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Care Provider Advantage · Forms library

The IHSS provider forms, explained

Every form has a number and a purpose, but none come with a plain-language guide. This library does: what each one is, who signs it, where it goes, how to fill it right, and the mistakes that get it sent back. Official CDSS PDFs linked on every entry; nothing here replaces them.

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You fill out and sign

  • SOC 426Provider Enrollment Form

    The form that starts your enrollment: your identity, your contact details, and a yes/no disclosure about certain convictions. Signed under penalty of perjury and returned in person with original ID.

    Official PDF (rev. 6/16)

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  • SOC 846Provider Enrollment Agreement

    The rules you agree to as a provider: timesheets, the workweek and overtime limits, travel time, the four-violation ladder, sick leave, mandated reporting. Signed once, usually at orientation.

    Official PDF (rev. 10/19)

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  • SOC 2279Live-In Family Care Provider Overtime Exemption (Exemption 1)

    Lets a parent, stepparent, adoptive parent, grandparent or legal guardian who lives with and cares for two or more recipients work up to 90 hours a week and 360 a month instead of 66. Only for providers who already met the conditions on January 31, 2016 — everyone else uses Exemption 2.

    Official PDF (rev. 1/16)

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  • SOC 840Provider or Recipient Change of Address and/or Telephone

    The one-page form for a new home address, mailing address or phone number. Your paychecks, W-2, violation notices and SOC 2271 all go to the address on file, so this is the form that keeps them reaching you.

    Official PDF (rev. 10/12)

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Form numbers, revision dates and official links were checked against the CDSS PDFs on the date shown on each entry. CDSS lists every form, with Spanish versions, on its forms index; your county office has printed copies. More forms are added each month — members get them automatically.

THIS PRODUCT OR SERVICE HAS NOT BEEN APPROVED OR ENDORSED BY ANY GOVERNMENTAL AGENCY, AND THIS OFFER IS NOT BEING MADE BY AN AGENCY OF THE GOVERNMENT. IHSSProviderReady.com is an independent educational resource, not affiliated with CDSS or any county. The official forms are published by CDSS.