Senior Care: Buyer Beware
Why hiring “off the books” could cost you more than you think
We don’t often look for senior care services until we’re in crisis, usually for a parent or spouse.
The online search can feel like a minefield: dozens of agencies offering similar care, but not all operate the same way.
Some present themselves as full-service, legitimate providers when they’re actually referral or placement agencies with minimal oversight.
The Hidden Loophole
California law requires home care agencies to be licensed and caregivers to be registered—but enforcement is weak, and many families unknowingly hire from unlicensed providers. These “off-the-books” arrangements may seem cheaper or more convenient, but they expose families to serious risks:
Here’s what’s at stake:
- Insurance and liability: Private hires often lack workers’ comp or liability coverage. If a caregiver is injured or neglects a patient, the family may be held financially responsible. Licensed agencies carry insurance and bonding to protect everyone involved.
- Background checks: Agencies conduct DOJ and FBI fingerprint checks. Referral agencies may only run basic 5-point checks, which rely on public records and miss critical red flags.
- Employment law: In California, caregivers are employees—not independent contractors. You cannot legally issue a 1099. Families who hire privately become employers, responsible for payroll taxes, Social Security, and unemployment insurance.
- Continuity of care: If a private caregiver quits or calls out, you’re stuck. Agencies provide trained backup staff to ensure uninterrupted service.
What You Can Do
Before hiring any caregiver or agency, ask these four questions—and verify the answers:
1. Are you licensed by the State of California?
Ask for their license number and verify it using the Home Care Organization License Lookup
2. Is the caregiver registered and fingerprinted?
Ask for their Personal Identifier (Per ID) and confirm it using the Home Care Aide Registry Search
3. Do you carry liability insurance and workers’ comp?
Request proof of current coverage.
4. How long have you been in business?
Longevity and transparency matter.
Also, don’t rely solely on hospital referrals. Ask friends, neighbors, and family for recommendations. Read online reviews. Call multiple agencies and compare rates. If one quote is dramatically lower, that’s a red flag.
Risk Overview
How to Protect Your Family
Before hiring any caregiver or agency, take these two steps:
- Verify the agency’s license using the Home Care Organization License Lookup
- Check the caregiver’s registration using the Home Care Aide Registry Search
If either one isn’t listed, walk away. A licensed agency will always be transparent about its credentials.
Hiring privately may seem like a shortcut—but it’s a gamble. The protections offered by a licensed agency aren’t just bureaucratic—they’re your safety net. Do your homework, ask the right questions, and verify credentials before trusting someone with your loved one’s care.
