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Is this an individual profile or organization profile?
Choose whether you'd like to create a profile for yourself or on behalf of an organization.
Individual
Organization
Contact Information
Name
Job Title
Respite Caregiver
Basic Behavior Trainee
Direct Support Professional
Applied Behavior Analyst Therapist
Certified Nursing Assistant
Other
Other Job Title
Work Phone Number
Website
This must be an external URL such as
https://example.com
.
Office Information
Office Address
နိုင်ငံ
- တစ်ခုမှမဟုတ် -
အမေရိကန် ပြည်ထောင်စု
Street address line 3
City
Zip code
Contact Person
Name
Job Title
Email
Phone
Background and Expertise
Picture
One file only.
100 မီကာဘိုက် limit.
Allowed types: jpg jpeg.
Provider Type
ABA service provider
Adaptive skills training
Behavioral consultation
Community Care Facilities
Day Program
Home Care Agencies
Housing specialist
IHSS worker
Independent Living Skills
Job Coach
Personal Assistance
Respite Care or Day Care
Specialized therapeutic therapy
Supportive Living skills
Supportive living/independent living training
Wellness specialist
Areas Served
Check all of the areas you are willing to commute to and work in.
Alameda County
Contra Costa County
Marin County
San Francisco County
San Mateo County
Areas of Expertise
Fast-Track Respite Training
Basic Behavior Training
Direct Support Professional
Applied Behavior Analyst
Other
Other Areas of Expertise
Year your IDD Service Provider services started
Brief Bio
About text formats
A two to three sentence description of you or your organization.
Programs Info
About text formats
A two to three sentence description of the types of programs your organization offers.
Program Eligibility Requirements
About text formats
A short description of eligibility requirements (if any) for the programs your organization offers.
Introductory Video
Include a video introducing yourself or your organization to potential clients. It is recommended to upload your video to
YouTube
and then paste the video URL into this field.
Gender(s)
Choose gender identities that apply to you or your organization. This will help potential clients find providers that reflect their own gender experience.
Female
Male
Non-Binary / Third Gender
Transgender / Gender Variant
Other
Prefer not to answer
IDD Service Provider Identities
Choose all that apply to you or your organization.
ABA service provider
Adaptive skills training
Behavioral consultation
Deaf / Hard of Hearing
Housing specialist
IHSS worker
Immigrant
Independent Living Skills
Job Coach
LGBTQ+
Parent
Personal Assistance
Refugee
Specialized therapeutic therapy
Supportive Living skills
Supportive living/independent living training
Veteran
Wellness specialist
Specialized In
Choose all that apply.
Infant (under ages 3)
Children (ages 4- 13)
Youth (ages 15 to 18)
Transitional Youth (Ages 18 to 22)
Adult (ages 22 and up)
Seniors (Ages 65 and up)
LGBTQ+
Parents
Asylees/Refugees/Immigrants
Veterans
Languages
Languages
Choose
only languages
in which you or your organization are
competent
to provide services in.
American Sign Language
Arabic
Burmese
Cantonese
Dari
English
Farsi
French
Hebrew
Hindi
Hmong
Japanese
Khmer
Korean
Kurdish
Lao
Mandarin
Nepali
Pashto
Punjabi
Russian
Spanish
Tagalog
Turkish
Ukrainian
Urdu
Vietnamese
Other
Other Languages
Types of services
Types of Services
Choose all that you or your organization offer.
Behavior Services
Behavioral Day Program
Competitive Integrated Employment Opportunities
Coordinated Family Supports
Counseling (specific to individual situation)
Funding for Family Training
In-Home Respite
In-Home Respite (Kinship care)
Incontinence Supplies (exceptional cases)
Independent Living Services (ILS)
Interpreter and Translator Services
Medic Alert Services
Medical Equipment and Supplies/Pharmaceutical
Nursing Services
Out-of-Home Respite
Out-of-Home Respite (Camp-Kinship care)
Out-of-Home Respite (including Camp)
Paid Internship Program (PIP)
Personal Assistant
Personal Assistant through a Financial Management Service
Residential Homes
-Adult Residential Facility for People with Special Health Care Needs (ARFPSHN)
-Community Care Facility
-Community Crisis Home (CCH)
-Enhanced Behavior Support Homes (EBSH)
-Intermediate Care Facility
-Specialized Residential Facility (SRF)
Social Recreational Services
Specialized Crisis Resources
Specialized Day Care
Specialized Day Care (Kinship Care)
Specialized Program Support for Inclusion
Specialized Transportation
Specialized Transportation (exceptional cases)
Supported Employment
Supported Living Services
Other Types of Services
Does your organization provide transportation?
N/A
Yes
No
Finances
Funding Method
N/A
Private Pay
Regional Center
Department of Developmental Services
Hourly Rate
Types of Payment Accepted
Cash
Credit Card
Medi-Cal
Medicare
Private Insurance
Availability
Accepting New Participants
No
Yes
Published Status
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Draft (do not show on site)
Publish (pending review)