Caregiver credential requirements by state

Every state does this differently, and almost none of it is written for the person who actually has to follow it. It's in administrative code, a licensing FAQ, a statute that got amended last October... so I went and read the actual rules for ten of the biggest home care states, for private-pay, non-medical agencies, and put them in one place.

Two things before the tables. Rules change. Every state below says when we last checked it and links the official source, so click through and read the current version before you rely on any of it.

And First Shift doesn't run any of these checks. It reads each application against your job and flags what the applicant didn't tell you, like "no registry check stated" or no CPR expiry, so you know what to chase before you call. The registry search, the fingerprints, the TB test... those are still yours.

How to use this page: find your state, work down the table before you book a first shift, and use the links under it to run the lookups yourself. Where a state doesn't set a rule, the table says so instead of guessing.

Texas

Texas is the one where the registry checks do most of the work, and they come back every year.

Last checked 23 Sep 2026. Sources:

• HHSC HCSSA Frequently Asked Questions (updated July 2026)
• 26 TAC §558.247, verification of employability
• 26 TAC §558.404, personal assistance services standards
• Health & Safety Code chapter 250

California

California runs its own Home Care Aide Registry, and nobody goes into a client's home until they're cleared on it.

Last checked 23 Sep 2026. Sources:

• CDSS home care aide application process
• Health and Safety Code §1796.43
• Health and Safety Code §1796.44 (training)
• Health and Safety Code §1796.45 (TB)
• SB 412 (2025), home care aides

Florida

In Florida the first question is whether your caregivers do hands-on care, because that decides which license you need.

Last checked 23 Sep 2026. Sources:

• Fla. Stat. §400.509, companion and homemaker registration
• Fla. Stat. §400.462, definitions
• Fla. Stat. §400.512, screening
• Fla. Stat. §435.04, level 2 standards
• Fla. Stat. §435.06, contact before clearance
• Fla. Stat. §430.5025, Alzheimer's training
• Fla. Admin. Code 59A-8.0095, home health personnel

New York

New York has the most paperwork of the ten, but also the clearest rules. Health records, fingerprints and a registry, all spelled out.

Last checked 23 Sep 2026. Sources:

• 10 NYCRR 766.11, personnel
• 10 NYCRR 402.4, criminal history record check
• 10 NYCRR 700.2, definitions
• Home Care Registry FAQs
• DOH guide to operating a PCA training program

Illinois

Illinois puts almost everything through one portal: the Health Care Worker Registry.

Last checked 23 Sep 2026. Sources:

• 77 Ill. Adm. Code 245.71, home services workers
• IDPH Health Care Worker Registry
• IDPH new hire background check checklist
• IDPH home services agency FAQs

Ohio

If you've read that Ohio doesn't license non-medical home care, that's out of date. ODH issues a nonmedical home health services license now.

Last checked 23 Sep 2026. Sources:

• ODH home health agency licensure
• ODH nonmedical home health services license application
• Ohio Admin. Code 3701-60-01, definitions
• Ohio Admin. Code 3701-60-05, database review
• Ohio Admin. Code 3701-60-06, criminal records check
• Ohio Admin. Code 3701-60-07, conditional employment

Pennsylvania

Pennsylvania licenses companion work too, not just personal care, and it's strict about the order things happen in.

Last checked 23 Sep 2026. Sources:

• 28 Pa. Code chapter 611
• 28 Pa. Code §611.52, criminal background checks
• 28 Pa. Code §611.54, provisional hiring
• 28 Pa. Code §611.55, competency
• 28 Pa. Code §611.56, health screening

Georgia

Georgia splits caregivers into personal care assistants and companions or sitters, and the training rules follow that split.

Last checked 23 Sep 2026. Sources:

• DCH Private Home Care Program
• Rule 111-8-65-.09, administration and organization
• DCH GCHEXS
• DCH Georgia Caregiver Registry

North Carolina

North Carolina licenses companion and sitter agencies as well as in-home aide agencies, and the background check clock starts at the conditional offer.

Last checked 23 Sep 2026. Sources:

• DHSR home care FAQ (revised 5/30/25)
• 10A NCAC 13J, licensing of home care agencies
• DHSR Health Care Personnel Registry

Arizona

Arizona is the gap on this list. For private-pay, non-medical care we couldn't find a state rule at all, so most of what applies comes from who's paying.

Last checked 23 Sep 2026. Sources:

• A.R.S. 36-151, definitions
• A.R.S. 36-425.01, home health agency licensure
• A.R.S. 36-594.01, fingerprinting of DDD providers
• AHCCCS ACOM 429, direct care worker training and testing

What every state has in common

Read all ten back to back and the pattern is pretty clear, even where the details aren't.

• A criminal background check before the caregiver is alone with a client. Nine of the ten set one for licensed agencies, most of them fingerprint-based. Arizona only does for some Medicaid-funded work.
• At least one registry lookup. Texas has its two registries, California and New York have home care registries, Illinois has the Health Care Worker Registry, Ohio lists six databases, and North Carolina has the Health Care Personnel Registry. Where the state names the HHS OIG exclusions list (Illinois, Ohio, Georgia), it's a two-minute search, so do it.
• TB is where states split. California, New York, Pennsylvania and North Carolina want TB screening before client contact. Texas says outright there's no state requirement for its agencies. The rest don't set one in the rules we read.
• CPR is mostly your call. Only Florida's home health aides and Arizona's Medicaid direct care workers have a state CPR certification rule on this list. If your clients or payers expect it, that's your policy, not the state's.
• Training runs from "show you can do it" to set hours. Texas, Pennsylvania and North Carolina want demonstrated competency. California (5 and 5), Illinois (10 and 10), Georgia (40 for personal care assistants, then 8 a year) and New York (40 for personal care aides, then 6 a year) count hours.

The part that actually catches agencies out isn't the first check, it's the second one. Texas registries every 12 months. TB every 12 months in New York and Pennsylvania, every two years in California. Criminal re-checks every 5 years in Ohio and Florida. None of those dates are hard to track for three caregivers, and all of them slip at twenty. The credential tracker keeps a date per caregiver per check and turns red at 90, 60 and 30 days, and what to check before a caregiver's first shift walks through the order to do it in.

On the hiring side, First Shift's caregiver role template already asks applicants for their state registry number, background check date and CPR or first aid expiry, and holds the TB question until after an offer. The fit score then flags whatever's missing. See how it works, or what it looks like for an independent agency.

This page is general information, not legal advice. It summarizes state rules as we read them on 23 Sep 2026 for private-pay, non-medical home care agencies. Medicaid waiver, VA and other payer contracts often add their own requirements, and cities and counties can too. Before you rely on any row, confirm it with the state agency linked under that table.