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Home Care Organization Application Process

To apply for a license to operate a HCO, please complete the following steps:

  1. Review the HCS 281 for application instructions.
  2. Click on the links in the Section A chart below to access the appropriate application forms.
  3. Complete the application forms and compile all the supplemental documents listed in the Section B chart.
  4. Mail the completed application with appropriate application fees to the HCSB at:

California Department of Social Services
Home Care Services Bureau
744 P Street, M.S. T8-3-90
Sacramento, CA 95814

SECTION A: Home Care Organization Application Forms

Section Form Number Form Title
A1 HCS 200 Application for a Home Care Organization License
A2 HCS 215 Licensee Applicant Information
A3 HCS 308 Designation of Home Care Organization Responsibility
A4 HCS 309 Partnership/Corporation/Limited Liability Company Organization Structure
A5 HCS 402 Employee Dishonesty Bond
A6 LIC 508 Criminal Record Statement
A7 HCS 9165 Board of Directors Statement

SECTION B: Home Care Organization Application Supplement Documents

Section Title of Supplemental Document
B1 Partnership Agreement/Articles of Incorporation/Articles of Organization
B2 Job Description(s) - Each Position
B3 Personnel Policies
B4 Training Plan
B5 Home Care Organization Program Description
B6 Insurance Information

After you submit your application, you will receive a notice stating that your application has been received. This notice will also provide you with information regarding:
  • Your HCO number which you should use in all future communication;
  • How to commence with the fingerprinting process; and
  • How to complete the online orientation.