The short answer California runs two regimes: CDSS-licensed Home Care Organizations must use registered Home Care Aides with 5 hours entry-level training plus 5 hours annual training (Home Care Services Consumer Protection Act), while CDPH-certified home health aides need a 120-hour state certification. Home Care Aides must also be listed on the state HCA registry and have TB clearance.
What California requires
California
HCA entry training. HSC 1796.44 requires affiliated Home Care Aides at licensed Home Care Organizations to complete 5 hours of entry-level training before client contact — 2 hours of orientation plus 3 hours of safety training (basic safety, emergency procedures, infection control).
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HCA annual training. HSC 1796.44 also requires 5 hours of annual training tied to core competencies and population-specific topics; CDSS enforcement (including fines for training violations) is administered by the Home Care Services Bureau.
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HCA registry & TB. Home Care Aides must register on the CDSS Home Care Aide Registry (searchable via the Guardian system) with background clearance, and HSC 1796.45 requires a TB examination as a condition of providing home care services.
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HHA 120-hour certification. Home health aides at CDPH-licensed home health agencies must hold state HHA certification based on a 120-hour training program (max 75 classroom hours; CNAs may qualify via a 40-hour bridge), per HSC 1736.6 and 22 CCR 74747.
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HHA in-service. Certified HHAs must also meet the federal 12 hours/year in-service requirement at Medicare-certified agencies under 42 CFR 484.80.
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The federal baseline (applies in every state)
Federal
75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training.
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Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry.
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12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse.
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RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals.
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Primary sources for this page
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=1796.44
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=1796.44
- https://www.ccld.dss.ca.gov/hcsregistry/About.aspx
- https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/120-Hour-Home-Health-Aide-Training-Program-Applicants.aspx
- https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-484/subpart-B/section-484.80
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