Assisted Living Waiver Program Waitlist Application

Review the information and eligibility requirements

Complete the 2 page Guidant Care Waitlist Application and include:

• The full 13 digit MediCal number on application
• Email address and phone number for primary contact
• Advanced Health Care Directive (AHCD) or Medical Power of Attorney (MPOA) if applicable

Submit completed Waitlist Application and AHCD

The Waitlist application will be submitted to the State of California the next business day.

The State of California, Department of Health Care Services maintains the Waitlist.

Guidant Care checks MediCal eligibility monthly while on the waitlist, if you become MediCal ineligible in this time period, we will notify you and give guidance on how to resolve if necessary.

Once your name is called off the State of California waitlist, we will contact you and schedule an Assessment of your care needs. Our RN will schedule a time and place for a meeting to evaluate your care needs on the ALW Assessment tool and develop an Individualized Service Plan or ISP.

The completed initial documentation packet is then submitted to the State of California ALW office for review and approval to move into a participating ALW facility.