What documentation shows my child's need for protective supervision?

To apply for IHSS protective supervision for your child, the main document you need to submit is SOC 821 form, which is filled out by your child's doctor to indicate your child has potentially hazardous behavior in terms of judgment, orientation, and/or memory. You might ask your doctor if they would like you to fill out a copy of the form as a guide and then provide them with a blank copy to fill out themselves.

Along with the SOC 821 form, you can also submit other documentation to IHSS, including:

• hazardous behavior logs written by you or another caregiver; be sure to note in your behavior log that it is not an exhaustive list.
• a letter from your child’s Regional Center outlining their impairments related to judgement, orientation, and/or memory
• a copy of your child’s ABA assessments
• a copy of your child’s IEP or other documentation that demonstrates an elevated need for close and constant supervision due to non-self-direction

For more information, see our full article IHSS Protective Supervision and Paramedical Services. You can also follow our step-by-step guide to make applying for protective supervision easier: