Form Soc 2272a - In-Home Supportive Services Program Notice To Provider Acknowledgement Of Receipt Of County Violation Review For Exceeding Workweek And/or Travel Time Limits

ADVERTISEMENT

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
IN-HOME SUPPORTIVE SERVICES PROGRAM
NOTICE TO PROVIDER
ACKNOWLEDGEMENT OF RECEIPT OF COUNTY VIOLATION REVIEW
FOR EXCEEDING WORKWEEK AND/OR TRAVEL TIME LIMITS
(ADDRESSEE)
COUNTY OF:
Notice Date:
Provider Name:
IHSS Office Address:
IHSS Office Telephone Number:
To: In-Home Supportive Services (IHSS) Provider
This notice is to inform you that the IHSS office has received your request to review the
violation you received.
The county now has ten (10) business days to conduct the county review and issue a
decision on your request to review the violation. If you are requesting the review of
your third or fourth violation, your ineligibility to provide and be paid to provide
authorized IHSS to your current recipient or any other person will not begin until after
the county has made a decision on your request. You will receive notification of the
outcome of your dispute request.
If you have any questions about this notice, you may contact your IHSS office at the
phone number above.
SOC 2272A (4/16)

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Soc 2265 - In-home Supportive Services Program Notice To Provider Reduction Of Total Violation Count Form Soc 2265 - In-home Supportive Services Program Notice To Provider Reduction Of Total Violation Count 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 2267a - In-home Supportive Services Program Notice To Provider Denial Of Exception To Exceed Weekly Hours Form Soc 2267a - In-home Supportive Services Program Notice To Provider Denial Of Exception To Exceed Weekly Hours Legal
Form Soc 2266a - In-home Supportive Services Program Notice To Provider Approval Of Exception To Exceed Weekly Hours Form Soc 2266a - In-home Supportive Services Program Notice To Provider Approval Of Exception To Exceed Weekly Hours Legal
Form Soc 2269a - In-home Supportive Services Program Notice To Provider Cancellation Of Alternate Schedule Due To Recurring Event Form Soc 2269a - In-home Supportive Services Program Notice To Provider Cancellation Of Alternate Schedule Due To Recurring Event Legal
Form Soc 2272 - In-home Supportive Services Program Notice To Provider Of Right To Dispute Violation For Exceeding Workweek And/or Travel Time Limits Form Soc 2272 - In-home Supportive Services Program Notice To Provider Of Right To Dispute Violation 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
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 2280 - In-home Supportive Services Program Notice To Provider Upholding First Or Second Violation For Exceeding Workweek And/or Travel Time Limits Form Soc 2280 - In-home Supportive Services Program Notice To Provider Upholding First Or Second Violation For Exceeding Workweek And/or Travel Time Limits Legal
Form Soc 2259 - In-home Supportive Services Program Notice To Provider Of Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Form Soc 2259 - In-home Supportive Services Program Notice To Provider Of Fourth Violation (one-year Period Of Ineligibility) For Exceeding Workweek And/or Travel Time Limits Legal

Related Categories

Parent category: Legal
Download
Go