Requirements to Become A+ Rated

Agencies interested in becoming A+ Rated must adhere to the following.
Experience in the Industry

Agency owner or operating manager or a person in a control position must have been in the paying home care business for at least one year.

Background Check

All agencies must have a multi-tiered background check policy, including but not limited to, a 50 state multi-jurisdictional, criminal, sex offender registry.  HCSB will again review background documentation during the annual audit.

Motor vehicle record search must be done if caregivers transport clients.  Agency is required to have a policy regarding motor vehicle use and required licenses.  Motor vehicle record search must be done on an annual basis.

A grandfather clause is in place that allows caregivers, employed by agencies prior to receiving the A+ rating, to have undergone a background check with the following components:

  • Social Security number trace and verification;
  • National database search (multi-jurisdictional)
  • Motor vehicle record search must be done if caregivers transport clients.  Agency is required to have a policy regarding motor vehicle use and required licenses. 

Note: Caregivers hired after agency receives A+ rating must undergo the background check with all three tiers listed above.

If your employees currently do not undergo a background check and you do not have a provider of this service, HCSB has facilitated the process by negotiating comprehensive and cost-effective background checks from First Advantage https://ca.fadv.com/CA/homecarebureau. You may also find your own provider of background checks. Again, HCSB will review background documentation during the annual audit.

Department of Motor Vehicles Report (when caregivers transport clients)
  • Driver’s license is suspended and caregiver is required to provide transportation to clients.
  • Two (2) or more DUIs in last five (5) years
Criminal Background Check:

(Includes County, National Criminal Database Searches & Sex Offender Registries).

The following are all limited to the past 7 years:

  • Any felony conviction
  • Any misdemeanor convictions that fall under the following categories:
    Abuse – elder abuse, abuse of vulnerable/disabled adult, patient abuse, abuse by Caretaker.
    Child abuse, endangerment and neglect
    Sex Crimes – child related, miscellaneous, offender, prostitution, unlawful contact, violence
    Substance Abuse (misdemeanor convictions reviewed by the HCSBRegulatory Board): distribution, possession, DUI-alcohol & Unspecified, DUI-drug Related, intoxication – drugs, marijuana – distribution, marijuana possession, other – drug related
    – Theft and Burglary:
    bad check, burglary, forgery, fraud, identify theft related, receiving/possession, securities related, tax related, theft
    – Violence and Threats: animal cruelty, arson, assault and battery, attempted murder, fighting, hate crimes, kidnapping, manslaughter, murder related, other violence, robbery, stalk/harass/threats, tampering, vehicular manslaughter, weapons-criminal, weapons use
  • Any active warrants.

Note: Exceptions may be made when the State has granted a waiver for an employee.

Education and Testing

In order to obtain the A+ Rating all Caregivers must demonstrate that they meet basic education standards by completing 12 hours of approved core Caregiver education.  If a home care agency already has an equivalent, or greater, caregiver education program in place the agency will have met this standard.

Education and training for your Caregivers must include the following general content areas to meet this requirement:

  • Becoming a Caregiver
  • Duties of a Caregiver
  • Communicating with Others
  • Understanding Elder Abuse
  • Understanding Dementia
  • Infection Control
  • Environmental Hazards and Safety
  • Promoting and Maintaining Good Mobility
  • Providing Personal Care
  • Observation, Reporting and Recording
  • Caregiver First Aid
  • Medication Self-Administration Training

If your agency does not have access to an educational curriculum that includes these content areas, your A+ Rating will provide you access to an educational program at no additional cost. HCSB will provide A+ Rated agencies access to online, web-based programs for anytime, anywhere access, included in your A+ Rating.

During the annual audit, A+ Agencies will be required to demonstrate that each caregiver is in compliance with the educational requirement. The platform utilized to access Caregiver education makes it easy for agencies to track caregiver’s progress and completion of this requirement. If your Caregivers are already completing training that covers the 12 hours of approved core Caregiver education, your Caregivers will not be required to participate in the HCSB training Program.

Continuing Education

In addition to completion of the core caregiver educational courses, each caregiver will be required to complete 12 hours per year of continuing caregiver education.

Insurance

A requirement for A+ rated Agencies is that they must carry minimum insurance that includes:

General Liability – Each applicant seeking the rating must carry a minimum of $1,000,000 per occurrence bodily injury and property damage general or public liability coverage, and $2,000,000 bodily injury and property damage liability in the aggregate.

  • Each applicant must carry a minimum of $5,000 in medical payments coverage as part of the General Liability Insurance Policy.
  • Each Applicant must carry a minimum of $1,000,000 per occurrence coverage for completed operations or products coverage.
  • Each applicant must carry minimum limits of $1,000,000 of hired and non-owned liability coverage if no independent auto policy is present.

Note: If  the agency provides any type of medical services the agency will be required minimum professional coverage for bodily injury and property damage of $1,000,000 / $3,000,000.

Auto Liability – If vehicles are owned by the agency, it must carry a minimum of $1,000,000 combined bodily Injury and Property Damage Auto Liability coverage.  If other vehicles are borrowed, hired, or not owned, the applicant must carry a minimum of non-owned and hired coverage for the same $1,000,000 combined single limit.

Incidental (non-medical) Professional Liability – A minimum of $250,000 of incidental professional liability coverage for bodily injury and property must be purchased by the applicant.

Workers Compensation Coverage – If required by the state where the operation is based, the company should comply with the state statutory WC limits and a minimum of $500,000 employer’s liability.

Note: Attach certificate of insurance. Agency may find an insurance carrier of your choice or contact a preferred provider from the Home Care Standards Bureau. HCSB has negotiated a discounted price for insurance that meets the minimum insurance requirements.

Expertise in the Field of Aging

The agency must have on staff, advisory committee or Board one qualified person in the field of aging that meets the HCSB requirements. Examples are:

  • Gerontologist
  • Registered Nurse or Licensed Practical Nurse
  • Geriatric Care Manager
  • Certified Senior Advisor

Other (other disciplines can qualify – such as Licensed Social Worker).

Applicable Licenses and Accountability

The A+ agency must be fully and properly licensed by applicable State and Federal regulatory organizations.

The agency must complete and submit a monthly disclosure form.

All Caregivers employed or contracted by the agency must have all applicable licenses.

90% of agency employees must be W2 employees of the agency.

The agency must have no unresolved complaints with state licensing agencies.

The agency must agree to abide and sign the HCSB Regulatory Board Code of Standards and Ethics.

The agency must agree to both scheduled and unannounced on-site audits.

HCSB strongly encourages Caregivers employed or contracted by the agency to be proficient in the language of the population being served.

Agency Complaints

A+ Rated Agencies are required to have a complaint resolution policy and maintain a log of complaints and outcomes consistent with this policy.  Please attach a list of unresolved (i.e., under investigation) complaints against the Agency that fall within the following categories: elder abuse, neglect or endangerment; sex crimes; child abuse, neglect or endangerment; theft and burglary, including financial exploitation; violence and threats.

Please Note:  If you do not meet the above standards you will still be allowed to complete the application and provide payment for the monthly fee.  You will be required to meet the requirements for the A+ rating (for example, by obtaining background checks for your caregivers or obtaining the minimum insurance) within 90 days.  If you have not met all requirements for the A+ rating within 90 days of submission of this application, you will be notified and your application will be withdrawn.  When someone is looking for a care provider in your area, your agency will show up on the HCSB website locator as “In Process” until you have met all requirements.

If you are willing and able to meet these requirements,
please complete the Application to become an A+ Rated agency.