Starting a California Home Health or Personal Care Agency?

This page presents three common startup paths:

• California Medicare Home Health Agency — skilled home health services with California approval and federal Medicare certification.
• California Home Health Agency — skilled home health services without Medicare billing.
• California Home Care Agency Non-Medical — personal care services provided in a client's residence.

Medical Home Health Agencies are licensed by CDPH. Non-medical Home Care Organizations are licensed by CDSS, and their affiliated Home Care Aides must be registered.

The California Department of Public Health (CDPH) licenses and surveys medical Home Health Agencies under Title 22. The California Department of Social Services (CDSS), Home Care Services Branch licenses non-medical Home Care Organizations under the Home Care Services Consumer Protection Act.

CDSS currently lists a $5,603 two-year Home Care Organization license fee and a $35 two-year Home Care Aide registration fee. CDPH publishes a separate annual fee schedule for Home Health Agencies. Applicants should verify both agencies' current schedules before payment because fees can change.

Requirements depend on the applicant, ownership structure, location, and proposed services. The application process generally requires:

• A completed application and licensing fee.
• Business, ownership, governing-body, and organizational information.
• HCS 200, HCS 215, HCS 308, HCS 309, HCS 402, and HCS 9165 forms, as applicable.
• Business-formation documents, organizational information, job descriptions, personnel policies, a training plan, and a program description.
• Required liability insurance, workers' compensation coverage, and an employee-dishonesty bond.
• Background checks for specified owners and officers, registered affiliated Home Care Aides, and completion of the CDSS orientation.

Each applicant must identify the persons responsible for operating the organization and document the ownership, management, job duties, policies, training, and background-clearance information required by the applicable regulator. Medical HHAs also require qualified clinical leadership, including a Director of Patient Care Services.

A California HCO must maintain a California office and required records, and an out-of-state entity must also register to do business in California. Medical HHAs likewise need an approved operational location. Applicants should verify zoning, lease, privacy, record-security, accessibility, and local business requirements before committing to a site.

Processing time varies with application completeness, document review, applicant readiness, inspection scheduling, and correction of deficiencies. Medicare certification or accreditation adds separate steps. Home Health Forms does not guarantee a state or federal processing time.

An HCO may arrange non-medical services such as bathing, dressing, grooming, toileting, transferring, feeding, meal preparation, light housekeeping, shopping, laundry, transportation, companionship, and medication reminders within the lawful non-medical scope.

Skilled nursing and other medical services require the separate CDPH Home Health Agency pathway.

Yes. An HCO must use affiliated Home Care Aides who are listed on the CDSS Home Care Aide Registry and have completed required background checks. The organization is also responsible for training, verifying qualifications, maintaining records, and supervising services.

California law contains limited exclusions and exemptions, but labels alone do not determine status. Providers should compare their actual services and business model with the current statute and obtain legal guidance before relying on an exemption.

Not solely because it holds California licensure. An organization planning to seek federal certification must first obtain California state licensure and then complete the applicable Medicare certification and enrollment process. Medicare-certified agencies must also comply with applicable federal Home Health Conditions of Participation.

Yes. A California HCO must implement written policies and procedures approved by its governing body. They must address the agency's administrative, personnel, client-care, emergency, quality-management, and other applicable operational requirements and be reviewed at least annually.

Home Health Forms provides startup guidance, customized documents, and application-preparation assistance. CDPH and CDSS make state licensing decisions, and the appropriate federal authorities determine Medicare certification.

The applicant is responsible for truthful and complete information, qualified personnel, an appropriate office, financial and insurance requirements, fees, regulator requests, inspections, and ongoing compliance. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after Home Health Forms receives all company information needed to complete the customization. Other package components may have separate production timelines.

Cancellation and refund eligibility depends on the work already completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.