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Home care staff requirements in Washington

Washington's Department of Health licenses in-home services agencies, with separate home care, home health and hospice categories under one rule chapter. Staff with direct contact with vulnerable people need a Washington State Patrol background check and disclosure statement renewed every two years, and long-term care workers at home care agencies also need an FBI fingerprint check. Home care workers generally need 75 hours of entry training (5 before giving care, all within 120 days), a home care aide certification, and 12 hours of continuing education each year.

Licenses

• Anyone who employs or contracts with two or more people to provide in-home services must hold a current in-home services agency license from the Department of Health (WAC 246-335-315).
• The license covers home care, home health and hospice service categories, which are explained in a required pre-application orientation (WAC 246-335-320(1)).
• Home care services are nonmedical services such as personal care and homemaker help for ill, disabled or vulnerable people (WAC 246-335-410(5)).

Background checks

• Personnel, contractors, volunteers and students with direct contact with children under 16, people with developmental disabilities or vulnerable persons need a criminal history background check processed through the Washington State Patrol and a department-approved disclosure statement (WAC 246-335-425(6)(a)-(b); WAC 246-335-525(6)).
• Those background checks and disclosure statements must be renewed within two years of the previous check (WAC 246-335-425(6)(c)).
• If a check shows nondisqualifying convictions, pending charges or negative actions, the agency must make and document a character, competence and suitability determination (WAC 246-335-425(7)).
• Long-term care workers, which include direct care workers employed by home care agencies, must be screened through state and federal background checks, including FBI fingerprints for workers hired on or after January 7, 2012 (RCW 74.39A.009(20)(a); RCW 74.39A.056(1)(a)-(b)).
• A worker who clears the state check may work with unsupervised access while the FBI fingerprint result is pending, as allowed by rule (RCW 74.39A.056(1)(b)(ii)).
• A provider may not have unsupervised access to vulnerable adults if listed on the vulnerable adult abuse registry or subject to certain founded abuse or neglect findings (RCW 74.39A.056(2)).

Training and competency

• Long-term care workers must complete 75 hours of approved entry-level training within 120 days of hire, including 2 hours of orientation and 3 hours of safety training before they may provide care (RCW 74.39A.074(1)(a), (b), (d)).
• To become a certified home care aide, a worker must complete that training and pass a certification exam with a skills demonstration and a written or oral test (RCW 18.88B.031(1), (3)).
• Long-term care workers must complete 12 hours of continuing education each year, which is also required to keep home care aide certification (RCW 74.39A.341(1)-(2)).
• Home care agencies must give in-person orientation and verify each worker's skills or training before the worker gives client care on their own (WAC 246-335-425(9)).
• Home health agencies must make sure registered nursing assistants become nursing assistants certified within 12 months of hire or stop giving patient care (WAC 246-335-525(10)).
• Agencies must do annual performance evaluations of direct care staff, including on-site observation of care and skills (WAC 246-335-425(13); WAC 246-335-525(16)).

Health screening

• Agencies must do a TB risk assessment on every new employee at hire using the Department of Health form, test if the form calls for it, and repeat the risk assessment every year (WAC 246-335-425(12)(c)(i)-(ii); WAC 246-335-525(15)(c)).
• Workers must receive TB training at hire or during new employee orientation (WAC 246-335-425(12)(c)(iii)).
• If a risk assessment shows likely exposure to blood, the agency must offer the hepatitis B vaccine series at its own expense, and workers may decline (WAC 246-335-425(12)(e)(ii)).

Also in the personnel file

• Home care personnel records must include current certification or credential (or documented exemption), references, orientation, skills verification, background checks, training, communicable disease testing and vaccination, and performance evaluations (WAC 246-335-430).
• Workers who prepare food for clients need a food worker card, equivalent FDA-based training, or home care aide certification (WAC 246-335-430(8)).
• Home health direct care staff and contractors must have current CPR training with hands-on skills observed by a certified trainer (WAC 246-335-525(14); WAC 246-335-530(9)).
• The home care supervisor must contact each client by phone or visit every six months to check the plan of care and satisfaction (WAC 246-335-445(6)).
• Home health aide supervision must happen monthly for acute care patients and every six months for maintenance or aide-only patients (WAC 246-335-545(7)-(8)).

Common questions

Some rules for Washington weren't confirmed from an official source. Check with the state before relying on this page.

Sources

• WAC 246-335, In-Home Services Agencies (Washington Legislature, official)
• RCW 74.39A.009, definitions (Washington Legislature, official)
• RCW 74.39A.056, background checks (Washington Legislature, official)
• RCW 74.39A.074, entry-level training (Washington Legislature, official)
• RCW 74.39A.341, continuing education (Washington Legislature, official)
• RCW 18.88B.031, home care aide certification (Washington Legislature, official)

This page summarizes state licensing rules in plain words, with links to the rules themselves. It is not legal advice, rules change, and your license type decides what applies: check the linked source and your licensing agency. Medicare-certified home health agencies also follow 42 CFR 484.80. Checked October 2026.

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