Public Social Services Forms and Office Locations – Government Agency in Los Angeles County, CA

Forms & Documents Contact Info & Office Locations Questions & Answers

Forms & Documents

Browse all Public Social Services government forms

1 - 20 of 23 forms

Form Title	Topics
PA 2457 - Civil Rights Information Notice
PUB 13 - Your Rights Under California Welfare Programs
PUB 13 Your Rights Under California Welfare Programs (Large Print)
SOC 2255 - In-Home Supportive Services (IHSS) Program Provider Workweek & Travel Time Agreement
SOC 2256 - In-Home Supportive Services Program Recipient and Provider Workweek Agreement
SOC 2274 - In-Home Supportive Services Program Accompaniment to Medical Appointment
SOC2279 - In-Home Supportive Services (IHSS) Program Live-In Family Care Provider Overtime Exemption
SOC 2298 - In-Home Supportive Services (IHSS) Program and Waiver Personal Care Personal Services (WPCS) Live-In Self-Certification Form for Federal and State Wage Exclusion
SOC 2299 - Personal Services (WPCS) Live-In Self-Certification Cancellation Form for Federal and State Wage Exclusion
SOC 2326 - In-Home Supportive Services Recipient’s Responsibility to Stop Sexual Harassment in the Workplace
SOC 2327 - In-Home Supportive Services Provider’s Right to File a Sexual Harassment Complaint
SOC 295 - Application For In-Home Supportive Services
SOC 295L - Application For In-Home Supportive Services (Large Print)
SOC 321- Request for Order and Consent Paramedical Services
SOC 426A - In-Home Supportive Services Program Designation of Provider
SOC 426 - In-Home Supportive Services Program Provider Enrollment Form
SOC 825 - Protective Supervision 24-Hours-A-Day Coverage Plan
SOC 838 - In-Home Supportive Services Recipient Request for Assignment of Authorized Hours to Provider
SOC 839 - In-Home Supportive Services Designation of Authorized Representative
SOC 840 - In-Home Supportive Services Program Provider or Recipient Change of Address and/or Telephone Form

Contact Information & Office Locations

1 - 20 of 56 contact points

Belvedere Office

Address:
5445 Whittier Blvd.
Los Angeles, CA 90022

Phone numbers:

(866) 613-3777

Civic Center

Address:
813 E. 4th Pl.
Los Angeles, CA 90013

Phone numbers:

(866) 613-3777

Compton Office

Address:
211 E. Alondra Blvd.
Compton, CA 90220

Phone numbers:

(866) 613-3777

East Valley Office

Address:
7555 Van Nuys Blvd.
Van Nuys, CA 91405

Phone numbers:

(866) 613-3777

East Valley & Santa Clarita Sub Office

Address:
7555 Van Nuys Blvd.
Van Nuys, CA 91405

Phone numbers:

(877) 292-4246

El Monte Office

Address:
3350 Aerojet Ave.
El Monte, CA 91731

Phone numbers:

(866) 613-3777

Florence Office

Address:
1740 E. Gage Ave.
Los Angeles, CA 90001

Phone numbers:

(866) 613-3777

GAIN Region III Pomona, sub

Address:
2255 N. Garey Ave.
Pomona, CA 91767

Phone numbers:

(877) 292-4246

GAIN Region III San Gabriel Valley Main

Address:
3216 Rosemead Blvd.
El Monte, CA 91731

Phone numbers:

(877) 292-4246

GAIN Region III Santa Anita, Sub

Address:
3216 Rosemead Blvd.
El Monte, CA 91731

Phone numbers:

(877) 292-4246

GAIN Region II - West San Fernando Valley

Address:
21415-21615 Plummer St.
Chatsworth, CA 91311

Phone numbers:

(877) 292-4246

GAIN Region IV Central County Main

Address:
3833 S. Vermont Ave.
Los Angeles, CA 90037

Phone numbers:

(877) 292-4246

GAIN Region I West County Main

Address:
5200 W. Century Blvd.
Los Angeles, CA 90045

Phone numbers:

(877) 292-4246

GAIN Region V Compton - G4026

Address:
211 E. Alondra Blvd.
Compton, CA 90220

Phone numbers:

(877) 292-4246

GAIN Region V Harbor One Stop, Sub

Address:
222 West 6th St.
Ste. 410
San Pedro, CA 90731

Phone numbers:

(877) 292-4246

GAIN Region VII - East San Fernando Valley

Address:
3307 N. Glenoaks Blvd.
Burbank, CA 91504

Phone numbers:

(877) 292-4246

GAIN Region VI Southeast County Main

Address:
5460 Bandini Blvd.
Bell, CA 90201

Phone numbers:

(877) 292-4246

GAIN Region V South Central - G4027

Address:
10728 S. Central Ave.
Los Angeles, CA 90059

Phone numbers:

(877) 292-4246

GAIN Region V South County Main

Address:
2959 E. Victoria St.
Rancho Dominguez, CA 90221

Phone numbers:

(877) 292-4246

GAIN Region V South Family - G1031

Address:
17600 A Santa Fe Ave. East
Rancho Dominguez, CA 90221

Phone numbers:

(877) 292-4246

Forms & Documents

Browse all Public Social Services government forms

Contact Information & Office Locations

Belvedere Office

Civic Center

Compton Office

East Valley Office

East Valley & Santa Clarita Sub Office

El Monte Office

Florence Office

GAIN Region III Pomona, sub

GAIN Region III San Gabriel Valley Main

GAIN Region III Santa Anita, Sub

GAIN Region II - West San Fernando Valley

GAIN Region IV Central County Main

GAIN Region I West County Main

GAIN Region V Compton - G4026

GAIN Region V Harbor One Stop, Sub

GAIN Region VII - East San Fernando Valley

GAIN Region VI Southeast County Main

GAIN Region V South Central - G4027

GAIN Region V South County Main

GAIN Region V South Family - G1031

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