California licenses home care agencies and registers individual aides in two separate systems. Here is how San Diego families check both before anyone starts a shift.
By Marcus Reyes, LSW · July 25, 2026
Families often assume that an in-home caregiver is licensed the way a nurse is. That is not how California works. Since the Home Care Services Consumer Protection Act took effect, the state regulates in-home care through two connected but separate systems, and a caregiver can be legitimate under one and invisible in the other.
The first is the Home Care Organization (HCO) license. That is the agency — the business that employs caregivers, schedules shifts, carries workers' compensation and liability coverage, and sends you the invoice. HCOs are licensed by the California Department of Social Services and are subject to the same enforcement arm that oversees assisted living facilities.
The second is the Home Care Aide Registry. This lists individual caregivers who have cleared a Department of Justice criminal background check, submitted tuberculosis clearance, and completed the state's required entry-level training. Aides employed by a licensed agency must be on the registry. Independent caregivers who work directly for a family may register voluntarily — many good ones do, and many do not, which is exactly why the check matters.
Both lookups run through the state's care facility search at ccld.dss.ca.gov, the same portal San Diego families use to pull assisted living inspection reports. Search by the agency's legal business name rather than its marketing name; a company advertising as "Coastal Companions of North County" may be licensed under an LLC name that looks nothing like it. Ask for the exact licensed name and the license number in writing, then confirm the two match what the state shows.
Check the license status and the issue date. An agency whose license was issued three weeks ago is not disqualified, but it changes what you should ask about supervision and backup staffing. Also check whether the license covers the county where care will actually be delivered — an agency headquartered in Orange County can serve Oceanside or Carlsbad, but you want that stated on paper.
For the individual aide, search the Home Care Aide Registry by name. A caregiver who is on the registry has cleared the background check. A caregiver who is not on it has not been screened by anyone except the person who hired them, and if that person is you, the screening is your responsibility.
In-Home Supportive Services runs on a different track entirely. IHSS providers are vetted by San Diego County rather than through the registry — background check, provider enrollment paperwork, and county orientation. If your parent qualifies for IHSS through Medi-Cal, County of San Diego Aging & Independence Services at 800-339-4661 can explain how provider enrollment works and whether a family member can be paid.
A licensed HCO should produce, in writing and before care starts: the license number, proof of workers' compensation coverage for the caregiver entering your home, the employee dishonesty bond that protects against theft, a written service agreement with the hourly rate and minimum shift length, and a care plan describing what tasks the aide will and will not perform.
That last item prevents the most common conflict. Home care aides are not licensed to perform medical tasks. They can remind a client to take medication, help with bathing, transfers, meals, and housekeeping. They cannot administer injections, manage wound care, or change a catheter. If an agency is casual about that boundary in the sales conversation, it will be casual about it at 2 a.m.
Ask directly how the agency handles a caregiver calling out. In practice this is the difference between an agency and a staffing referral service. A licensed HCO that employs its caregivers sends a substitute. A registry-style matching service typically leaves you to find one.
Treat these as reasons to stop: an agency that will not give you its license number, cash-only payment, pressure to sign a long-term contract at the first visit, a caregiver who arrives without the agency having introduced them, or any suggestion that the aide be added to a bank account, deed, or will. That last one is not a gray area — it is the standard opening move in financial elder abuse.
If something has already gone wrong, San Diego County Adult Protective Services takes reports 24 hours a day at 800-510-2020. Complaints about a licensed home care agency go to the Department of Social Services through ccld.dss.ca.gov. If the person lives in an assisted living facility or nursing home rather than at home, the Long-Term Care Ombudsman for San Diego County is 800-640-4661. You do not need proof to make a report — a reasonable suspicion is the standard, and investigators sort out the rest.
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