How to Choose an In-Home Care Agency in California
“In-home care” isn’t a regulated term by itself, but the agency behind it is. In California, any business that sends non-medical caregivers into a home for pay must hold a Home Care Organization (HCO) license from the Department of Social Services. That license is the single most important thing to check before you sign anything — whether you’re hiring an agency based in Grass Valley, Nevada City, or one that covers Penn Valley and Truckee out of a single office.
Verify the HCO license first
Search the agency by name on the CDSS Home Care Aide/Organization public license search. An active HCO license confirms the agency has passed a background check itself, carries workers’ compensation and liability insurance, and is subject to state complaint investigations. A business advertising “home care” without one is operating illegally — walk away regardless of how the sales call goes.
Employee model vs. registry model
Ask directly: are caregivers your W-2 employees, or independent contractors you place? Most licensed HCOs employ caregivers directly, which means the agency handles payroll taxes, workers’ comp, and is legally responsible if a caregiver is injured on the job or accused of theft or abuse. A “registry” model that treats caregivers as contractors it merely introduces you to shifts most of that liability onto the family — confirm which model you’re actually buying before comparing prices.
Questions to ask on the intake call
- How is a caregiver matched to my parent, and can we request a different one if it’s not a fit?
- What’s the required background check — DOJ Live Scan, or something less?
- What’s the minimum shift length, and is there a minimum weekly commitment?
- Who do we call for a same-day callout, and what’s the backup-coverage plan?
- Is there a written plan of care, and who updates it as needs change?
- What’s included in the hourly rate — is there a separate fee for holidays, overnight, or live-in shifts?
Red flags
- No HCO license number, or a license the state search shows as revoked or suspended.
- Pressure to sign a long-term contract before a trial shift.
- Vague answers about who actually employs the caregiver.
- No written plan of care, or a caregiver who arrives with no information about medications or routines.
Once you’ve narrowed it to two or three licensed agencies, ask each for a trial shift before committing to a schedule. A good agency expects the question and welcomes it.
Looking for one? See our In-home care agencies directory — every listing is a clearly-labeled, flat-fee placement, never a referral fee, never tied to whether you hire them.
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