Form Soc 2283 - In-Home Supportive Services Program Notice To Recipient Upholding Provider'S Third Violation (90-Day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Page 2

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
If your provider does not file a request for a State Administrative Review within 10 calendar
days from the date of this notice, he/she will not be eligible to provide IHSS services 20
calendar days from the date of this notice, for a period of 90 days.
If you need assistance finding a new provider until your regular provider is eligible to
provide services again, please contact your county IHSS office.
If you are unsure of the date your provider is eligible to be an IHSS provider or have
questions about this notice, please contact your county IHSS office.
PAGE 2 OF 2
SOC 2283 (7/16)

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Form Soc 2285 - In-home Supportive Services Program Notice To Recipient Upholding Provider's Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2285 - In-home Supportive Services Program Notice To Recipient Upholding Provider's Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2258a - In-home Supportive Services Program Notice To Recipient Of Provider's Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2258a - In-home Supportive Services Program Notice To Recipient Of Provider's Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2282 - In-home Supportive Services Program Notice To Provider Upholding Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2282 - In-home Supportive Services Program Notice To Provider Upholding Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2286 - In-home Supportive Services Program State Administrative Review Request Response Letter To Provider Upholding Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2286 - In-home Supportive Services Program State Administrative Review Request Response Letter To Provider Upholding Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2258 - In-home Supportive Services Program Notice To Provider Of Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2258 - In-home Supportive Services Program Notice To Provider Of Third Violation (90-day Suspension Of Eligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2281 - In-home Supportive Services Program Notice To Recipient Upholding Provider's First Or Second Violation For Exceeding Workweek And/or Travel Time Limits Form Soc 2281 - In-home Supportive Services Program Notice To Recipient Upholding Provider's First Or Second Violation For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2259a - In-home Supportive Services Program Notice To Recipient Of Provider's Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2259a - In-home Supportive Services Program Notice To Recipient Of Provider's Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2264 - In-home Supportive Services Program Notice To Recipient Rescinding Provider Violation Form Soc 2264 - In-home Supportive Services Program Notice To Recipient Rescinding Provider Violation Legal
Form Soc 2272b - In-home Supportive Services Program Notice To Recipient Acknowledgement Of Provider's Request For County Violation Review For Exceeding Workweek And/or Travel Time Limits Form Soc 2272b - In-home Supportive Services Program Notice To Recipient Acknowledgement Of Provider's Request For County Violation Review For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2284 - In-home Supportive Services Program Notice To Provider Upholding Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2284 - In-home Supportive Services Program Notice To Provider Upholding Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Legal

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