Every board and care home and assisted living community for older adults in California is licensed by the Department of Social Services, Community Care Licensing Division, as a Residential Care Facility for the Elderly, or RCFE. The license sets how many residents a home may have. Additional clearances and waivers decide which residents it may accept and keep.
Capacity
The license states the maximum number of residents. Most board and care homes are licensed for six. If you count more residents than the license allows, that is a serious warning sign.
There are 1,648 licensed RCFEs in Los Angeles County in the state's public dataset, and 1,361 of them are licensed for six or fewer residents.
Bedridden and non-ambulatory residents
A non-ambulatory resident is someone who cannot leave the building on their own in an emergency. Under California's rules, a home that accepts or keeps a resident who is bedridden, other than during a temporary illness or recovery from surgery, must hold an appropriate fire clearance and notify the local fire authority within 48 hours. Its emergency plan must cover how those residents would be evacuated.
In the industry this is often called being cleared or waivered for non-ambulatory residents. It is why a good home may still say no to a resident who uses a wheelchair or is bedridden.
The hospice care waiver
A home must hold a hospice care waiver from the Department before it can keep a resident who is on hospice. Under the rules:
- Each resident contracts individually with a hospice agency of their choice.
- The agency must be licensed by the state and certified by Medicare.
- A written hospice care plan is agreed before services begin.
- Accepting the resident must not threaten the health and safety of other residents.
Bedridden hospice residents may stay if the home also meets the requirements for bedridden care.
Dementia care
California has additional training and safety requirements for homes that accept residents with dementia. Ask any home how its caregivers are trained, and how the home is secured for residents who wander.
How to check a license
- Go to the CDSS Care Facility Search.
- Search by the home's name, address, or facility number.
- Check the status is Licensed and the capacity matches.
- Read recent inspection reports and any citations.
Every home receives citations at some point. What matters is how serious they were, and how the home answers when you ask about them.