California IHSS Program Recipient Notice of Hours
This document provides recipients of the IHSS program with vital information regarding their authorized maximum weekly hours. It includes essential contact information for social workers and guidelines for managing caregiver schedules. Understanding this notice is crucial for recipients to ensure compliance with IHSS regulations.
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How do I fill this out?
To fill out the IHSS Recipient Notice, first verify the notification date and your personal information at the top of the document. Next, calculate your maximum weekly hours based on the provided monthly authorized hours. Lastly, keep this document accessible for your reference regarding provider hours.

How to fill out the California IHSS Program Recipient Notice of Hours?
1
Locate your notification date and personal information.
2
Calculate your maximum weekly hours from the monthly authorized hours.
3
Ensure you understand your responsibilities as a recipient.
4
Review your provider's schedule to comply with hourly limitations.
5
Save the document for future reference.
Who needs the California IHSS Program Recipient Notice of Hours?
1
IHSS recipients who want to understand their service hours.
2
Caregivers who need to keep track of their work hours for recipients.
3
Social workers who assist clients with managing their IHSS hours.
4
Families of IHSS recipients seeking clarity on service provision.
5
Administrative staff in social services needing to verify hour allocations.
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What are the instructions for submitting this form?
To submit your IHSS Recipient Notice, contact your social worker using the provided telephone number or email. You may also fax your completed notice to the social services office. Ensure all required fields are filled accurately to avoid delays in processing.
What are the important dates for this form in 2024 and 2025?
Key important dates concerning changes in authorized hours or notifications will be communicated through official channels. Always refer to your latest notices to stay updated. Make sure to review your hours each month as needed.

What is the purpose of this form?
This form serves to inform recipients of the In-Home Supportive Services (IHSS) Program about their maximum authorized hours. It is crucial for ensuring caregivers are compensated appropriately while complying with IHSS regulations. Understanding this notice helps recipients manage their care and provider schedules efficiently.

Tell me about this form and its components and fields line-by-line.

- 1. Notification Date: The date this notice is provided to the recipient.
- 2. Recipient Name: The full name of the individual receiving IHSS services.
- 3. Recipient Case Number: A unique identifier for the recipient's case.
- 4. Social Worker Name: The name of the social worker assigned to the case.
- 5. Social Worker Number: The identification number of the social worker.
- 6. Social Worker Telephone: The contact phone number of the social worker.
- 7. Social Worker Address: The mailing address of the social worker.
- 8. Authorized Monthly Hours: The total number of service hours authorized per month.
- 9. Maximum Weekly Hours: The calculated maximum number of service hours per week.
What happens if I fail to submit this form?
Failing to submit this form may result in a lack of clarity regarding the authorized service hours. Recipients could face unauthorized hours exceeding the limits set forth by the IHSS program. It's vital to submit the form timely to avoid any disruptions in service.
- Inaccurate Hours: Without proper submission, recipients may not have accurate records of their service hours.
- Provider Payment Issues: Providers may not be compensated correctly if hours exceed authorized limits.
- Service Disruptions: Failure to submit could lead to interruptions in necessary in-home services.
How do I know when to use this form?

- 1. Receiving New Hours: When you are notified of new maximum hours for your IHSS services.
- 2. Adjusting Care Provider Schedules: To coordinate schedules effectively between you and your provider.
- 3. Tracking Service Hours: For personal record-keeping of the hours authorized for your caregivers.
Frequently Asked Questions
How can I edit my IHSS Recipient Notice?
You can easily edit your IHSS Recipient Notice by uploading it to PrintFriendly and using our intuitive editing tools.
Can I calculate my weekly hours with this document?
Yes, this notice provides guidelines for calculating your maximum weekly hours based on your monthly authorized hours.
Is there a way to save my changes?
After making the necessary edits, you will be able to download the updated PDF to your device.
How do I share my edited document?
You can share your edited document directly from PrintFriendly through email or social media.
What should I do if my hours change?
If your hours change, you will receive a notice of action, and it's important to update your provider's schedule accordingly.
Who should I contact for questions?
For any questions regarding the IHSS notice, please reach out to the social worker listed on the document.
Can caregivers edit the notice?
Yes, caregivers can edit the notice to reflect their working hours as needed.
What if I make a mistake while editing?
You can easily undo changes or re-edit the document until you are satisfied with the final result.
Do I need a special account to use PrintFriendly?
No special account is required to use PrintFriendly’s editing and sharing features.
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