A “Board and Care Home” in California is the common term for a specific type of licensed non-medical residential setting that provides care and supervision. These facilities offer a supportive living environment for individuals who require assistance with daily tasks but do not need the continuous, skilled medical care found in a nursing home. California state law regulates these facilities differently than medical institutions, focusing on custodial and personal support rather than complex clinical intervention.
The Definition of Residential Care in California
The official legal designation for what the public typically calls a “Board and Care Home” is a Residential Care Facility for the Elderly (RCFE), or an Adult Residential Facility (ARF) for those under 60 years old. These facilities are defined by the state as providing a housing arrangement with varying levels of care, supervision, and personal assistance. The defining characteristic of an RCFE or ARF is the provision of non-medical, custodial care, which separates them from skilled nursing facilities.
Most Board and Care homes are smaller, home-like environments often located in residential neighborhoods. Many house four to six residents, though licensed capacity can vary widely, sometimes up to 15 or more, depending on the facility’s size. The smaller scale generally allows for a higher staff-to-resident ratio and more individualized attention compared to large-scale assisted living communities.
Essential Services Provided to Residents
The primary function of a Board and Care home is to provide twenty-four-hour personal care and supervision to aid residents with Activities of Daily Living (ADLs). These services include hands-on assistance with basic self-care tasks such as bathing, dressing, grooming, and toileting. Staff also provide support for mobility, including ambulation and transferring between a bed and a chair or wheelchair.
Beyond personal care, facilities must provide residents with three nutritious meals daily, along with healthy snacks, and accommodate special dietary needs. They also manage housekeeping tasks, including cleaning a resident’s room, and provide laundry services. Staff can assist with the self-administration of medication by reminding residents to take prescribed doses and opening containers, but they are not permitted to perform medical administration like injections.
Facilities must provide protective supervision to ensure the safety of residents, particularly those who may wander or have cognitive impairments. They must also offer social and recreational activities to promote engagement and well-being. This structured support system serves residents who need daily help but whose health conditions do not necessitate the presence of a medical professional.
California’s Licensing and Oversight Structure
The regulatory authority for all Board and Care Homes in California is the Community Care Licensing Division (CCLD), which operates under the Department of Social Services (DSS). The CCLD is responsible for issuing licenses, conducting inspections, and enforcing regulations found primarily in the California Health and Safety Code and Title 22. The agency conducts unannounced visits to facilities to ensure compliance with staffing minimums, physical plant safety, and resident care standards.
A facility’s license dictates its maximum resident capacity and the specific population it is authorized to serve, such as the elderly. The non-medical nature of the license imposes strict limitations on the care provided by staff. Staff cannot provide continuous, twenty-four-hour skilled nursing care, as that requires a separate medical license. If a resident’s medical needs exceed the scope of the non-medical license, the facility must arrange for outside medical services or relocate the resident to a more appropriate setting.
Resident Eligibility and Financial Considerations
Eligibility is centered on the individual’s need for help with ADLs without requiring continuous medical treatment or intensive behavioral health services. Residents, typically age sixty or older, must have needs that the facility is licensed and equipped to handle. A pre-admission appraisal ensures the facility can meet the resident’s specific care and supervision requirements outlined in the licensing standards.
Payment for care is predominantly handled through private pay, meaning costs are covered by the resident or their family using personal funds, long-term care insurance, or veteran benefits. The monthly cost is highly variable, influenced by the resident’s level of care required, the type of room, and the facility’s location. For low-income individuals, a limited public assistance option is available through the Supplemental Security Income (SSI) and State Supplementary Payment (SSP) program.
While SSI/SSP payments generally do not cover the full market rate of care, California law establishes a specific, lower maximum rate that licensed facilities must accept as payment in full for basic services for residents who qualify for the program. This mechanism is designed to make custodial care accessible to low-income seniors and adults, though it means that residents using this option may be limited to facilities that accept the regulated rate.