Verify Employment as an IHSS Care Provider

The County of Fresno and Department of Social Services In-Home Supportive Services (IHSS) ARE NOT THE EMPLOYER. However, verification that the care provider has been employed by one or more recipients of the IHSS program can be provided. Please read this important information and instructions below before submitting your request. This is the only form that is authorized for use to request Employment Verification from our office. Please allow seven (7) to ten (10) business days to process your request.

Instructions & Important Information

1. All employment and wage verification requests must be requested by completing sections I – V of the IHSS 0177 IHSS Employment & Wage Verification Request Form(PDF, 183KB) . Other signed authorizations will not be accepted.  
2. Please allow 7 - 10 business days to process your request. All requests will be returned by USPS mail or secure email. There is no in office ‘pick-up’ option or return by fax available.
3. Information is only available back to the beginning of the current calendar year.  If seeking information on prior years, the IHSS Provider must request a W-2 from the Internal Revenue Service (IRS).
4. Electronic & Digital signatures are not accepted.
5. If the form is incomplete, completed incorrectly or illegible, there could be a delay or we may not be able to process your request.
6. If the requested verification will be returned to the care provider, the address provided on the IHSS 0177 must match the current address on file. You can change your address and/or phone number on file by visiting the Electronic Services Portal & updating it immediately. If you would like to use a paper form, you can submit a SOC840 Change of Address(PDF, 132KB) to update you address/phone number.
7. If this information is needed for your Eligibility Worker/Job Specialist (EW/JS) to verify income or employment for CalWORKs/CalFresh/General Relief or Welfare to Work, please contact your EW/JS to obtain the required form.
8. Due to the availability of data, employment & wage verifications can only be processed once per pay period for each individual Care Provider.

The only information that our office will provide is listed below:

• Start Date
• Job Title
• Hourly Wage
• Total Gross Year-to-Date income for current year
• Last pay period date (only provided when employment has been terminated)
• Year-to-Date Wage Verification

Information that cannot be provided/verified is listed below:

• Reasons for termination (or verification of reasons for termination)
• Amount of hours worked, hours assigned, or overtime hours
• Anticipated pay
• Verification of employment if the care provider did not work for IHSS in Fresno
• Verification of current employment status (cannot verify if employee is actively employed)
• Verification of wages or employment status pertaining to a specific IHSS recipient. All wages will be combined.
• Pay Stubs
• Additional dates, re-verification, verbal verification or any other information
• IHSS Recipient names or case numbers

Download the IHSS 0177 Employment & Wage Verification Request Form Now(PDF, 183KB)

Return completed form by:
USPS mail: IHSS, PO Box 1912, Fresno, CA. 93718-1912
Fax: (559) 600-7762
or by
Secure Document Submission!