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Phone: 4167433892 Fax: 4167437654 Email: information@canes.on.caCaregiver Support and Counselling Referral Formation 1 Date of Referral Applicants Last Name Address CityPostal Code Date of birth mm/dd/yyyyAgeCatchment
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How to fill out in home supportive services

01
To fill out the In-Home Supportive Services (IHSS) application, follow these steps:
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Gather necessary documents: You will need to provide proof of identity (such as a driver's license or passport), proof of California residency, and proof of income. Make sure you have these documents ready before starting the application process.
03
Contact your local IHSS office: Find the contact information for your county's IHSS office and reach out to them. They will guide you through the application process and provide any additional forms or instructions.
04
Complete the application form: Fill out the IHSS application form accurately and thoroughly. Make sure to provide all required information, including personal details, medical conditions, and any specific needs or requirements.
05
Submit supporting documents: Along with the application form, you may need to submit additional documents, such as medical records or caregiver certifications. Follow the instructions provided by the IHSS office and include all necessary paperwork.
06
Attend an assessment interview: Once your application is received, you will be scheduled for an in-person assessment interview. This interview is conducted to determine your eligibility and the level of support required. Answer all questions honestly and provide any additional information or documentation requested.
07
Wait for a decision: After the assessment, the IHSS office will review your application and determine whether you qualify for in-home supportive services. It may take some time to receive a decision, so be patient.
08
Follow up with the IHSS office: If you have any questions or need updates on your application status, don't hesitate to contact your local IHSS office. They can provide you with the necessary information and assist you throughout the process.
09
Start receiving services: If your application is approved, you can start receiving in-home supportive services. The IHSS office will work with you to create a care plan and assign a caregiver based on your needs.
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Note: The application process and eligibility requirements may vary slightly depending on your county. It is recommended to reach out to your local IHSS office for specific instructions and guidance.

Who needs in home supportive services?

01
In-Home Supportive Services (IHSS) is primarily designed to assist individuals who have disabilities, are elderly (65 years or older), or blind. It is a program that provides services and support to help these individuals remain safely in their own homes and avoid institutionalization.
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Specific groups of people who may benefit from IHSS include:
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- Individuals with physical disabilities or cognitive impairments
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- Older adults who need assistance with daily activities
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- Individuals with chronic illnesses or medical conditions
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- People recovering from surgeries or accidents
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- Those with visual or hearing impairments
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- Individuals in need of personal care assistance
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- Low-income individuals who cannot afford other care services
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The eligibility for IHSS is determined based on various factors, including the individual's functional limitations, income, and resources. It is advised to contact your local IHSS office for detailed information on eligibility criteria and requirements.
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In Home Supportive Services (IHSS) is a program designed to provide assistance to individuals who are elderly, disabled, or blind, allowing them to remain in their homes rather than entering institutional care.
Individuals applying for IHSS must file for the program, demonstrating their need for assistance based on their physical or mental condition.
To fill out the IHSS application, one must complete the necessary forms provided by the state or county, provide documentation of their medical needs, and submit the application to the local IHSS office.
The purpose of IHSS is to help eligible individuals live independently by providing them with personal care services and support within their home environment.
Applicants must report their personal information, medical needs, income, and any other relevant details that demonstrate their eligibility for the program.
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