1/00) - Continuation Page - Overpayment Computations (Ortega 9/1/95 to 12/31/97), NA 274E (6/11) - Notice Of Action Overpayment Computations For 1-1-98 to 6-30-2011, NA 274F (6/11) - Notice Of Action - Overpayment Amount Owed (For Overpayments Occurring On Or After 7/1/2011), NA 274G (7/19) - Notice Of Action - Continuation Page - Overpayment ComputationsOccurringOn Or After10/1/2013, NA 274H (12/20) - Notice Of Action - Continuation Page - Overpayment Computations Between 6/1/2020 and 05/31/2021, NA 274I (7/21) - Notice Of Action - Continued - Overpayment Amount Owed For Overpayments Occurring Between 6-1-2021 and 5-31-2022, NA 274J (7/21)-Notice of Action Continued - Overpayment Amount Owed For Overpayments Occurring On or after 6-1-2022, NA 275 (4/99) - Continuation Page - Overpayment Adjustment Computation - Cash Aid, NA 277 (1/00) - Continuation Page Optional Persons Transfer of Property, NA 278 (1/00) - Discontinue/Suspend Optional Persons Transfer of Property, NA 279 (1/00) - Excess Property (with Good Faith), NA 280 (1/00) - Excess Property (w/o Good Faith), NA 281 (6/11) - Notice Of Action - Underpayment Amount Owed (For Underpayments Occurring on or After 1-1-98 thru 6-30-2011), NA 281A (6/11) - Notice Of Action Underpayment Amount Owed (For Underpayments Occurring On Or After 7/1/2011), NA 281B (5/13) - Notice Of Action Continuation Page - Underpayment Computations On Or After 10/1/2, NA 281C (7/19) - Notice Of Action - Continuation Page - Underpayment Computations Occurring On Or After 6/1/2020, NA 281C (12/20) - Notice Of Action Continuation Page - Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2020 and 5-31-2021), NA 281D (7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2021 and 5-31-2022), NA 281E(7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring On Or After 6-1-2022), NA 290 (2/14) -Notice Of Action - Multipurpose, NA 300 (7/19) - Notice Of Action - Continuation Page - Recipient Financial Eligibility Test, NA 300 (10/21) - Notice Of Action - Continuation Page - RecipientFinancial Eligibility Tests, NA 301 (10/21) - Continuation Page - Applicant Financial Eligibility Test, NA 403 (1/22)- Notice Of Action - For Resource Families, Including Homes Certified By AFoster Family Agency, County Approved Relative Homes, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians, Intensive Treatment Foster Care and/or Intensive Services Foster Care, Group Homes and Short-Term Residential Therapeutic Programs, NA 403A (4/17) - Notice Of Action Approval, Change Or Discontinued For Kinship - Guardians Only, NA 421 (6/21) Assistance Dog Special Allowance (ADSA) - Notice Of Action - Approval, NA 422 (11/21) - Assistance Dog Special Allowance (ADSA), NA 422L (1/22) -Assistance Dog Special Allowance (ADSA) Notice of Action Denial, NA 530 (4/11) - Notice Of Action -48-Month Time Limit, NA 530 (4/21) - Notice Of Action - 60-Month Time Limit, NA 531 (12/20) - Notice Of Action - Continuation Page-48-Month Time Limit- Includes Budget, NA 531 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 531 (7/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 532 (7/19) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue, NA 532 (12/20) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue - Includes Budget, NA 532 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 532 (11/21) - Notice Of Action- Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 691 (3/18) - Notice Of Denial - Cash Assistance Program For Immigrants (CAPI), NA 692 (12/17) - Notice Of Change - Cash Assistance Program For Immigrants (CAPI), NA 693 (9/22) - Notice Of Approval - Cash Assistance Program For Immigrants (CAPI), NA 791 (9/18) - Notice Of Action - Approval/Denial/Change, NA 816 (3/14) - Notice Of Action - Sanction Of Other Parent After Failed Compliance Plan, NA 817 (3/14) - Notice Of Action - Sanction Of Participant After Failed Compliance Plan, NA 818 (3/14) - Notice Of Action - Taking You Out Of Welfare To Work, NA 820 (1/01) - Notice Of Action - Transportation Approval, NA 821 (1/01) - Notice Of Action - Transportation Approval/Denial, NA 822 (7/16) - Notice Of Action - Transportation Change, NA 823 (8/00) - Notice Of Action - Ancillary Expenses Approval/Denial, NA 825 (8/00) - Notice Of Action - Payment Adjust Transportation, NA 827 (7/99) - Notice Of Action - Recoupment Unused Advance Payment, NA 828 (7/99) - Notice Of Action - Transportation And Ancillary Exp Overpayment, NA 832 (3/20) - Notice of Action - Child Care Services, NA 833 (4/20) - Notice of Action - Child Care Services Change, NA 834 (3/20) - Notice of Action - Child Care Services Denial, NA 835 (3/20) - Notice of Action - Child Care Services Discontinuance, NA 840 (3/14) - Notice Of Action - Welfare To Work Plan, NA 840A (10/03) - Notice Of Action - Determination Of Good Cause/No Good Cause, NA 841 (3/14) - Notice Of Action - Welfare-To-Work Plan, NA 843 (6/99) - Notice Of Action - Ineligible, NA 844 (8/99) - Notice Of Action - Adequate Progress, NA 845 (3/14) - Notice Of Action - Sanction and Removal Of The Other Parent's Needs, NA 960X SAR (9/13) - Notice Of Action - Stop Aid;Report Not Received, NA 960Y SAR (10/14) - Notice Of Action - Stop Aid;Report Incomplete, NA 991 (10/03) - Notice Of Action - Refugee Cash Assistance (RCA)/Entrant Cash Assistance (ECA) MC-Decrease/Expiration (Time-Expiration), NA 992 (5/03) - Refugee Cash Assistance (RCA) Application Approval, NA 994 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Requirement (Violation Prior To Three Consecutive Month Grace Period), NA 995 (5/13) - Food Stamp Notice of Denial/Disqualification For The California Food Assistance Program, NA 996 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Rule (Violation After Receipt Of Three Consecutive Month Grace Period, NA 1209 (2/02) - Notice Of Action - Change In The Amount Of Kin-Gap Payment, NA 1210 (4/02) - Notice Of Action - Discontinue, NA 1211 (2/00) - Notice Of Action - Denial, NA 1212 (2/00) - Notice Of Action - Discontinue Property, NA 1213 (2/00) - Notice Of Action - Discontinue Restricted Account, NA 1214 (2/00) - Notice Of Action - Change Under/Overpayment, NA 1217 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice of Overpayment, NA 1218 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice Of Underpayment, NA 1230 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Approval, NA 1231 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Partial Waiver Approval, NA 1232 (2/21) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Denial, NA 1233 (3/02) - Notice Of Action - Multipurpose, NA 1239 AR (12/20) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 AR (8/21) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 SAR (12/20) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1239 SAR (8/21) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1240 (4/13) -Notice Of Action - Food Stamp Overissuance & Dormant EBT Account, NA 1250 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1250L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1251 (5/09) -Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1251L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1252 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1252L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1253 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1253L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1254 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1254L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1255 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1255L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1256 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1256L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1257 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1257L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1261 (1/16) - Notice Of Action - Form and Instructions - For Group Homes, Short-Term Residential Treatment Centers, Foster Family Agencies, Transitional Housing Placement-Plus Foster Care and Transitional Housing Placement Program, NA 1261A (3/20) - Notice Of Action For Approved Relatives, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians or Non-Minor Dependents Residing In A Supervised Independent Living Setting, NA 1261B (1/16) - Notice Of Action - Form And Instructions - For Kinship-Guardians Only, NA 1263 (8/11) - Notice Of Action - Overissuance Budget Worksheet, NA 1267 (4/13) - CalFresh Informing Notice Of Receiving Intercounty Transfer, NA 1268 (4/13) - CalFresh Informing Notice Of Sending Intercounty Transfer, NA 1269 (11/11) - Notice Of Action - Approve Non-Minor Dependent, NA 1270 (11/11) - Notice Of Action - Discontinue Non-Minor Dependent, NA 1271 (5/14) - Notice Of Action - Denial Of Home Assessment/Approval, NA 1273 (7/13) - Electronic Notification Agreement, NA 1274 (7/13) - Electronic Notification Notice, NA 1275 (7/13) - Electronic Notification Cancellation Notice, NA 1276 (1/15) - Notice Of Action - Welfare-to-Work 24-Month Time Clock Limit Notice, NA 1277 (1/16) - Notice Of Action - Approved Relative Caregiver (ARC) Overpayment, NA 1278 (11/16) - Notice Of Action - Approve Approved Relative Caregiver (ARC) Payment, NA 1279 (5/22) Notice of Action Deny Approved Relative Caregiver (ARC) Payment, NA 1280 (5/22) Notice of Action Discontinue Approved Relative Caregiver (ARC) Payment, NA 1281 (11/16) - Notice Of Action - Change Approved Relative Caregiver (ARC) Payment, NA 1282 (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, NA 1282L (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, PI 2 (6/15) - IRS Office Of Safeguards Data Incident Report, PUB 13 (5/22) - Your Rights Under California Public Benefits Programs - For People Applying For Or Receiving Public Aid In California, PUB 56 (12/06) - The In-Home Supportive Services Program, PUB 69 (5/22) - County Forms Catalog2021-2022, PUB 104 (12/06) - In-Home Supportive Services Individual Provider Benefits and Services Information, PUB 179A (5/15) - A Manual Communication Guide For Field Officers, PUB 190 (8/06) - How To Hire And Supervise Your In-Home Supportive Services (IHSS) Provider, PUB 203 (1/04) - In-Home Supportive Services - Guide to Workers Compensation Benefits for Individual Providers. IHSS Timesheet Issues/Questions: If, however, the child only touches the hot stove when the parent is cooking, then it may well be considered a predictable behavior (as the parent knows when the child may attempt the behavior). The application is also available in other languages, including, but not limited to: SOC 295 in Spanish; SOC 295 in Chinese; and SOC 295 in Armenian. It can be challenging to secure protective supervision. Your ability to provide convincing documentation may very well make or break your case for protective supervision. As a Parent, Do I Qualify for (IHSS) Protective Supervision as a Provider? Of course, no applicant engages in potentially dangerous activity every minute of every day. Protective Supervision is part of the In-Home Support Services (IHSS) program in California. For more information and resourcesvisit the In-Home Supportive Services Program website. The reasons to request a rehearing include: You can submit your rehearing request by: State Hearings Division What happens at the assessment for Protective Supervision? The home visit is an important part of the initial assessment, which forms the basis of the countys decision to authorize or deny protective supervision. endobj Nonself-directing means an inability, due to a mental impairment/mental illness, for individuals to assess danger and the risk of harm, and therefore, the individuals would most likely engage in potentially dangerous activities that may cause self-harm. (All County Letter (ACL) No. According to theCalifornia Department of Social Services (CDSS) current interpretation of the regulations, an individual must: For minors, there is an additional requirement. This assessment will include information given by you and, if appropriate, by your family, friends, physician or other licensed health care professional. laid off for a reason other than the need to care for their child is not Furnel, Inc. has been successfully implementing this policy through honesty, integrity, and continuous improvement. A parent living with their minor recipient child is Get paid faster? Our advocates can lead you through everything, as well as provide resources to better assist you and your child with special needs. Schedule for 2022 Year-End Payroll Processing. Web1) Assessment Of Need For Protective Supervision for In-Home Supportive Services Program (SOC 821 (3/06)). You can appeal your denial of protective supervision by: California Department of Social Services WebIHSS is a California government program that provides financial support for in-home caretakers of impaired elders, persons with disabilities, and children with developmental disabilities including autism. Protective supervision is available for both adults and minors (18 and under). If you have an authorized representative, the judge will ask if he/she would like to make the applicants opening statement. 0 Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision. The recipients doctor will also need to be provided a If you lock your account, you won't be able to log in again. For example: A fully paralyzed person is not capable of putting himself/herself at risk of harm. IHSS Application in English If your county has homemaker employees, you may receive services from a county homemaker. To defend the countys position, a county hearing representative will attend the hearing, often accompanied by a county social worker. Services that can be performed in the workplace include meal preparation and cleanup, personal care services (except routine bed baths), and paramedical services. A parent who is on paid or unpaid leave or has been IHSS Providers: How to Become an IHSS Provider How to Appeal if You are Denied IHSS Provider Resources IHSS Timesheet Issues/Questions: IHSS Provider How to Secure Protective Supervision - A Complete Guide, Cmo Obtener IHSS Protective Supervision - Una Gua Completa, Copyright 2021 IHSS Law Office of James Diskint. What are the eligibility requirements for Protective Supervision? While a variety of benefits are available, the most important for families of children with special needs is Protective Supervision. If income too high for SSI, may qualify with share of cost. mentally unable to provide IHSS services; 4) the parent is unavailable because While a variety of benefits are available, the most important for families of children with special needs is Protective Supervision. 21 Engel Injection Molding Machines (28 to 300 Ton Capacity), 9 new Rotary Engel Presses (85 Ton Capacity), Rotary and Horizontal Molding, Precision Insert Molding, Full Part Automation, Electric Testing, Hipot Testing, Welding. How do I request a rehearing for Protective Supervision? If so, what is the date of the Notice of Action? Box 944243, Mail Station 6-16-50 IHSS includes the following services: Domestic Services: General household chores to maintain the cleanliness of If the applicant is a minor and client of a regional center, provide relevant regional center documents, such as an IPP or IFSP. Instead, the applicant must show a propensity for placing him/herself in danger. x[[o~0o provider if the parent left full-time employment or is unable to obtain To apply for Protective Supervision, first complete the Application for In-Home Supportive Services, also known as SOC 295. Note that it is CDSS policy that leaving an applicant alone for some fixed short period of time, is not, by itself, a reason to deny protective supervision. Therefore, it is a bit confusing and repetitive for CDSS to include an additional requirement that the individual must be likely to engage in potentially dangerous activities. Keep a log to describe all the potential accidents that would happen if your child were not supervised. Why Choose an IHSS Lawyer for Your Appeal? An IHSS provider may be paid to watch a child who has special needs to prevent injuries or accidents, when that child needs 24-hour supervision so he can remain safely IHSS helps older adults and people with disabilities with daily activities such as bathing, dressing, laundry, shopping, and cooking. for employment or essential purposes related to care for the recipients A parent can be a paid IHSS provider for their minor This is a valuable opportunity to support your case for protective supervision, because social workers dont always have the opportunity to observe the applicants dangerous behaviors during the short home visit, an unfortunate circumstance which can lead to a denial. A Parent, Do I qualify for protective Supervision ) Assessment of need for protective Supervision, it... Hours of Services per month, including protective Supervision no applicant engages in dangerous... Services from a county homemaker the judge will ask if he/she would like to make applicants! 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