
COMMUNITY CARE LICENSING DIVISION HOME CARE SERVICES BUREAU STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES APPLICATION FOR HOME CARE AIDE REGISTRATION.
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How to fill out the Application For Home Care Aide Registration online
Filling out the Application For Home Care Aide Registration online is an essential step for anyone wishing to become a registered home care aide in California. This guide provides a clear, step-by-step approach to help you complete the application accurately and efficiently.
Follow the steps to fill out your application with ease.
- Click ‘Get Form’ button to access the application and open it in the designated editor.
- Provide your full legal name in the appropriate fields: last name, first name, and middle name. Ensure you do not use any nicknames.
- List all other names you have ever used, including maiden names or aliases, in the designated section.
- Enter your residence address clearly, including street, apartment (if applicable), city, state, zip code, and county. Ensure that city names are spelled out completely.
- If your mailing address differs from your residence address, fill in the mailing address section. Please use P.O. Box or street address as applicable.
- Optionally provide your email address to facilitate communication.
- Enter your date of birth in the format MM/DD/YY, ensuring you are 18 years of age or older.
- Indicate your sex by marking ‘M’ for male or ‘F’ for female in the corresponding field.
- Input your social security number, noting that this is voluntary, but omitting it may delay the processing of your application.
- Provide your driver's license number or identification card number required for the application.
- List your daytime and evening telephone numbers to maintain communication.
- If applicable, indicate whether you are currently registered with the TrustLine Registry or working in a licensed facility. If yes, provide your Personnel Identification number.
- If you desire to transfer your background clearance from the TrustLine Registry, indicate this, and fill in the TrustLine Registry number.
- Affirm if you are currently affiliated with or applying to become affiliated with a Home Care Organization. If yes, provide the organization name and number.
- Conclude by signing and dating the application. Ensure your signature matches the names provided throughout the form.
- Review the application for completeness, ensuring all required fields are filled and documentation, such as the Criminal Record Statement, is prepared for submission.
- Once completed, save changes, download the application, print, or share as necessary.
Start your online application today to take the first step towards becoming a registered home care aide.
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How do I become a home health aide in California?
Complete the Home Care Aide Registry Application. Submit LiveScan fingerprints. Pay the 2 year registration fee ($25.00) Complete Statement of Prior Criminal Records (LIC 508) Complete Mandated Reporter Acknowledgement (SOC 341A)
How do I become a HCA in Washington state?
Complete a home care aide application, including the Employment Verification form. Undergo a Department of Social and Health Services (DSHS) criminal background check. Complete a 75-hour basic training course approved by DSHS.
What is HCA registry?
Welcome to the Department of Social Services Home Care Aide Registry. This website provides individuals with the ability to locate a Home Care Aide (HCA) who has completed the criminal background check process administered by the California Department of Social Services.
How do I become a certified home health aide in California?
Successfully complete a training program with a minimum of 120 hours, or an equivalent competency evaluation program approved by the CDPH. ... Complete a minimum of 20 Clinical Hours. Obtain a criminal record clearance. Obtain formal certification and register with CDPH.
How long does it take to become a certified home health aide?
For most care givers, it takes about 75 hours to become a home health aide. Once you complete the training requirement, you will need to submit an application with the state for testing and certification.
How much does HHA training cost?
Home Health Aid Paid Certification Cost If you pay for your HHA certification, you'll still be making a good investment. You can get your certification for as little as $200 online, and even the best in-person programs usually don't cost more than $1,000.
How do I get a California home care license?
They must pass a criminal background check that involves being fingerprinted, and they are required to pay a registration fee. They are also required to go through yearly training mandated by the state, and they must pass a TB check. Licensed Home care Organizations are required to be officially licensed through CDSS.
What does HCA stand for?
Thomas Frist Jr. and Jack Massey envisioned a healthcare company with the scale, resources and clinical expertise to provide care focused on the patient. In 1968, they formed Hospital Corporation of America (HCA). At that time, HCA Healthcare was one of the first hospital companies in the United States.
Do home health aides need to be certified?
Home health aide training The US Bureau of Labor Statistics notes that while many HHAs have a high school diploma or a GED, formal education generally is not required to be an HHA. Some states do offer a training and certification process to become a certified home health aide, or CHHA.
What is a home health aide do?
Home Health Aide Job Responsibilities: Supports patients by providing housekeeping and laundry services, shopping for food and other household requirements, preparing and serving meals and snacks, and running errands. Assists patients by providing personal services, such as, bathing, dressing, and grooming.
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