State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES PROGRAM
NOTICE OF NON-RECEIPT OF EXEMPTION FROM WORKWEEK LIMITS
PROVIDER AGREEMENT (SOC 2308)
County of:
(ADDRESSEE)
Notice Date:
IHSS Office Address:
IHSS Office Telephone:
Provider Name:
Provider Number:
To: In-Home Supportive Services (IHSS) Provider
As of____________________, you were approved for an exemption from workweek
limits for extraordinary circumstances, which authorized you to work up to 360 hours
per month (not to exceed the recipients’ authorized hours).
As a condition of being granted an exemption, you were required to sign the IHSS
Program Exemption from Workweek Limits for Extraordinary Circumstances Approved
Exemption Provider Agreement (SOC 2308) and return it to the county. The completed
SOC 2308 would affirm that you understand and agree that you cannot work more than
360 hours per month.
As of the date of this notice, the ______________________________has not received
your signed SOC 2308. Failure to sign and return the SOC 2308 will make you
ineligible for renewal of the exemption after the exemption expires on
____________________.
Without an approved exemption, you are required to comply with the existing workweek
limitations. Therefore, the maximum number of hours you may work in a workweek for
two or more recipients combined is 66 hours. The recipients you work for will need to
hire another IHSS provider(s) to work any remaining authorized IHSS hours.
If you would like to continue to be eligible for the exemption, please complete,
sign, and return the enclosed SOC 2308 to the IHSS Office Address indicated
above by ____________________. If you have any questions about this notice,
please contact the IHSS Office at the telephone number listed above.
SOC 2311 (2/18)
Page 1 of 1
State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES PROGRAM
NOTICE OF NON-RECEIPT OF EXEMPTION FROM WORKWEEK LIMITS
PROVIDER AGREEMENT (SOC 2308)
County of:
(ADDRESSEE)
Notice Date:
IHSS Office Address:
IHSS Office Telephone:
Provider Name:
Provider Number:
To: In-Home Supportive Services (IHSS) Provider
As of____________________, you were approved for an exemption from workweek
limits for extraordinary circumstances, which authorized you to work up to 360 hours
per month (not to exceed the recipients’ authorized hours).
As a condition of being granted an exemption, you were required to sign the IHSS
Program Exemption from Workweek Limits for Extraordinary Circumstances Approved
Exemption Provider Agreement (SOC 2308) and return it to the county. The completed
SOC 2308 would affirm that you understand and agree that you cannot work more than
360 hours per month.
As of the date of this notice, the ______________________________has not received
your signed SOC 2308. Failure to sign and return the SOC 2308 will make you
ineligible for renewal of the exemption after the exemption expires on
____________________.
Without an approved exemption, you are required to comply with the existing workweek
limitations. Therefore, the maximum number of hours you may work in a workweek for
two or more recipients combined is 66 hours. The recipients you work for will need to
hire another IHSS provider(s) to work any remaining authorized IHSS hours.
If you would like to continue to be eligible for the exemption, please complete,
sign, and return the enclosed SOC 2308 to the IHSS Office Address indicated
above by ____________________. If you have any questions about this notice,
please contact the IHSS Office at the telephone number listed above.
SOC 2311 (2/18)
Page 1 of 1