Your Trusted Source for Confidential, Accurate, and Affordable Alcohol and Drug Testing from home including observed urines at your location.
Know Who's Really in the Home with Your Family — Before the Pills, the Children, the Wallet, or the Car Keys
- If you're hiring someone to spend long stretches of time in your home, a caregiver for an aging parent, a nanny for young children, or an au pair living with the family, the stakes are higher than most families realize.
- The person you choose will spend hours alone with a vulnerable family member, whether that's an older adult who can no longer keep track of their own medications or a toddler who can't yet tell you what happened during the day. They will often have access to prescription opioids, benzodiazepines, sleep aids, and stimulants kept in a medicine cabinet or pill organizer. They may handle a checkbook, a wallet, car keys, and the daily routine of someone who depends on them.
- The vast majority of caregivers, nannies, and au pairs are honest, hardworking, and exactly who they appear to be on the application. A small minority are not and the cost of finding out the hard way is measured in stolen medications, falsified logs, missed doses, financial losses, an impaired driver behind the wheel of a car with your child in the back seat, and in the worst cases, direct harm to the person you were trying to protect.
- Most families feel underequipped to screen for this. Agency-run background checks catch criminal history, but they don't catch active substance use. Au pair agencies and nanny placement services rely on self-disclosure, references, and a generic health form none of which detect what's actually in someone's system the week they move in.
- Pre-employment urine screens, when they happen at all, typically miss the substances most relevant to a home with prescription medications, young children, or both. And once a caregiver, nanny, or au pair is hired, almost no one runs a periodic check even though substance use problems often develop, or resurface, on the job. The Family Wellness Box (FWB) was built to close that gap, for individual families and the small agencies that place caregivers, nannies, and au pairs in private homes.
What an In-Home Hire Has Access To
The typical American home holds more controlled substances than most families think about. In a home with an older adult: oxycodone or hydrocodone left over from a hip replacement, a benzodiazepine like Ativan or Xanax for anxiety or sleep, a stimulant for daytime alertness, muscle relaxants, sleep aids, cough syrups with codeine, a fentanyl patch for chronic pain. In a home with younger children: leftover prescriptions from a parent's surgery or anxiety treatment, ADHD medication for an older sibling, sleep aids in a nightstand, alcohol in a cabinet a nanny or au pair walks past every day. None of these are kept in a vault — they sit in a kitchen cabinet, a bedside drawer, or a weekly pill organizer that the person you hired is often the one handling.
An in-home hire with an active substance use problem has steady, low-visibility access to all of it. Pills can be diverted one or two at a time. A patch can be cut. A bottle can be partially refilled with a look-alike. Reports from the person being cared for are easy to dismiss — an older adult with dementia who can't remember whether they had their afternoon dose, a four-year-old who can't yet describe what their nanny did during the day. The added concern with childcare is impairment on the job: a nanny driving children to school after using, an au pair watching toddlers near a pool or stove while sedated. By the time a parent or adult child notices a prescription running short three days early or a behavior change in a young child, the pattern has often been going on for months. FWB gives you a way to address this before it starts, and to check in periodically while the arrangement is ongoing.
What The Family Wellness Box Gives You
A 74-substance panel — far beyond a pharmacy cup test or what other labs test for
FWB's CLIA-certified LC/MS (Liquid Chromatography Mass Spectrometer) lab tests for 74 substances, including prescription opioids and their metabolites, benzodiazepines, ADHD stimulants, antidepressants, sleep aids, muscle relaxants, alcohol metabolites, marijuana, and the newer synthetic compounds that increasingly show up in adult populations as well as in teens. Please see the list of substances tested for at the What We Test For tab. Every result is reviewed by a PhD with decades of experience on this instrument before it reaches you.
Collected at home, on your timeline.
The box arrives with securely packaged cup(s), all collection materials, and prepaid return shipping. Twelve commonly abused drugs show immediate cup-level results within minutes — useful for a same-day decision on a new hire, an arriving au pair, or a reasonable-suspicion check. The full 74-substance lab analysis follows by encrypted email, typically within 24–48 hours.
Confidential and discreet — fully HIPAA compliant.
Nothing goes to an employer, an insurance carrier, a state licensing board, or any permanent record unless you choose to share it. The conversation, the result, and the decision stay between you, the caregiver, and if you choose the agency that placed them.
An observed collection option, when integrity of the sample matters.
For pre-employment screens, for periodic checks where you want documented chain-of-custody, or for any reasonable-suspicion situation where a caregiver might have advance notice, FWB can send a licensed Paramedic or Nurse to the home for a small additional fee. All observed collections follow strict chain-of-custody. This is the option to choose if a result may ever need to support an employment decision or be shared with an agency. An observed urine does not include the observe witnessing the sample being provided but rather to oversee the process.
Medication-aware results, not just a yes/no.
Because the panel includes prescribed medications, results can show whether a caregiver is on substances that affect alertness, reaction time, or judgment — even when those substances are legally prescribed. A muscle relaxant and a benzodiazepine taken together. A sleep aid still in the system on a morning shift. An opioid level inconsistent with what the caregiver disclosed or took from the person they are caring for and over the counter dangerous compounds such as Kratom. These are conversations worth having before a problem develops, and FWB makes them visible without requiring you to be a clinician.
Affordable enough for periodic use.
Effective screening of an in-home hire isn't a one-time test; it's a baseline at hire followed by periodic check-ins for as long as the person is in the home. FWB's pricing is built for that pattern. Multi-cup boxes can be used across multiple caregivers, nannies, or au pairs in a single household, across an extended family with both childcare and elder care arrangements or shared among small agencies placing several people in private homes. Purchases can be financed over several weeks at no interest.
This lab-confirmed home drug test gives families the information they need while keeping the process private and manageable.
When Families and Agencies Use FWB
FWB is built for two distinct moments: a planned, consent-based screen as part of hiring or ongoing employment, and a reasonable-suspicion check when something specific has changed. Both are valid uses; the conversation with the caregiver is different for each.
Before a caregiver, nanny, or au pair starts in the home, you ask them in writing, as part of the hiring paperwork or the placement contract to complete an FWB screen. Many families do this without an observer; small agencies and au pair sponsors that want documentation typically add the in-home Paramedic or Nurse collection. A clean baseline at hire establishes the standard for the relationship and signals that the family takes the integrity of the home seriously.
Periodic, ongoing checks during employment.
The screen most families skip — and the one that often catches the most. Substance use problems can develop on the job, or resurface in someone who has been in recovery. Periodic random screens, agreed to in writing at hire and conducted on no predictable schedule, are the single most effective deterrent to medication diversion and on-the-job impairment in the home. Families with elder care often pair this with a quarterly visit from a supervising adult child; families with a nanny or au pair commonly run it at the start of a new school year, after an extended trip home, or at the renewal of a placement year.
Consent Forms
You may download both consent forms for testing and releasing the results of those tested in your home on the Forms & Tools tab on this website.
When something has changed.
A caregiver who suddenly seems drowsy in the afternoon. A nanny smelling of alcohol at pickup or napping while a toddler is awake. A pill count consistently a day or two short. Money or small items missing from the home. A care recipient reporting pain that wasn't there before or asking for extra doses of a controlled medication. A child returning from a day with the au pair with a story that doesn't add up. None of these is proof of anything on its own but together, or escalating, they warrant a reasonable-suspicion screen. FWB's instant cup gives you a same-day read on twelve commonly abused drugs; the full lab panel follows within 24–48 hours.
When a small agency wants to differentiate.
Agencies that place caregivers, nannies, or au pairs in private homes — including au pair sponsor organizations can use FWB as a marketing and risk-management tool. Running a screen at placement, and periodically thereafter, is something families ask about and most agencies cannot currently offer. FWB pricing scales for this use, and chain-of-custody collections are available for any screen that may support an employment or placement decision.
How It Works
Order on this website.
Place your order right here. Standard delivery is typically within 24 hours at no charge; guaranteed overnight is available for a small fee. If you'd like an in-home observed collection you can add it at the time of order.
Collect the sample at home.
The box arrives with securely packaged cup(s), all collection materials, and prepaid return shipping. There is no clinic to drive to, no waiting room, and nothing to log into a portal. For caregivers, this matters: a screen run in the home where they already work, on a day they're already there, is far less disruptive than a trip to a lab and far easier to schedule on short notice.
See immediate results, then full lab results.
Twelve commonly abused drugs are visible on the cup within minutes — including opioids, benzodiazepines, amphetamines, cocaine, methamphetamine, marijuana, and methadone. A small portion of the sample is collected from the cup, packed in the prepaid envelope, and dropped at any UPS location. The full 74-substance lab analysis returns by encrypted email, typically within 24–48 hours, with PhD review.
If you choose an observed collection.
A licensed Paramedic or Nurse comes to the home, oversees the collection, takes immediate custody of the sample, and delivers it to UPS. The caregiver is instructed not to open the cup before providing the sample, and chain-of-custody is maintained throughout. This is the option to use whenever a result may need to support an employment decision, be shared with a placing agency, or stand up to later challenge.
If a result is disputed.
If the caregiver claims a discrepancy, a re-test is conducted within 24 hours and must include an observer, regardless of how the original sample was collected. If the discrepancy is confirmed, the retest is free and the original test is refunded.
What It Costs
All boxes include collection materials and shipping.
Four-Cup Box
$52 each
Three-Cup Box
$60 each
Two-Cup Box
$72 each
One-Cup Box
$80 each
Addiction treatment program Cup BOX
$62 each
Optional in-home observed collection by a licensed Paramedic or Nurse
$70
Multi-cup boxes can be used across multiple caregivers in a single home, across an extended family caring for more than one older adult, or shared among small agencies coordinating screens at placement and periodically thereafter. Purchases can be financed for up to several months at no interest.
FWB also offers reduced costs or free testing under certain circumstances — including for families caring for a parent on a fixed income. If cost is a barrier, please ask.
A Family's Guide: Talking with a Caregiver About Drug Testing
Disclaimer: The information in this guide is provided for general educational and informational purposes only and is not a substitute for professional medical, legal, or human-resources advice. Family Wellness Box is not a healthcare provider, an employment law firm, or a placement agency, and reading this guide does not create a clinician-patient, attorney-client, or employer-employee relationship. Drug-testing requirements for in-home caregivers, nannies, and au pairs vary by state, by the structure of the employment relationship (direct hire vs. agency placement vs. household employee vs. sponsored au pair), and by the substances tested. Before implementing a screening program — especially one that may affect employment decisions — consult an employment attorney or HR professional licensed in your state. If you suspect that an in-home hire is actively diverting medication or that a vulnerable adult or child is in immediate danger, contact your local Adult or Child Protective Services agency or call 911.
Asking a caregiver, nanny, or au pair to take a drug test is uncomfortable. It can feel like an accusation even when it isn't, and an in-home hire who has been honest and dependable can reasonably feel insulted. Done well, the conversation is a normal part of professional hiring — no different from a background check — and frames the screen as something the family does for every person they bring into the home, not something targeted at this one. The guide below walks through how to prepare, what to say, and how to handle the reaction, both for a pre-employment screen and for a reasonable-suspicion check.
Decide What Kind of Conversation This Is
Before you say anything to the caregiver, get clear in your own mind about which conversation you're having. A pre-employment screen is a hiring step — neutral, applied to every candidate, framed in writing as part of the offer. A periodic screen during employment is the enforcement of a policy the caregiver already agreed to at hire — it should not come as a surprise. A reasonable-suspicion screen is a response to specific, observable changes — and is the only one of the three where the caregiver may reasonably hear it as an accusation. Each requires a different tone and a different script. Mixing them up is the most common mistake families make.
If you're working through an agency or au pair sponsor, call them before you raise the topic with the person directly. A good agency or sponsor will handle the conversation for you, or at minimum coordinate it so the person doesn't feel ambushed. If you're a direct hire, you are the employer — and a brief, written screening policy you can hand the caregiver, nanny, or au pair is much easier than improvising the conversation.
Lead with the Policy, Not the Person
For pre-employment and periodic screens, the framing that works best is institutional, not personal: "As part of how we hire anyone who works in this home, we ask everyone to complete a drug screen. It's not about you specifically — it's the same step we'd take with anyone caring for my mother" — or "anyone caring for our kids," "anyone living with us as part of the family." An in-home hire who hears "this is what we do" is far less likely to take it as an insult than one who hears "we want to test you."
For a reasonable-suspicion screen, be honest about what's driving the request, without escalating. For elder care: "We've noticed a few things over the last couple of weeks — the afternoon pill count has been short twice, and my mother has mentioned feeling foggier — and we want to rule out anything related to a medication interaction or anything else before we go further." For childcare: "We've had a couple of pickups recently where something felt off, and our daughter mentioned something we want to be sure we understand. We'd like to take this off the table before we go any further." Frame it as a request for information, not a verdict. An in-home hire who is innocent will almost always agree; one who refuses is giving you important information either way.
Put It in Writing — Always
Whether you're a direct-hire family or a small agency, the screening policy should be written, signed, and dated at the start of the employment relationship. A one-page document is enough: which substances are tested, how often, who pays, who sees the results, what happens with a positive result, and what happens after a sustained period of clean results. A caregiver who has signed this at hire cannot later claim they were singled out, and you have a clear record if an employment decision is ever challenged.
For a reasonable-suspicion screen of a caregiver who never signed a baseline policy, ask for written consent at the time of the screen. FWB can provide a simple consent template on request. A caregiver who is willing to take the screen will sign; a caregiver who refuses has given you a decision to make, and you have made it without testing them against their will.
Explain Exactly How the Screen Will Work
Predictability lowers the temperature of the conversation. Walk the caregiver through the mechanics in detail:
- Where and when: in the home where they already work, on a day they're already scheduled, at the start or end of their shift.
- Who is present: just you, or — for an observed collection — a licensed Paramedic or Nurse sent by FWB.
- What is tested: a 74-substance lab panel including prescription medications, with twelve commonly abused drugs read immediately on the cup.
- Disclosure of prescriptions: ask the caregiver to disclose any prescribed medications in writing before the screen so legitimate prescriptions are not mistaken for diversion.
- Who sees the results: in a direct-hire family, just the family member running the screen; in an agency placement, the agency contact and the family.
- What happens with a positive result: a confirmation test before any decision, then a conversation — not an immediate termination.
- Privacy: nothing is reported to a state licensing board, an insurance carrier, or any permanent record unless the family chooses to share it.
Distinguish a Positive from a Problem
A positive result on a screen is not the same as evidence of impairment on the job. A caregiver legitimately prescribed a benzodiazepine for anxiety, or an opioid for chronic back pain, will register positive — and that is not, on its own, a reason not to employ them. The question is whether the prescription was disclosed, whether the level is consistent with prescribed dosing, and whether the medication affects the caregiver's ability to do the job safely. FWB results include the underlying levels and metabolites, and the PhD review can help you tell the difference between "prescribed and taking as directed" and "taking far more than prescribed."
What is a problem: undisclosed use of controlled substances, levels inconsistent with prescribed dosing, the presence of substances no one is prescribed (especially fentanyl, methamphetamine, or cocaine), or any substance that impairs alertness during work hours. These warrant a real conversation, and depending on what you find, an end to the employment relationship.
Expect Pushback — and Read It Carefully
Common reactions from caregivers asked to take a screen include surprise, mild offense, a request to think about it, and — most commonly — quick agreement and a clean result. Stay professional. Acknowledge that the request is uncomfortable and explain that it is policy, not personal. Avoid debating the policy in the moment; if the caregiver wants to discuss it after the screen, that conversation is welcome.
A flat refusal to take a screen that the person agreed to in writing at hire is, in itself, grounds to end the relationship — you do not need a positive result to act. A refusal in a reasonable-suspicion situation is harder, because the person may not have signed a baseline policy; in that case, you have a decision to make about whether you continue to leave them alone with your parent, your children, or living in your home. Most families, faced with that question honestly, already know the answer.
Make Clear What a Clean Result Means — for Both of You
A clean screen is not just a hiring milestone. It is information that helps the family relax and helps the caregiver work without the cloud of suspicion that arises in any home where someone notices missing pills. Tell the caregiver that — explicitly. A negative result on a periodic screen means the family is not going to second-guess them when the pill count is off by one on a Sunday morning; it means the relationship has the foundation to last. Many of the best long-term caregiver relationships started with a screen that the caregiver was initially uncomfortable about and that, in hindsight, both sides were glad happened.
End the conversation with a concrete next step: when the screen will happen, who will be there, when the result is expected, and how the family will share it with the caregiver. Then follow through. Consistency is what makes a screening program credible — both as a deterrent and as a sign of respect for the caregiver who passes it.