Washington · In-home services agency license, home care · Free checklist
Washington home care license checklist
Every step to a Washington home care license, from DOH’s orientation class and your two key people to the paper application, the policy manual DOH reviews, the initial survey, your first hires and renewal, each with the rule or DOH source it comes from. Answer a few questions to tailor it, tick steps off as you go and email it to yourself.
- Rule-verified October 2, 2026
- 47 steps, each cited
- Free, no account
Quick answer
If you employ or contract with two or more people to provide home care in Washington, you need an in-home services agency license in the home care category from the Department of Health (DOH) (WAC 246-335-315). You take DOH’s orientation class first (WAC 246-335-320(1)), then mail a paper application with $5,000, DOH’s initial fee for a 12-month license, not a CareRulebook price (WAC 246-335-990(1)).
DOH says the policies the rules require make up "a P&P manual that DOH must review and approve before your license can be issued", but you do not mail it with the application: its survey office asks for it later (DOH 505-109). An announced initial survey follows, and you have nine months from applying to finish every step (WAC 246-335-320(3)-(4)).
Steps that say "the rule" come from chapter 246-335 WAC or the statutes. Steps that say "DOH says" or "DOH’s form" come from DOH’s application packet (DOH 505-052, April 2026) or its web pages, and steps about caregivers’ background checks and training come from DSHS and the long-term care laws. Where we add advice of our own, the step says "our suggestion". The application, form by form →
Tailor your checklist
Seven quick questions
Your answers stay in this browser. The checklist below updates as you answer.
That needs the home health or hospice category
A home health agency provides two or more home health services, such as nursing, therapy or home health aide services. Home health and hospice are separate categories on the same DOH license, each with its own fee and survey. This checklist covers the home care category: change your first answer to see it.
RCW 70.127.010(7)An individual working directly for each client is outside the license
The statute exempts an individual providing home care through a direct agreement with the person receiving care. Once you employ or contract with two or more individuals to provide care, DOH’s rule makes you subject to licensing: change your first answer to see the steps.
RCW 70.127.040(3)Adding the home care category to an existing license
A licensee adding a category sends the application items the rule lists, has an initial survey for the new category and has nine months to finish, but needs no orientation class. DOH’s fee is $5,000 for each new category. The steps below are adjusted.
WAC 246-335-320(5); -990(2)Medicaid and WA Cares come later
DOH’s application instructions say DSHS contracts are not available to newly licensed home care agencies. DSHS’s application asks for three years as a licensed Washington home care agency, and WA Cares asks for three consecutive years. By our reading a new agency starts with private-pay clients, and the steps below still apply.
DOH 505-053 (February 2026), page 3Your checklist
Showing the steps for a new private-pay home care agency serving one county from one Washington office, without the optional services. Answer the questions above to tailor it.
Before you apply
Fill in the application and mail it
DOH’s review and the initial survey
Each caregiver you hire
Once you are licensed: your first clients
Renewal, changes 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 policy manual” from your answers
Answer a few questions about your agency and CareRulebook writes its Washington policy and procedure manual, covering every tag of DOH’s home care policy checklist (DOH 505-141) and the rest of chapter 246-335 WAC, with your details filled in and the rule quoted under each policy in the full manual. You also get a DOH review copy for when DOH’s survey office asks for your policies: every section, in your agency’s own words, with the rules cited but not quoted, and without Proposed changes, Recommended practice or the crosswalk.
- 42 policies, 154 requirements mapped
- Free preview before you pay
- Editable Word and PDF, plus the DOH review copy
- 12 months of updates: download again after a rule change
$199CareRulebook founding price for the first 50 Washington agencies, then $249. Not a DOH fee.
Frequently asked questions
What do I need to get a home care license in Washington?
An in-home services agency license in the home care category from the Washington State Department of Health (DOH). Before you apply: DOH’s orientation class, an administrator and a supervisor of direct care services with State Patrol background checks and disclosure statements, commercial general liability insurance, a Washington office, business licenses and the counties you will serve. You then mail DOH’s paper application with its $5,000 initial fee. DOH says it must review and approve your policy manual before it issues the license, and you must pass an announced initial survey.
Do I send my policy manual with the Washington application?
No. DOH’s license requirements sheet (DOH 505-109, April 2026) says not to submit the manual with the application, because its survey office asks for it later in the licensing process. DOH must review and approve it before it issues the license, so our suggestion is to have it written before you apply.
How long does a Washington home care license take?
DOH does not publish a processing time, and we did not find one in the rules. The rule gives you nine months from submitting the application to finish every step, or DOH may close the application without refunding the fee. The orientation class comes first, and DOH’s schedule lists one class a month.
Can I take Medicaid clients as a new Washington agency?
Not through a DSHS contract at first. DOH’s application instructions say contracts are not available to newly licensed home care agencies, and DSHS’s application asks for three years as a licensed Washington home care agency. WA Cares also asks for three consecutive years of licensing. By our reading a new agency starts with private-pay clients.
Do I get any of DOH’s fee back if I withdraw?
Partly. DOH refunds two-thirds of the initial fees, less $50, if no on-site survey or technical assistance has happened, and one-third, less $50, if it has. Nothing comes back after more than one on-site visit, or once nine months have passed without a license (WAC 246-335-990(9)-(10)). These are DOH’s fees and refunds, not CareRulebook’s.
Do I need professional liability insurance as well?
The rule and DOH’s application ask for commercial general liability cover: $1 million per occurrence or a $2 million combined single limit. The statute’s wording is wider, asking applicants to maintain professional liability, public liability and property damage insurance in an amount DOH sets (RCW 70.127.080(1)(d)). DOH’s rule does not mention professional liability, so ask your insurer and DOH.
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 or DOH source it links to.
Get Washington rule-change alerts
DOH is considering changes to chapter 246-335 WAC (fines and background checks), and DSHS training rules changed in 2026. Leave your email and we will tell you when a Washington change affects your checklist or your policies.
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Keep reading
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The full guide behind this checklist.
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DOH’s paper packet form by form, the manual DOH reviews, the initial survey, renewal and changes.
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Every topic on DOH’s home care policy checklist, preview free.
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Washington license cost and timeline
DOH’s fees, what is free, and the nine-month limit.
Indiana
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The same tool for an IDPH home services agency license.
North Carolina
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The same tool for a DHSR home care license, also reviewed before licensing.
Georgia
Georgia license checklist
The same tool for a Georgia private home care license.
Virginia
Virginia license checklist
The same tool for a Virginia home care organization license.
Texas
Texas license checklist
The same tool for a Texas HCSSA license.
Sources
- Chapter 70.127 RCW, In-home services agencies · Washington State Legislature (app.leg.wa.gov) · retrieved October 1, 2026
- Chapter 246-335 WAC, In-home services agencies (Parts 1, 2 and 13; home health and hospice parts for comparison) · Washington State Legislature (app.leg.wa.gov) · retrieved October 1, 2026
- Chapter 74.39A RCW, Long-term care services options (sections .009, .056, .074, .076, .086, .341) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- Chapter 246-980 WAC, Home care aide rules (as amended by WSR 26-12-065, effective July 3, 2026) · Washington State Legislature (app.leg.wa.gov) · retrieved October 2, 2026
- In-Home Services License Application Packet, DOH 505-052 (April 2026), with 505-053 instructions (February 2026), 505-109 license requirements (April 2026), 505-051 application, 505-055 disclosure statement and 505-137 FTE worksheet · Washington State Department of Health · retrieved October 1, 2026
- Home Care Agencies: License Requirements · Washington State Department of Health · retrieved October 1, 2026
- In-Home Services Orientation Class (information, registration and 2026 schedule) · Washington State Department of Health · retrieved October 1, 2026
- In-Home Services Survey Program (home care agencies) · Washington State Department of Health, Office of Investigation and Inspection · retrieved October 2, 2026
- Home Care Policy and Procedure Checklist, DOH 505-141 (May 2018) · Washington State Department of Health · retrieved October 2, 2026
- Home Care Agencies: Updated Rules (guidance on the 2018 rules: background checks, character, competence and suitability, TB risk assessment) · Washington State Department of Health · retrieved October 2, 2026
- Background Checks: Private Home Care Agencies (HCA) · Washington State Department of Social and Health Services · retrieved October 2, 2026
- Home Care Agencies: Medicaid provider application form (posted April 2026) · Washington State Department of Social and Health Services, Home and Community Services · retrieved October 2, 2026
- WA Cares: Home care agency provider application details (updated February 3, 2026) · WA Cares Fund (Washington State) · retrieved October 2, 2026