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Printable checklist
IHSS Application Document Checklist for California
Updated September 16, 2026. Reviewed September 16, 2026 against public CDSS, DHCS, Medicare.gov, VA, and CareScout 2025 California tables. County wages, hours, and wait times still change. Official .gov pages decide.
A printable list of documents California families usually gather for IHSS: Medi-Cal, SOC 295, SOC 873, copies, and provider enrollment. Counties decide when a file is complete.
Based on public CDSS, DHCS, Medicare.gov, VA, and California Department of Insurance pages retrieved 2026-09-16. County, Medi-Cal, Medicare, VA, and insurer staff decide what actually pays. Hourly rates, hour totals, waiver slots, and wait times are local and change.
Short answer
Most stalled IHSS files are missing a page, not missing a diagnosis. Confirm Medi-Cal, submit a signed SOC 295, return SOC 873 or the alternative documentation the county names, keep copies, and start provider enrollment if you will give the care. The county decides when the packet is complete.
Who decides
County IHSS and Medi-Cal staff decide completeness, eligibility, and hours. CDSS publishes the forms. This checklist is the family side.
What to do next
Print this page, download SOC 295 and SOC 873 from the CDSS catalog, and put dated copies in one folder.
Before you send SOC 295
- Confirm the person lives in California in a home they choose, not a hospital or licensed facility as “own home.”
- Write the home address and county.
- Check Medi-Cal status. If it is missing, start BenefitsCal or the county Medi-Cal office.
- Ask whether a share of cost applies. Do not guess the amount.
- Talk with the person about who may sit in on the visit and who they want as provider.
- Ask how an adult child can be listed so the county can speak with you.
Core pages
- SOC 295, signed, from the CDSS forms catalog.
- SOC 873, completed by a licensed health professional, or alternative documentation the county names.
- A simple typical-day list (bathing, dressing, meals, toileting, transfers, unsupervised risk if it applies). Not an hour demand.
- Copies of Medi-Cal evidence if you have it, labeled, not dumped.
- A folder of dated copies of everything you submit.
If you will be the provider
- County provider orientation.
- SOC 426 and the provider agreement (SOC 846) as the county packet uses them.
- Identity and work-authorization documents the county lists.
- Background check steps the county requires.
- Ask about EVV and, if you live in the home, SOC 2298 live-in self-certification.
After you submit
- Note the date and how you submitted (in person, mail, portal).
- Call once to confirm the file is complete. Daily calls rarely speed assignment.
- Prepare for the home visit with the assessment packing list.
- Read the Notice of Action when it arrives. That is the list that counts.
Forms live on CDSS, not on a rumor
Download SOC 295 and SOC 873 from CDSS. The forms catalog is the index. The longer narrative is an IHSS paperwork checklist and what to send with the application.
Spanish-speaking families can start with cómo solicitar. County offices still run the English and translated official forms they accept.
Questions people ask
- Do I attach the entire hospital chart?
- Usually no. SOC 873, or the alternative the county names, is the medical piece they ask for. Bring extra pages only when a worker asks.
- Can provider enrollment wait until after the notice?
- It can, but starting early means the first authorized timesheet is less likely to sit. Orientation and background checks take their own time.
- Where do I get the forms?
- The CDSS forms catalog. Links on this page go there. Do not pay a random site for SOC PDFs.
Official sources for this page
Related pages
Official program pages: CDSS: In-Home Supportive Services, CDSS: IHSS for children, County IHSS offices, CDSS: IHSS providers, CDSS: county IHSS wage rates, CDSS: provider orientation, CDSS: Electronic Visit Verification, CDSS: Electronic Services Portal, DHCS: Medi-Cal, Apply for Medi-Cal, BenefitsCal, CDSS: hearing requests, CDSS: forms catalog, CDSS: IHSS overtime and workweek, DDS: regional centers.