This is a review of quality assurance practices for in-home care programs administered by the Department of Social and Health Services, Aging and Adult Services Administration and coordinated by Washington's Area Agencies on Aging. Recommendations call for improvements in monitoring and investigation practices, and for more accountability in the Individual Provider (IP) payment system. Also, the Aging and Adult Services Administration should improve its quality assurance controls for more vulnerable clients within the IP program. (Report 99-2, 2/16/99) Download Exhibit 3 and Appendix 2 as separate files.