California Home Care Regulations: What Families Need to Know in 2026

California home care regulations

When you invite a caregiver into your home to care for a loved one, you’re placing an extraordinary amount of trust in that person. You deserve to know they’ve been properly screened, trained, and held accountable.

That’s exactly why California enacted the Home Care Services Consumer Protection Act (AB 1217). Now celebrating a decade of protecting families, this landmark legislation established one of the most comprehensive home care regulatory frameworks in the nation—requiring background checks, training, and state licensing for all non-medical home care organizations and their caregivers.

The need for these protections couldn’t be more urgent.


Why Home Care Regulation Matters

According to the U.S. Department of Justice, 1 in 10 adults over age 60 experiences some form of elder abuse each year. The World Health Organization estimates that only 1 in 24 cases ever gets reported to authorities—meaning the true scope of the problem is far greater than official statistics suggest.

The numbers are sobering:

  • Up to 5 million older Americans experience abuse, neglect, or exploitation annually
  • Nearly half of seniors with dementia experience some form of abuse or neglect
  • Financial exploitation alone costs elderly Americans an estimated $28.3 billion per year
  • 90% of elder abuse cases occur in the victim’s own home—often by someone they trust

How California Protects Home Care Consumers

The California Department of Social Services (CDSS) oversees all non-medical home care through its Home Care Services Branch—a division within the Community Care Licensing Division. This branch is responsible for licensing home care organizations, maintaining a public registry of caregivers, and enforcing compliance throughout the state.

In 2024, the state significantly expanded its enforcement efforts, hiring 15 new employees dedicated to identifying and shutting down unlicensed home care providers. The message is clear: California takes caregiver accountability seriously.

What Home Care Organizations Must Do

To operate legally in California, every Home Care Organization (HCO) must:

  • Obtain a state license from the Home Care Services Branch
  • Maintain general and professional liability insurance ($1 million per occurrence, $3 million aggregate)
  • Carry a valid workers’ compensation policy
  • Submit to background checks for all owners holding more than 10% interest
  • Register all caregivers with the state before they provide care
  • Renew licensing every two years
  • Submit to unannounced compliance inspections

Caregiver Requirements: The Home Care Aide Registry

Every caregiver employed by a licensed home care organization in California must be registered as a Home Care Aide (HCA) with the state. This registration process includes:

  • Submitting an application through the state’s Guardian online portal
  • Completing a Live Scan fingerprint-based background check (FBI and DOJ)
  • Paying a $35 registration fee
  • Completing required training hours
  • Renewing registration every two years

Once approved, each caregiver receives a unique Personnel Identification Number (PER ID) that families can use to verify their status on the public registry.

Training Requirements

California mandates specific training for all Home Care Aides:

Initial Training (5 hours minimum):

  • 2 hours of orientation covering the caregiver’s role and employment terms
  • 3 hours of safety training, including emergency procedures and infection control

Annual Training (5 hours minimum):

  • Client rights and safety protocols
  • How to report, prevent, and detect abuse and neglect
  • Population-specific competencies based on client needs
  • Core caregiving skills and best practices

What Services Fall Under These Regulations?

Home care services covered by the Consumer Protection Act include non-medical assistance with activities of daily living such as:

  • Bathing and personal hygiene
  • Dressing and grooming
  • Meal preparation and feeding assistance
  • Medication reminders
  • Toileting and incontinence care
  • Mobility assistance and transfers
  • Light housekeeping and laundry
  • Companionship and supervision
  • Transportation and errands
  • Exercise assistance and range of motion support

How to Verify a Caregiver or Agency

California makes it easy for families to verify credentials before hiring. The public Home Care Aide Registry allows you to search for any registered caregiver using their first name, last name, and PER ID number.

The registry displays:

  • Caregiver’s name
  • Registration number
  • Current registration status
  • Expiration date
  • Home care organization affiliation (if applicable)

Verify caregivers — Visit the California Home Care Aide Registry and search using the caregiver’s name and PER ID

Verify agencies — Search the CDSS Home Care Services database to confirm an organization’s license is active and in good standing


Labor Protections for Caregivers in 2026

California’s regulatory framework doesn’t just protect families—it also ensures fair treatment for the dedicated professionals providing care. Understanding these protections can help you recognize a quality agency that invests in its caregivers.

Current labor requirements include:

  • Minimum wage: $16.90 per hour statewide (effective January 1, 2026), with some local jurisdictions requiring higher rates
  • Overtime pay: 1.5× regular pay after 9 hours per day or 40 hours per week for personal attendants under California’s Domestic Worker Bill of Rights
  • Paid sick leave: Minimum 5 days per year for all employees
  • Employee classification: All home care aides must be W-2 employees—not independent contractors—ensuring proper tax withholding, workers’ compensation coverage, and labor protections

When caregivers are treated fairly and compensated properly, they’re more likely to stay long-term, which means better continuity of care for your loved one.


Why Choosing a Licensed Agency Matters

With the growing demand for home care—by 2030, roughly one in four Californians will be over age 60—families have more options than ever. But not all options offer the same protection.

Some families consider hiring a private caregiver directly or using an unlicensed referral service to save money. While this might seem like a cost-effective choice, it can expose you to significant risks.

What You Risk Without a Licensed Agency

No verified background checks — Private caregivers aren’t required to undergo FBI and DOJ fingerprint screening

No liability protection — If a caregiver is injured in your home or causes damage, you could be personally liable

No workers’ compensation — You may become the employer of record, responsible for workers’ comp insurance and claims

No guaranteed training — No requirement for safety training, abuse prevention education, or ongoing competency development

No state oversight — No inspections, no complaint process, no accountability

Tax complications — You may be responsible for payroll taxes, employment paperwork, and IRS compliance

What a Licensed Agency Provides

Verified, registered caregivers — Every caregiver has passed a comprehensive background check and is listed on the state registry

Full insurance coverage — General liability, professional liability, and workers’ compensation protect you and your loved ones

Trained professionals — Caregivers complete required initial and ongoing training in safety, abuse prevention, and care skills

Backup coverage — If your regular caregiver is sick or unavailable, a licensed agency provides qualified replacements

Care management — Professional oversight ensures care plans are followed, and quality is maintained

Regulatory accountability — The state monitors licensed agencies, investigates complaints, and enforces compliance

Peace of mind — You can verify your agency’s license and your caregiver’s registration at any time

The regulations exist for one reason: to protect vulnerable seniors and give families confidence in the care their loved ones receive. Choosing a licensed agency isn’t just about compliance—it’s about choosing safety, accountability, and quality.


References

  1. California Department of Social Services. Home Care Services Consumer Protection Act Overview. Accessed January 2026.
  2. California Department of Industrial Relations. Minimum Wage Information. Updated January 2026.
  3. National Council on Aging. Get the Facts on Elder Abuse. Accessed January 2026.
  4. World Health Organization. Abuse of Older People Fact Sheet. June 2022.
  5. California Health and Safety Code, Sections 1796.10–1796.63. Home Care Services Chapter.
  6. U.S. Bureau of Labor Statistics. Home Health and Personal Care Aides Occupational Outlook. 2024.

Let All Heart Home Care Help

At All Heart Home Care, we’ve been a licensed, compliant home care organization since before California’s regulations took effect—because we’ve always believed in doing things the right way. As a veteran-owned, nurse-led agency serving San Diego County since 2014, we hold ourselves to the highest standards of caregiver screening, training, and professional oversight.

Every one of our caregivers is registered with the state, background-checked, and fully trained. We carry comprehensive insurance coverage. And we believe in complete transparency—because when it comes to caring for your loved one, you deserve nothing less.

Have questions about California’s home care regulations or want to learn how All Heart can help your family? We’re here to help.

Contact All Heart Home Care at (619) 736-4677 to speak with our care team.

Share:

More Posts

About the author

Eric Barth, co-founder and CEO of All Heart Home Care San Diego

Eric Barth

CEO, All Heart Home Care

Eric Barth is the founder and CEO of All Heart Home Care™, an award-winning San Diego agency dedicated to providing compassionate, personalized in-home care for seniors. As the writer behind the All Heart Home Care blog, Eric shares insights and stories drawn from years of hands-on experience leading one of San Diego’s most trusted home care teams.

Additional FAQ's on Digital Home Care System

Yes. HITRUST CSF Certified security—same gold standard hospitals use. More secure than paper.

Extremely rare (99.9% uptime), but caregivers can work in offline mode if connectivity is temporarily lost. Care continues without interruption. Documentation syncs automatically when connection returns.

Caregivers document throughout their shift in real-time. Notes are typically finalized and visible in Family Room within minutes of the caregiver clocking out.

We can set up Family Room accounts for as many family members as you want—local siblings, children in other states, anyone you authorize. Everyone sees the same information. No limit on number of accounts.

Yes. Family Room includes secure document storage. Upload medical records, insurance cards, POLST forms, medication lists, doctor’s instructions, photos—anything important. All authorized family members can access these documents. No more searching for forms.

We update the digital care plan immediately, and all caregivers receive instant notification of changes. This is one of the biggest advantages over paper—updates reach everyone simultaneously, not gradually over days or weeks.

Absolutely. Family Room is a tool for families who want it, not a replacement for human connection. We’re always reachable by phone at (619) 736-4677. Many families use both—portal for quick updates, phone calls for detailed conversations.

We train every caregiver on the WellSky mobile app before their first shift. The app is intuitive—designed specifically for caregivers, not engineers. If someone can text and use GPS navigation, they can use our caregiver app. And we provide ongoing support.

Yes. The Family Room care calendar shows upcoming shifts with caregiver names and times. You’ll know exactly who’s coming and when. No more surprise caregiver switches.

Use the two-way messaging feature in Family Room. Send your message, and the caregiver receives an instant notification on their mobile app. They’ll see it and can respond or confirm receipt immediately.

Yes. All notes are searchable. Want to see every mention of “appetite” from the past month? Type it in the search bar and find all relevant notes instantly. No more flipping through pages of handwritten entries.

You can access the complete care history from the day Family Room access began. Review notes from last week, last month, or since care started. Historical data helps identify patterns over time.

Family members cannot delete caregiver documentation—that’s protected and maintained by All Heart for record-keeping purposes. You can delete your own uploaded documents, but we can often recover those if needed within a certain timeframe.

With your authorization, we can provide limited Family Room access to healthcare providers. This allows better coordination between home care and medical teams. You control exactly who has access and what they can see.

Family Room works both ways. You can access it through any web browser (Chrome, Safari, Firefox, Edge) on your computer, or download the mobile app for easier access on your phone or tablet. Your choice.

All authorized Family Room users see the same care information—we can’t create different access levels for different family members. However, you (as the primary contact) control who gets Family Room access in the first place. If family dynamics are challenging, you decide who receives login credentials.

The messaging system shows when messages are delivered and read. You’ll see confirmation that the caregiver received and opened your message. For critical information, you can also call our office to ensure the message was received.

Yes. You can print individual shift notes, date ranges, or specific types of documentation (like Change of Condition reports) directly from Family Room. Useful for doctor appointments or insurance purposes.

If your loved one transitions to hospice, hospital, or another care setting, we can maintain your Family Room access for a transition period so you have complete records. After care ends, we provide a final data export if requested, then access is closed according to your wishes and legal requirements.

Yes. Family Room is accessible from anywhere with internet connection. If you’re traveling abroad, you can still check on your loved one’s care. The system works globally.

Family Room doesn’t support selective information sharing—all authorized users see the same care documentation. For private family communications, you’d need to use personal email, phone, or text outside the Family Room system.

Change of Condition reports automatically alert you when caregivers document significant health changes. For custom alerts (like specific behaviors or situations), talk to our office—we may be able to add special flags to your loved one’s care plan that trigger notifications.

We typically set up Family Room access during your initial care planning meeting, before the first caregiver shift. You’ll have login credentials and a brief tutorial on how to use the portal. Most families are viewing their first shift notes within 24 hours of care beginning.

Complete Security & Privacy Information

HITRUST CSF Certification - What This Means

HITRUST CSF (Common Security Framework) is the most rigorous security certification in healthcare. It's harder to achieve than HIPAA compliance alone. This certification requires:

Why it matters: If it’s secure enough for hospital patient records, it’s secure enough for your loved one’s care information.

Bank-Level Encryption Explained

Data in Storage (At Rest):

Data in Transmission (In Transit):

What this means: Even if someone intercepted the data (extremely unlikely), they would only see scrambled, unreadable information.

Strict Access Controls

Who Can See What

Family Member Access:

Caregiver Access:

Staff Access:

Audit Trail:

HIPAA Compliance - Federal Protection

The Health Insurance Portability and Accountability Act (HIPAA) establishes federal standards for protecting health information. Our compliance includes:

Privacy Rule Compliance:

Security Rule Compliance:

Breach Notification:

Business Associate Agreements:

Continuous Backup & Disaster Recovery

Automated Backups:

Redundancy:

Disaster Recovery Plan:

What this guarantees: Your loved one’s care information is never truly lost. Even if an entire data center were destroyed, complete backups exist elsewhere.

99.9% Uptime Guarantee

What “99.9% uptime” means:

Monitoring:

If the system goes down:

Multi-Factor Authentication (Optional)

For families who want extra security, we can enable multi-factor authentication (MFA):

Mobile Device Security

Caregiver Phones:

Your Devices:

Security Incident Response

In the extremely unlikely event of a security concern:

Digital vs. Paper Security Comparison

Security Concern
Paper Binders
WellSky_Color

Who can read it?

Anyone who enters the home

Only authorized users

Can it be lost?

✔︎ — permanently

— backed up continuously

Can it be damaged?

✔︎ — spills, fires, floods

— stored digitally

Is access tracked?

✔︎ Access logged & audited

Encryption protection?

✔︎ — bank-level encryption

Updates reach everyone?

— printing/distribution delays

✔︎ — instant notification

Survives disasters?

✔︎ — redundant backups

HIPAA compliant?

— difficult to prove

✔︎ — certified & audited

Can be accidentally discarded?

✔︎

— requires a password

Verdict: Digital is significantly more secure than paper in every measurable way.

Common Security Questions

"What if I forget my password?"

Secure password reset process via email or phone verification. We verify your identity before resetting access.

"Can hackers access the system?"

Multiple layers of security make unauthorized access extremely difficult. Regular penetration testing simulates attacks to identify and fix vulnerabilities before hackers can exploit them.

"What if my phone is stolen?"

Change your password immediately from any other device. The thief would still need your password to access Family Room.

"Can All Heart staff see my credit card information?"

No. Payment processing is handled by a separate, PCI-compliant payment processor. We never see or store your full credit card number.

"What happens to the data if I stop using All Heart?"

Your data is retained according to legal requirements (typically 7 years for healthcare records), then securely deleted. You can request a copy of your data at any time.

This isn’t just secure—it’s among the most secure systems available in healthcare.

Your information is safer in our digital system than it ever was in a paper binder sitting on a kitchen counter.

Complete Care Plan Contents:

Care Goals & Priorities

Emergency Contact Information

Medical Conditions & Health History

Mental Health & Cognitive Status

Medications & Supplements

Mobility & Transfers

Personal Care Routines

Meal Preparation & Dietary Needs

Daily Routines & Schedules

Activities & Engagement

Home Environment Details

Transportation & Driving

Additional Important Information

This comprehensive information ensures every caregiver provides consistent, personalized care from day one.

Tracking health changes that matter.

The Change of Condition form documents significant shifts in your loved one’s health—new symptoms, changes in mobility, behavioral differences, or improvements in their condition. This isn’t about minor day-to-day variations; it’s about meaningful changes that physicians, families, and caregivers need to know about.

Why have a separate form for this?

Instead of searching through weeks of caregiver narratives to find when symptoms started or conditions changed, this form puts all significant health changes in one easy-to-reference place. When doctors ask “when did the difficulty walking begin?” or family members want to understand the progression of a condition, you’ll have clear, dated documentation right at your fingertips.

What gets documented:

Each entry includes:

Why this form matters:

Early detection changes outcomes. When caregivers notice something different—increased confusion, difficulty walking, loss of appetite, or even positive improvements like better mobility—documenting it immediately allows for faster responses.

Your family stays informed about meaningful health changes. Physicians receive accurate updates during appointments instead of relying on memory. Incoming caregivers know exactly what’s changed and what new precautions or assistance your loved one needs.

One form. Complete health timeline. Better care.

Whether tracking a temporary change after a fall or documenting the progression of a chronic condition, the Change of Condition form creates a clear health timeline. This helps everyone—doctors, family members, and our San Diego caregiver team—understand how your loved one’s needs are evolving and respond appropriately.

Proactive monitoring isn’t just good practice. It’s essential senior care.

How the Caregiver Narrative works.

Each caregiver documents their shift using a simple timeline format that captures the essential details of your loved one’s day. This structured approach ensures consistency across all caregivers and makes information easy to find.

What we document in every narrative:

Narrative Format:

Each entry follows this structure:

Why this format works:

This timeline approach provides clear, chronological documentation that’s easy for incoming caregivers to read and understand. Instead of wondering what happened during the previous shift, they can see exactly what your loved one ate, how they felt, what activities they enjoyed, and any health changes observed.

One record. Every shift. Complete continuity.

Whether care is short-term, long-term, or evolving, the Caregiver Narrative ensures nothing gets missed and nothing gets repeated. Your family can review the journal at any time during visits, or we can share photos of recent narratives with long-distance family members who want to stay connected and informed.

Complete transparency and peace of mind, right when you need it.

Your loved one's complete care roadmap, now available digitally.

The All Heart Customized Care Plan is completed during your initial assessment and tailored to your loved one’s specific needs, preferences, mobility level, and safety requirements.

Now fully digital and accessible on every caregiver’s phone.

We’ve gone paperless. Your care plan is accessible through our digital platform—caregivers reference it anytime, anywhere. Updates happen in real-time, so when something changes, every caregiver sees it immediately.

What's included:

Care goals, emergency contacts, medical conditions, mental health & cognitive status, medications & supplements, mobility & transfers, personal care routines, meal prep & dietary needs, daily routines, activities & engagement, and home environment details.

One plan. Every caregiver. Consistent care.

This digital approach ensures every San Diego caregiver has the same accurate, up-to-date information from day one—promoting safety, continuity, and person-centered care.

See how we organize care information. This form becomes your loved one’s digital care roadmap.