I welcome you to call me to discuss all of your questions. I will be more than happy to answer any/all questions you have.  Just to let you know, all home care services are supervised by a Registered Nurse. Each and every client has R.N. oversight. I conduct a lot of research in this industry, and I do not see any evidence that this model of care is any less safe than a DOH licensed care home. A state license by no means secures a person's quality-of-care. If you have any evidence (actual research) to prove otherwise, I would love to see it. Hawaii tends to be a less progressive state when it come to elder care in the community. In fact, Washington (state) advertises both "licensed" and "unlicensed" homes on their DOH website, and in the state of Texas, a person can care for 3 elderly clients in their home without a license. We are behind the trends (as usual). Maile