Personal Care Services Program Provider/Enrollment Agreement

In most cases, care providers are required to sign a Personal Care Services Program Provider/Enrollment Agreement  (CDSS Form SOC 426 and SOC 426 SP) to work with IHSS clients.

• If you get a SOC 426 or  SOC 426 (en Español) in the mail from IHSS, care providers must complete the form. 
• If you obtain a copy the SOC 426 or SOC 426 (en Español) from this web site, the document is inter-active and can be completed online.   
• The care provider must sign and date the form.
• The care provider must return the form to the IHSS social worker who sent it to you. 

It is important to return this form to the IHSS social worker before you can be issued a paycheck!  You will not get your time card or be paid until this form is returned to the IHSS social worker at IHSS Public Authority offices. For more information, please call the IHSS Social Worker at (831)454-4101 or (831)763-8800.  

Important Information:

• If you will be doing personal care, please watch your mail for this form and return it immediately!
• Program de Servicios de Cuidado Personal Acuerdo del Proveedor/de Inscripcion SOC 426 SP