North Carolina · Home care agency license · Free checklist
North Carolina home care license checklist
Every step to a North Carolina home care agency license, from owner training to your first renewal, each with the rule it comes from. Answer six questions to tailor it, tick steps off as you go and email it to yourself.
- Rule-verified October 1, 2026
- 23 steps, each cited
- Free, no account
Quick answer
To provide hands-on in-home aide care in North Carolina you need a home care agency license from DHSR. First-time owners complete DHSR-approved training; you appoint a qualified agency director, line up an RN to supervise aides, and write the policies on DHSR’s checklist. You mail the application with DHSR’s $510 fee, then send your policies and personnel documents, which DHSR reviews in the initial survey. You have 12 months from applying to finish, and the license renews every December 31.
Companion, sitter or respite care on its own needs a different license, as a home assistance services provider.
Tailor your checklist
Six quick questions
Your answers stay in this browser. The checklist below updates as you answer.
You need a license, but a different one
Companion, sitter or respite care on its own is a home assistance service. A home assistance services provider still needs a license from DHSR, must carry liability insurance, tell new clients it gives no health care or hands-on care, and run criminal background checks. This checklist is for home care agencies that give hands-on in-home aide care. Change your first answer to see it.
G.S. 131E-138(h)Nursing brings extra rules
Nursing must be given by or under the supervision of an RN, with on-call nursing 24 hours a day. The steps below cover the license and in-home aide services; CareRulebook’s manual covers in-home aide, companion, sitter and respite services, not nursing.
G.S. 131E-138(a)Your checklist
Showing the steps for a first-time owner starting an in-home aide agency that also offers companion services. Answer the questions above to tailor it.
Before you apply
Apply and the initial survey
Once you are licensed
Every 90 days and every year
Email me this checklist
We send the checklist with your answers and a link back to it. Nothing else unless you tick the box.
CareRulebook
Tick off “write the policies” in an afternoon
Answer a few questions about your agency and CareRulebook writes every policy on DHSR’s initial survey checklist, with your details filled in and the rule quoted under every policy.
- 31 policies, 47 rule requirements mapped
- Live preview of your own manual before you pay
- Editable Word and PDF, delivered instantly
- 12 months of updates when the rules change
$199CareRulebook founding price for the first 50 North Carolina agencies, then $249. Not a DHSR fee.
Frequently asked questions
What do I need to get a home care license in North Carolina?
For hands-on in-home aide care you need a home care agency license from DHSR for each site. First-time owners complete DHSR-approved training. You mail the application with the $510 fee, then send DHSR your policies, procedures and personnel documents, which it reviews before licensing you. You have 12 months from applying to finish.
Do I need a license for companion care in North Carolina?
Yes. Since 2023, companion, sitter and respite care on its own is a home assistance service, and a home assistance services provider needs a license from DHSR. It must carry liability insurance, tell clients it gives no hands-on care and run background checks.
What does DHSR check before licensing?
The policies, procedures and personnel documents you send after applying. DHSR’s initial survey checklist lists 32 policy and procedure items, and DHSR says not complying with that checklist and the rules is the main reason applicants are not approved.
Is this checklist free?
Yes. It is free to use and to email to yourself. It is guidance, not legal advice, so check each step against the rule it links to.
Keep reading
North Carolina
How to start a home care agency in North Carolina
The full guide behind this checklist.
North Carolina
The North Carolina license application
The form, the fee, where to mail it and what DHSR does next.
Product
Build your North Carolina policy manual
Every policy on DHSR’s checklist, preview free.
Texas
Texas license checklist
The same tool for a Texas HCSSA license.
Georgia
Georgia license checklist
The same tool for a Georgia private home care license.
Sources
- 10A NCAC 13J, The Licensing of Home Care Agencies · NC Office of Administrative Hearings · retrieved October 1, 2026
- N.C. General Statutes Chapter 131E, Article 6 (home care agency licensure and home care clients’ bill of rights) · North Carolina General Assembly · retrieved October 1, 2026
- Home Care Initial Survey Checklist (rev. 9/21) · NC DHSR · retrieved October 1, 2026
- Home Care Frequently Asked Questions (rev. 5/30/25) · NC DHSR · retrieved October 1, 2026
- Requirements for Establishing a Home Care Agency · NC DHSR · retrieved October 1, 2026
- 10A NCAC 13O, Health Care Personnel Registry · NC Office of Administrative Hearings · retrieved October 1, 2026
- 29 CFR 1910.1030, Bloodborne pathogens · eCFR (OSHA) · retrieved October 1, 2026
- Complaint Intake and Health Care Personnel Investigations Section · NC DHSR · retrieved October 1, 2026
- Home Care All: agencies licensed by the State of North Carolina (as of 08/2026) · NC DHSR · retrieved October 1, 2026
- Licensure Application for Home Care, Nursing Pool, and Hospice (DHSR-4204, rev. 07/21, 2026 edition) · NC DHSR · retrieved October 1, 2026
- Home Care Provider Training (DHSR-approved trainers) · NC DHSR · retrieved October 1, 2026
- Establishing a Certified Home Health Agency (page last modified October 15, 2008) · NC DHSR · retrieved October 1, 2026
- 2026 State Medical Facilities Plan, Chapter 12: Home Health Services · NC DHSR, Healthcare Planning and Certificate of Need Section · retrieved October 1, 2026
- Proposed 2027 State Medical Facilities Plan, Chapter 12: Home Health Services · NC DHSR, Healthcare Planning and Certificate of Need Section · retrieved October 1, 2026
- QSO-26-11-HHA & Hospice: Six-Month National Moratoria on Hospice and Home Health Agency Enrollment (May 20, 2026) · Centers for Medicare & Medicaid Services · retrieved October 1, 2026