Assisted living in California

In California, a residential care facility for the elderly (RCFE) is housing for people 60 and older where 24-hour non-medical care and supervision is provided. RCFEs are often called assisted living facilities or board and care homes.cdss.ca.gov

The Senior Care Licensing Program of the California Department of Social Services licenses and monitors RCFEs and continuing care retirement communities.cdss.ca.gov

RCFEs are community care facilities licensed by the California Department of Social Services. Facilities that give medical care, such as skilled nursing facilities, are licensed by the California Department of Public Health.cdss.ca.gov

RCFEs provide housing, housekeeping, supervision, 24-hour staffing and help with daily activities such as hygiene, dressing, eating and walking to people 60 and older, according to a 2025 Assembly committee analysis.ahum.assembly.ca.gov

Since January 1, 2019, Community Care Licensing has been required to make an unannounced inspection of every RCFE each year, in addition to complaint investigations, according to a 2019 Assembly committee analysis.ahum.assembly.ca.gov

In 2020 the Legislative Analyst's Office listed the mandated inspection frequency for adult and senior care facilities as once a year.lao.ca.gov

When a complaint is filed, the local licensing office makes an unannounced visit to the facility to investigate within 10 days of receiving it.cdss.ca.gov

A facility's file holds reports of the licensing agency's evaluation visits and any complaints the Department substantiated, and its licensing reports can be read on the state's Facility Search website.cdss.ca.gov

A Type A deficiency is a violation of the regulations or the Health and Safety Code that, if not corrected, poses a direct and immediate risk to the health, safety or personal rights of people in care.cdss.ca.gov

A Type B deficiency is a violation that, without correction, could become a risk to the health, safety or personal rights of people in care, or a recordkeeping violation that would affect their care or the protection of their resources.cdss.ca.gov

The licensee must be told in writing of every licensing deficiency, and each one can cite the section of law or Title 22 regulation it is based on.cdss.ca.gov

Community Care Licensing decides complaints on a preponderance of the evidence standard: the evidence must show it is more likely than not (more than 50%) that the allegation is true.cdss.ca.gov

A complaint allegation is substantiated when the preponderance of the evidence standard is met.cdss.ca.gov

An allegation is unsubstantiated when the investigation shows there is not enough evidence to prove a violation occurred.cdss.ca.gov

An allegation is unfounded when the evidence shows it could not have happened, is false, or has no reasonable basis.cdss.ca.gov

An RCFE must give residents or their representatives at least 90 days' written notice of a rate increase, with the amount and the reasons, including a description of the added costs. Increases due to a change in the resident's level of care are an exception.ahum.assembly.ca.gov

When the rate goes up because a resident's level of care changes, the RCFE must give written notice within two business days after it starts providing the new level of care.ahum.assembly.ca.gov

The admission agreement must describe what the basic fee covers, what it does not, billing and payment policies, and the conditions under which rates may be increased.ahum.assembly.ca.gov

An RCFE may not charge a preadmission fee or deposit, such as an application, admission or community fee, to a person on SSP (state supplementary payment) who applies for admission.ahum.assembly.ca.gov

California's updated dementia care rules for RCFEs took effect January 1, 2025. They aim to support person-centered care and let residents age in place in the least restrictive setting they know as home.cdss.ca.gov

The dementia care standards, once kept in one regulation section, are now spread across several sections so they support care for all residents.cdss.ca.gov

The rules now address resident behaviors whatever the diagnosis, focusing on individual needs, and whether a resident may have items such as cleaning solutions or sharp objects depends on their own needs and appraisal.cdss.ca.gov

California's long-term care ombudsman programs advocate for residents of skilled nursing facilities and of 8,105 residential care facilities for the elderly.aging.ca.gov

California long-term care facilities must post the local ombudsman's number and the statewide hotline, 1-800-231-4024, which takes calls 24 hours a day, 7 days a week. Ombudsman services are free and complaints are confidential.aging.ca.gov