Which certifications are actually required?
It depends entirely on who employs you and what care you give. Working directly for a family, giving non-medical care, most states require nothing. Working for a Medicare-certified home health agency as an aide, federal rules set a 75-hour minimum training standard (42 CFR 484.80) and states commonly add to it. Giving skilled clinical care — injections, wound care, anything a nurse does — requires a nursing licence, and no short course substitutes for one.
Every state writes its own rules and they change. Your state health department or nurse aide registry is the authority. Do not take a training provider's word for what your state requires; they are selling the course.
Which certifications do families actually ask about?
In practice, three things come up again and again: CPR and first aid, dementia care training, and a criminal record check. None of them are usually required by law for private work. All three change whether a family calls you back.
CPR is the cheapest credibility you can buy. Dementia training matters because so much of home care is dementia care, and a family living with it can tell within one conversation whether you have been trained or are improvising.
What is not worth paying for?
Any certificate whose value is the certificate. If a course does not either satisfy a rule your state actually has, or teach you something a family can feel in how you work, it is a receipt.
Be especially careful with anything marketed as making you “verified” or “certified” for a directory. On The Care Royal, what families see is a plain statement of what you submitted and when — a criminal record check you obtained yourself. We do not sell a badge, and no course buys one.
What about a background check?
Get your own. Most states sell an official criminal record check direct to the individual for roughly $10 to $25, you keep the report, and you decide who sees it. That is cheaper than anything sold to you as a screening package and it belongs to you rather than to an employer.
On The Care Royal you submit that check once a year and we review it before your listing goes live. We review the document you obtained — we never order one about you, and we never sell one.