Washington requires most long-term care workers to be trained, background-checked and credentialed. Here is what those credentials mean, what they do not guarantee, and what to ask before a caregiver starts.
By Marcus Reyes, LSW · October 13, 2026
When a care home, agency or hospital discharge planner tells you a caregiver is “certified,” the word can mean several different things in Washington. Most paid caregivers in adult family homes, assisted living communities and home care agencies are long-term care workers. Unless they are exempt, they must hold a credential issued by the Washington State Department of Health (DOH), and the most common one is the home care aide certification.
A nursing assistant certified (NA-C) is a separate, more clinical credential, also issued by DOH, and is common in nursing homes and some assisted living settings. A registered nurse or licensed practical nurse is different again. Knowing which credential a person holds tells you what they are trained and legally allowed to do.
In general, a long-term care worker must complete state-approved basic training, pass a background check, and pass a certification exam to become a certified home care aide. The basic training is roughly 75 hours, and it includes orientation, safety, and hands-on skills such as transfers, bathing assistance and infection control. Certified aides then complete continuing education every year to keep the credential current.
The background check matters as much as the classroom hours. Washington runs a state and federal check through DSHS, and a record of certain offenses, including abuse, neglect or financial exploitation, can bar a person from working with vulnerable adults. Rules and hour counts are updated from time to time, so confirm current requirements with DOH or DSHS when it is a deciding factor.
Basic certification does not make someone a dementia specialist. Washington requires additional specialty training for caregivers who serve residents with dementia, mental illness or developmental disabilities, and adult family home and assisted living providers must make sure staff have the training that fits the residents they accept. Communities with a Specialized Dementia Care program or an adult family home with a dementia specialty designation typically go further.
Ask what the training covered and how recently it was refreshed. A caregiver who understands why a parent resists bathing or becomes agitated at dusk is more valuable than a certificate on the wall, and a good provider can describe how staff learn that.
Ask whether the caregiver holds an active home care aide certification or NA-C credential, and ask the provider how they confirm it. DOH offers a free online provider credential search, and you can look up the name and license number yourself in a couple of minutes. Ask about dementia training, how many residents each caregiver supports on nights and weekends, and who covers when a regular aide calls out.
Private caregivers hired directly by a family may be exempt from some requirements in specific situations, such as a relative caring for a family member, which is why verifying matters. If you are using an agency, ask whether staff are employees or contractors and what supervision the agency provides. For a facility, the DSHS inspection report will show whether staff training was cited, and that is worth reading alongside any tour.
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