How to Choose an In-Home Care Agency in California

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.