Since its creation in 1973, California’s Occupational Safety and Health Act has excluded an entire class of workers—those employed in private households as nannies, housecleaners, home health aides, and home attendants. This report documents the human cost of their exclusion at a time when COVID-19 and ecological disaster compound typical workplace hazards. Based on a recent survey of over 700 domestic workers across the Los Angeles and San Francisco metropolitan areas, the report offers a large-scale snapshot of safety and health challenges faced by this workforce. Findings demonstrate that job-related injuries, illness, and violence are common; that employers rarely provide safety training or personal protective equipment; and that economic necessity drives workers to endure these conditions. To mitigate adverse safety and health outcomes, and to end nearly fifty years of legal exclusion, California should extend safety and health protections to domestic workers, most immediately by enacting and enforcing SB 1257.