5 Questions to Ask Any Home Care Agency Before You Sign

Why it matters

This is the most important question on this list, and the one most families don't know to ask.

When a caregiver is a W-2 employee of an agency, the agency:

• Withholds payroll taxes
• Carries workers' compensation insurance — so if the caregiver gets hurt in your home, the agency's insurance covers it, not you
• Carries general and professional liability insurance
• Is legally responsible for supervision, training, and conduct
• Handles all employment paperwork

When a caregiver is a 1099 independent contractor — common with online "registries" and some lower-cost agencies — the family is often considered the employer. That can mean you're personally liable for workers' comp, payroll taxes, and any incidents in the home. It also typically means there's no real training, no supervision, and no clear recourse if something goes wrong.

Why it matters

You're inviting someone into your loved one's home, often when they're at their most vulnerable. The vetting process should be rigorous, and the agency should be able to walk you through it without hedging.

What to listen for:

• Background checks. In California, this should include Live Scan fingerprint background checks (state and federal) and verification against the state's Home Care Aide Registry.
• Driving record check if the caregiver will be transporting your loved one.
• Reference checks — actually called, not just submitted on paper.
• A multi-step interview process — not just a phone call.
• Initial and ongoing training. California requires a minimum of 5 hours of entry-level training and 5 hours of annual continuing education. Strong agencies do more.
• Specialized training for what actually comes up: dementia and Alzheimer's care, fall prevention, safe transfers, post-surgical recovery, end-of-life care.

A useful follow-up: "Walk me through how you hired the last caregiver you brought on." The answer tells you a lot.

Why it matters

Caregivers get sick. They have family emergencies. They go on vacation. The question isn't whether shifts will need to be covered — it's how the agency handles it when they do. This question quietly separates real agencies from those that are essentially staffing one or two people and hoping nothing goes wrong.

For 24/7 care or higher-acuity situations, a good follow-up is: "How many caregivers will typically be in our regular rotation, and how do you handle continuity over time?"

Why it matters

The hourly rate isn't the full picture. Several contract terms can meaningfully affect what you actually pay each month and how flexible the arrangement is.

Specific things to ask about:

• Minimum shift length. Many agencies require a 4-hour minimum per visit. If you only need someone for 2 hours, you're paying for 4.
• Minimum weekly hours. Some agencies require a minimum to start service. Find out the threshold.
• Holiday rates. Most agencies charge 1.5x or 2x on major holidays. Know exactly which holidays and what the multiplier is.
• Overtime. California overtime rules apply — especially relevant for live-in or 24/7 care.
• Rate increases. Some agencies raise rates annually with little notice. Ask how much notice you'll get and whether increases are capped.
• Cancellation. What happens if you cancel a shift same-day, or if your loved one goes to the hospital? Is there a notice period to end services entirely?

A good agency walks you through the contract before you sign anything. Verbal-only agreements, "don't worry about that," or fees that show up later are all reasons to keep looking.

Why it matters

Even with great caregivers, things come up. Medications change. Your loved one's mood shifts. The current caregiver turns out not to be the right fit. You need to know there's a real person — not just an answering service — who's accountable for sorting it out.

What to listen for:

• A named care manager or coordinator assigned to your case
• Regular in-home supervisory visits, typically every 30–90 days
• A clear escalation path — who you call first, and what happens after hours
• A documented care plan that's reviewed and updated as needs change
• For higher-acuity situations, willingness to coordinate with an RN, hospice, or your loved one's physician

The single best test: "What happens if we call at 8pm on a Saturday and there's a problem?" If the answer is "leave a message and we'll get back to you Monday," that's not the agency you want when things get hard.