How much does a home care license cost in California?

A Home Care Organization (HCO) license costs $5,603, paid to the California Department of Social Services (CDSS) for a two-year term. If you plan to provide skilled, medical care, a Home Health Agency (HHA) license costs $2,946 through the California Department of Public Health (CDPH). Which one you need depends on the type of care you want to deliver.

California home care license fees (2026)

California splits home care into two regulated categories, each with its own agency and fee:

• Home Care Organization (HCO): $5,603 biennial licensing fee to CDSS for non-medical, in-home personal care and companionship.
• Home Health Agency (HHA): $2,946 to CDPH for skilled nursing and medical home health services.

Home Care Organization (non-medical)

An HCO covers help with bathing, dressing, meals, medication reminders, and companionship, but it does not allow skilled nursing. Every caregiver you employ must register with the state Home Care Aide Registry and clear a criminal background check before working with clients. This is the most common license for a new non-medical agency in California.

Home Health Agency (skilled care)

An HHA lets you provide nursing, therapy, and other clinical services, often billed to Medicare or insurance. The state fee is lower, but the process is far more involved and includes Medicare certification and, in some regions, longer waits. You can learn more on our California licensing page.

What else you will pay for

The state fee is only one line on your budget. Most new California agencies also pay for:

• General and professional liability insurance, usually a few thousand dollars a year.
• A surety bond where required by your county or a payer.
• Business formation, such as setting up an LLC or corporation and registering with the state.
• Background checks and Live Scan fingerprinting for owners and caregivers.

How long does it take?

Once you file a complete HCO application, CDSS review commonly runs about three to six months. The HHA route usually takes longer because it adds Medicare certification and, in some counties, application backlogs. Filing a clean, complete application is the single best way to avoid delays.

Do you need to be a nurse?

No. You do not need to be a nurse or a doctor to own a non-medical Home Care Organization in California. You do need qualified staff, and an HHA that provides skilled care must employ licensed clinicians, but ownership itself is open to anyone who meets the state's requirements.

The most affordable path

If you only plan to offer non-medical personal care, the HCO license is the cleaner and faster route to open. Many owners start with an HCO, build a client base, and add skilled services later. Doing the paperwork right the first time is what actually keeps costs down, since a rejected application means lost time and repeated effort.

Get help with your California application

Cura prepares and submits your California application for a fixed price, so you know the full cost up front. See our HCO application support package or book a free discovery call to map out the best path for your agency.