Steps to Enroll

As part of the enrollment process, you must complete the following steps:

  1. Call the Provider Enrollment Department at 866-351-7722 to request an Enrollment packet or click here to submit your request online.
  2. Complete the SOC426 Provider Enrollment Form
  3. Complete the SOC426A IHSS Program Recipient Designation of Provider Form (The Consumer must sign this form)
  4. Submit fingerprints and undergo a criminal background check by the California Department of Justice “DOJ”
  5. Provide a valid government issued photo identification card
    -The name on your photo identification and Social Security card must match
  6. Provide your original Social Security card
    -Social Security card receipts or copies of your Social Security card will not be accepted
  7. Attend an enrollment session to submit your completed paperwork and proof of identification