Overview of California’s Home Care System
Home care delivery standards are legislated at both the federal and state level. Each jurisdiction must follow a heavily layered set of rules, and in California, agencies are regulated in part by the California Department of Social Services (CDSS).
This governing body focuses on non-medical assistance provided in clients’ homes, setting forth specific guidelines for client safety, regulatory compliance, and visit reporting, among other routine responsibilities. Read on to learn more about California home care regulations and discover which home care systems can help agencies stay on top of complex compliance needs.
Who Regulates Home Care in California?
CDSS provides a state-specific regulatory framework for non-medical home care. One of the departments under its umbrella is the Home Care Services Branch (HCSB), which administers the Home Care Services Consumer Protection Act and oversees licensing for agencies. Some of its main functions include reviewing and approving applications from prospective agencies, maintaining the Home Care Aide (HCA) registry, responding to complaints, and conducting compliance audits.
Under California law, agencies offering non-medical care must obtain a license from HCSB before they can open their doors. The evaluation process includes reviewing organizational documents, adherence to safety and operational standards, and renewal requirements. But it’s not a one-and-done verification: once a license is approved, CDSS continues to monitor agencies on an ongoing basis. If they fall out of step, CDSS may issue fines, corrective actions, and in extreme cases, even revoke an organization’s license.
CDSS also handles background checks for incoming caregivers. All HCAs in California must undergo a criminal background check before they are added to the HCSB registry, including fingerprinting and a criminal screening through the Department of Justice. Ultimately, all of these checks and balances exist to ensure agencies are maintaining proper records and following the required procedures, with the goal of ensuring safe and effective care for clients.
Home Care Licensing Requirements
The first step in an agency’s path to getting licensed is completing the official application forms. They’ll also need to provide documentation like personnel policies, a training plan, and their articles of incorporation. A hard copy of the complete application package must be mailed to the HCSB for review, and incomplete submissions are at risk of being returned without processing.
Applicants must pay a non-refundable fee along with their application. At the time of this writing, an HCO license costs $5,603 for the standard two-year period. There are also fees associated with mandatory criminal background checks for owners, executives, and anyone else with significant ownership or decision-making power.
The state must feel confident that it is greenlighting a legitimate business with the potential to thrive. Agencies must therefore demonstrate financial responsibility and operational readiness, providing proof of documentation like liability coverage, job descriptions, and a strong framework for care delivery.
Once the application package, fees, and background check documentation are received, CDSS will review the information to make sure it meets regulatory standards. If a correction is required or information is missing, they may reach out during the process for a correction. Once a license is approved, it’s typically valid for two years. After that, it will need to be renewed, which involves submitting updated documentation, paying a renewal fee, and verifying ongoing compliance.
Steps To Obtain a Home Care Organization (HCO) License
Step 1: Forms
Complete the core HCO application forms (Section A), including:
- HCS 200: Application for a Home Care Organization License
- HCS 215: Licensee Applicant Information
- HCS 308/HCS 309: Responsibility & Ownership Designation
- HCS 402: Employee Dishonesty Bond (if applicable)
- HCS 9165: Board of Directors Statement (if applicable)
Step 2: Organizational documentation
Gather all additional documents, including articles of incorporation, job descriptions, personnel policies, training plans, program descriptions, and insurance information.
Step 3: Submit
Send the entire application package, including all forms, supporting documentation, and fees, to the Home Care Services Branch, CDSS, 744 P Street, MS 9-14-90, Sacramento, CA 95814.
NOTE: Applicants are required to name an administrator responsible for the agency’s daily operations and oversight of compliance. While CDSS doesn’t require a separate administrator certification for home care agencies, the designated administrator must have clearly applicable professional experience and the capability to run the organization.
Step 4: Background check
Conduct background checks for all owners, partners, officers, and the designated administrator named in the application. Each person must undergo Live Scan fingerprinting and a criminal record check processed by the CDSS Care Provider Management Branch.
Step 5: CDSS review
HCSB reviews the submitted packet. If they find any missing items or deficiencies, the applicant will need to submit corrections. At this stage, CDSS may schedule an on-site inspection of the organization’s facilities to confirm it has the appropriate physical space, secure records, required postings, policies, and operational requirements.
Step 6: License issuance
Once the application is approved, the newly minted agency will receive its license and HCO number. Moving forward, it remains the agency’s responsibility to maintain updated records on staff background check clearances, training logs, client contracts, insurance certificates, and staff policies. These documents should be readily available in the event of a compliance audit.
Maintaining & Renewing Licenses
After two years, the operating license will come up for renewal, and the agency will need to submit the associated paperwork and fees to prevent it from expiring. At various intervals, CDSS reserves the right to conduct both planned and unannounced compliance inspections, which can include reviews of caregiver background clearances, training records, insurance coverage, and more.
Agencies that do not pass their inspections can be subject to a range of penalties, from receiving a deficiency notice that lays out corrective action to civil penalties, suspension, license revocation, or denial of renewal in severe cases.
California EVV Requirements
Electronic Visit Verification (EVV) in California is one of many compliance requirements agencies must respect. The state provides a free platform called CalEVV, though as an open state, agencies are free to choose any provider that is compatible with the state aggregator. In contrast, closed states must use a mandated EVV vendor with no flexibility to shop around.
As is mandated at the federal level, California EVV requirements state agencies must capture six key pieces of information to satisfy requirements: service type, name of the individual receiving care, date, location, caregiver name, and start/end times of each appointment.
Home Care Aide & Caregiver Requirements
An HCA is someone who is legally authorized to provide non-medical care services in a client’s home. To qualify for the role, they must pass a background check, obtaining either clearance or a criminal record exemption. Under state law, HCAs must meet specific caregiver training requirements for California, such as completing five hours of introductory training before they can serve clients. They must also complete five hours of annual training to maintain competency.
Home Care Aide Registry
In California, caregivers are added to the HCA Registry by creating a Guardian profile after their background checks and documentation have been accepted by CDSS. Each individual is assigned a registry ID and can be verified by licensed HCOs before receiving client assignments. Their background status, required annual training hours, and any disqualifying events are monitored regularly.
Caregivers who fail to renew their registration or complete the necessary training may become inactive. Employers must regularly re-verify their employees’ status, ensure ongoing compliance with California training requirements, and notify lapsed caregivers that they must complete any missed training, pay any outstanding fees, and submit any outstanding documentation before returning to work.
Employer Responsibilities & Compliance
California has set out clear expectations for employer conduct, requiring agencies to maintain detailed records, closely supervise their teams, and uphold clients’ rights to privacy and safe care.
Licensed HCOs must keep accurate documentation proving each caregiver has passed their background clearance and training, as well as client service agreements and care plans. Agencies are also responsible for informing clients of their rights, including privacy, dignity, freedom from retaliation, and access to grievance procedures.
How California’s Home Care Rules Protect Clients
California’s home care laws clearly outline who can provide services to clients and how care should be delivered. Mandatory background checks, training requirements, and ongoing monitoring ensure that only qualified, vetted caregivers can enter clients’ homes. At the same time, documentation and inspection requirements hold agencies accountable to important standards for operational safety and ethics.
Data security and privacy always factor into the equation when medical information is being handled, which is why CDSS regularly inspects record-keeping and confidentiality protocols. California also upholds a client’s right to choose their provider and caregiver, supporting their autonomy and empowering them to work with vendors that make them feel safe.
Recent Updates & Legislative Changes
Senate Bill 1350 recently legislated expanded Cal/OSHA protections for caregivers: on July 1, 2025, domestic workers employed by businesses such as home care agencies became eligible for injury and illness prevention benefits, hazard training, and other Title 8 workplace requirements.
In December 2025, changes to California Assembly Bill 1495 regarding training and certification gave HHAs greater flexibility to fulfill training and in-service requirements through online and distance learning. As of January 2026, the California Department of Health Care Services also began offering weekly drop-in technical assistance for EVV as part of their ongoing support and update efforts.
Manage Californian Home Care Regulations Effectively With AxisCare
AxisCare has helped countless California-based home care agencies stay compliant with licensing, caregiver training requirements, and EVV mandates. Our tailor-made platform streamlines scheduling, EVV, and training management, helping agencies protect client safety and stay on top of regulatory changes that directly impact their operations. Request a free demo to learn more about why organizations across the state rely on us as their vendor of choice.
