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I upgraded my license this past year and included HH and Dementia Care Specialist. I love doing HH and working with the ever increasing older folks who's family and themselves choose to stay at home. I worked in a SNF and was not happy there.
In CA. one must at least be a CNA to qualify for HH. I took the course through a private nursing school.
I also work through an Agency. They take care of all the insurance and taxes. I work as many/few hours as I choose. Currently I have five private clients and work 50-60 hrs. a week depending on their needs.
Hope this helps.