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Residential care homes (board and care, RCFEs)

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A residential care home, often called a board and care home, is a small private facility, usually with 20 or fewer residents, where residents receive personal care and meals and staff are available around the clock, but nursing and medical care usually are not provided.[1] In California these homes, together with larger assisted living communities, are licensed as Residential Care Facilities for the Elderly (RCFEs).[2]

Definition

NIA describes board and care homes, also called residential care facilities or group homes, as small private facilities in which rooms may be private or shared.[1] The California Department of Social Services defines an RCFE as a housing arrangement for persons 60 years of age and over where 24-hour non-medical care and supervision is provided, and notes that RCFEs are often referred to as assisted living facilities or board and care homes.[2] State law allows people under 60 with compatible needs to be admitted in some circumstances.[4]

What care is provided

California law defines the care in an RCFE in terms of “care and supervision” (ongoing assistance with activities of daily living, including help with medications, money management or personal care), “personal care” (help with dressing, feeding, toileting, bathing, grooming and mobility) and “protective supervision” for confused residents, including people with dementia.[4]

Licensing and inspections

See California RCFE licensing for a step-by-step guide.

Paying for a residential care home

In most cases residents pay the costs themselves. Medicare does not cover them; Medicaid may provide partial coverage depending on the state and eligibility; and some long-term care insurance plans cover this type of facility.[1] In California, Medi-Cal’s Assisted Living Waiver pays for care in participating RCFEs in 15 counties, including San Diego, while participants pay room and board.[7] CareScout reports that the 2025 California median for residential care facilities (its assisted living category) was $7,000 per month.[8]

Frequently asked questions

Is a board and care home the same as assisted living?

In California both are licensed as Residential Care Facilities for the Elderly; board and care usually refers to smaller homes, typically 20 or fewer residents.[2][1]

Do board and care homes provide nursing care?

Usually not. Residents receive personal care, meals and round-the-clock staff, but nursing and medical care usually are not provided at the home.[1]

How often are California RCFEs inspected?

Since January 1, 2019, the California Department of Social Services must inspect every RCFE at least once a year, unannounced.[3]

References

Web pages accessed September 28, 2026 unless noted. See sources and methodology.

  1. ^ "Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care". National Institute on Aging (NIH).
  2. ^ "Resources for Residents and Families (Senior Care Licensing)". California Department of Social Services.
  3. ^ "California Health and Safety Code §1569.33 (inspections of RCFEs)". California Legislative Information.
  4. ^ "California Health and Safety Code §1569.2 (definitions, residential care facilities for the elderly)". California Legislative Information.
  5. ^ "Senior Care Licensing Program". California Department of Social Services.
  6. ^ "Care Facility Search". California Department of Social Services, Community Care Licensing Division. Search tool.
  7. ^ "Assisted Living Waiver". California Department of Health Care Services.
  8. ^ "Cost of Care Survey 2025: Median Cost Data Tables (PDF, dated 03/02/26)". CareScout. 2025 data.
Categories: Types of senior living