California Home Care License Guide

Licensing in California

Two state agencies split the work. CDPH licenses skilled Home Health Agencies and Hospices; CDSS, through its Community Care Licensing Division, licenses non-medical Home Care Organizations. New hospice licenses have been frozen since January 1, 2022, now extended through at least January 1, 2027 under AB 177. Since May 13, 2026, CMS also froze new Medicare enrollment for HHAs and Hospices.

License routes we cover in California

Home Care Organization (HCO)

Non-medical personal care by registered Home Care Aides. Licensed by CDSS under the Home Care Services Consumer Protection Act.

Home Health Agency (HHA)

Skilled nursing, therapy, and aide services in the patient's home. Licensed by CDPH under Health and Safety Code Chapter 8 (§§ 1725 to 1742.7) and Title 22.

Hospice Agency

Palliative care for terminally ill patients. Licensed by CDPH under the California Hospice Licensure Act of 1990. Note: new licenses are under a state moratorium through at least January 1, 2027.

How we get you licensed

Set up your company and office

Form a California LLC or corporation and get an EIN. Sign a commercial lease in the entity's exact legal name, at least one year (no month-to-month), naming the facility type.

Line up your management team

HHA: name an Administrator and a Director of Patient Care Services (RN). Under Title 22 CCR § 74718, a non-RN administrator needs health-admin training and one year of supervisory experience; CDPH expects a bachelor's degree. Both roles need a qualified designee. HCO: name an owner. All key staff must pass Live Scan fingerprinting before the application is complete.

Submit your application packet

HHA: file the CDPH packet (forms HS 200, HS 215A, BCIA 8016, service-area maps, corporate docs, Title 22 policies) with the Centralized Applications Branch (CAB). HCO: file forms HCS 200, 215, 308/309, 402 (dishonesty bond), 9165, and Section B papers with the CDSS Home Care Services Branch in Sacramento, plus the $5,603 non-refundable fee.

Pass review and the on-site survey

CDPH CAB screens the packet; incomplete ones are returned. Then CDPH runs an on-site survey checking your office, policies, and staff under Title 22. CDSS reviews HCO packets and requests fixes before issuing a license number.

Enroll in Medicare/Medi-Cal (HHA)

After the state license, an HHA seeks Medicare certification through the MAC (NGS in California): file CMS 855A, pass an accreditation survey by ACHC, CHAP, or The Joint Commission (usually 10+ active patients), a MAC site visit and capital review, and a Tie-In Notice. Note: a six-month CMS enrollment moratorium on new HHAs began May 13, 2026.

Register your Home Care Aides (HCO)

Before working, each aide must pass a Live Scan check and join the CDSS Home Care Aide Registry ($35 per aide, two years). Aides also need a TB test within 90 days before or 7 days after hire, repeated every two years if negative.

Key California requirements

CDSS (Home Care Services Branch) licenses HCOs; CDPH (Center for Health Care Quality) licenses HHAs and Hospices. Apply to the right agency.

HHA administrator (Title 22 CCR § 74718): if not an RN, needs health-admin training, a bachelor's, one year supervisory experience, and a designee.

All HHA managers clear Live Scan fingerprinting via CDPH; HCO owners and staff via CDSS.

HCOs need $1M/$3M liability insurance, workers' comp, and a $10,000 dishonesty bond (form HCS 402).

All HCO caregivers must join the CDSS Home Care Aide Registry ($35 per aide, two years).

Medi-Cal HHAs must use CalEVV (or an approved alternate EVV) to log each visit before billing DHCS.

Traps that catch new owners

New hospice licenses are frozen since January 1, 2022. AB 177 (Chapter 999, Statutes of 2024) extends the ban through at least January 1, 2027 (or one year after CDPH adopts its emergency fraud-prevention regulations, whichever is later). Buy an existing hospice or wait.

The lease must match the entity's exact legal name, run longer than month-to-month, and name the facility type. One mismatch can delay approval by months.

Since May 13, 2026, a six-month CMS freeze blocks new HHA and Hospice Medicare enrollment. Applications reaching a MAC before that date are grandfathered.

California licensing packages

Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.

California Home Care Organization (HCO) license: Fixed-Price Application Support

$3,995.00

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California Home Health Agency (HHA) license: Fixed-Price Application Support

$5,495.00

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California licensing FAQs

Is there a Certificate of Need (CON) rule in California?

No. California has no Certificate of Need law for home health agencies or home care organizations. The only exception is hospice: the active moratorium works as a de facto ban on new entry until the state lifts it, expected no earlier than 2027.

Can one company hold both an HCO and an HHA license?

Yes. California lets one parent company hold both, but the licenses come from different agencies (CDSS for HCO, CDPH for HHA). Each needs its own application, management team, and office lease, and each is surveyed and renewed on its own.

How long does licensing and Medicare certification take?

CDPH review takes 8 months to 2 years. Medicare certification (accreditation survey, CMS 855A to NGS, MAC site visit) adds 3 to 6 months, or 18 months to over 3 years overall. A federal Medicare moratorium on new HHAs applies as of June 2026.

California Home Care, Home Health & Hospice Licensing