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About Assisted Living in California

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While the California weather may be ideal for retirement, the cost of living is more than a 3rd higher than the national average. However, social security income is not taxed and parts of the state are less expensive. Generally, other taxes are relatively high across the state.

What Options are Available for Assisted Living?

In the state of California Residential Care Facilities for the Elderly (RCFEs) are primarily made up of residents over 60 years of age. While there may be residents between the ages of 18-59, they all require varying levels of supervision.

Before admittance the RCFE will go over an admission statement with the potential resident, outlining basic and optional services, rates, payment provisions, and refund conditions, as well as comprehensive descriptions of items and services provided under a single fee, and descriptions of third-party services. Written notice must be provided to the resident 60 days prior to any basic rate changes. However, if a rate change is required due to a change in the resident’s level of care, written notice must be given within 2 days of providing the new services.

While all RCFEs must have smoke detectors only those licensed for seven or more residents must have sprinklers. There should be a written emergency disaster plan posted prominently in the facility and be available to emergency responders, containing evacuation details, including elements for sheltering, temporary relocation sites, and staff assignments.

What are the Alzheimer’s Requirements for RCFEs in California?

RCFEs may admit potential residents with Alzheimer’s or dementia as long as they can meet requirements, including adequate supervision, enhanced physical plant safety, and appropriate activity plan, as well as alert devices and locking doors and the additional special fire clearances that go along with them.

Senior Assisted Living Details and Costs for Cities in California

The listings below are some of the larger cities in California. Each city link provides details on senior and assisted living options, independent living, senior apartments and homes, and Alzheimer's care. Details include amenities, services offered as well as other useful information.

What Training is Required for ALF Staff?

All staff must have on-the-job training or experience in the area to which they are assigned. All training must be documented and kept on file by the facility. Staff assisting residents with ADLs must receive 10 hours training within the first 4 weeks of employment and at least 4 hours on-going training each year. Direct care staff will receive first aid training by a qualified agency, and all staff will receive training in recognizing and reporting elder abuse.

In facilities licensed to provide care for 16 or more residents direct care staff must complete 16 hours of initial training, including 8 hours hands-on shadow training. Once training is complete, they must pass an exam and complete additional training each year. All documentation must be retained on file and ready to review twice a year by a consultant pharmacist or nurse.

All staff that care for dementia residents must receive special training. Direct care staff must complete 6 hours of dementia care orientation within the first 4 weeks of employment and at least 8 hours of in-service dementia training each year.

Is an Assessment Required Before Move-In?

Potential residents are assessed before being admitted to a RCFE, consisting of a comprehensive physicians report, functional capacity, mental condition, and social factors. No standardized form is used, but appraisal must be updated once a year or upon a significant change in the resident’s condition.

What Care is Available in a RCFE?

  • Supervision of residents.
  • Assistance with activities of daily living (ADLs).
  • Observation and reassessment.
  • Self-releasing postural supports.

Outside agencies may provide licensed medical services to residents in an RCFE. Private paid personal assistance may only provide services outside the scope of a RCFEs care, or beyond what the RCFE offers.

How is Medication Managed?

Facility staff may assist residents with self-administration of medicine, but unless the staff-member is a licensed medical professional he or she cannot administer medication.

What are the Bathroom Requirements for a RCFE?

There must be at least 1 toilet and sink for every 6 residents, family, and facility-dwelling staff, as well as 1 bathtub or shower for every 10.

What are the Move-In or Move-Out Requirements?

Residential Care Facilities for the Elderly can only admit residents whose needs can be met by the facility, and they may not admit or retain residents who:

  • Have active communicable tuberculosis.
  • Require 24-hour skilled nursing or intermediate care.
  • Have an on-going mental disorder that is disruptive to other residents.
  • Require more care and supervision that other residents.
  • Cannot benefit from the facility program services.

The facility may issue a 30-day notice to a resident for non-payment, failure to comply with state and local laws, failure to company with facility policy, the occurrence of unidentified needs that cannot be met, or if there’s a change in the use of the facility. A 3-day eviction notice can be given if sufficient evidence is shown that a resident is a threat to himself or others.

Is a RCFE Facility Covered by Medicaid in the State of California?

California’s Assisted Living Waiver (ALW) is available in Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino, and Riverside counties.

Who can I contact for more information?

Department of Social Services, Community Care Licensing Division
Community Care Licensing Division
(916) 651-3456