Licensure needs to apply to the actual individual caregiver just like auto mechanics are individually licensed, not just the agencies. Standards need to be formaulated and testing should be required to measure their skills and then certify them. All good agencies already conduct background checks (prior to hiring the caregiver), insure and bond their caregivers without being mandated to. The issue is the actual caregiver needs to have something to lose (such as certification) should they not perform their duties ethically and professionally.