California RCFE license: six-bed homes, large facilities, CDSS steps and fees

One license, from a six-bed house to a large campus

California does not license “assisted living” as such. The license is called a Residential Care Facility for the Elderly (RCFE). Title 22 defines an RCFE as a housing arrangement chosen voluntarily by the resident or a representative, for people 60 and older, where varying levels of care and supervision are provided as agreed at admission or found necessary at reappraisal.⁠²⁶ “Care and supervision” means the facility takes responsibility for, or promises to provide in the future, ongoing help with activities of daily living, including help with taking medications, money management or personal care.⁠²⁶ If you promise that help, even in the future, you are an RCFE. Nobody may run one without a current license or special permit.⁠² CDSS’s own description is plainer: 24-hour non-medical care for people 60 and over, “often referred to as assisted living facilities, or board and care homes.”⁠⁵

There is no minimum or maximum size and no separate small-home license. The six-bed board and care home on a residential street holds the same RCFE license as a large building. The differences come from capacity thresholds in the regulations and from a set of zoning protections that apply only at six or fewer residents (covered below). CDSS’s fee table runs from 1 to 3 residents up to 701 or more.⁠²³

Within CDSS’s Community Care Licensing Division, the Senior Care Licensing Program licenses and monitors RCFEs and continuing care retirement communities through 14 regional offices.⁠⁴

People under 60 can live in an RCFE if their needs are compatible with the other residents’ and they need the same amount of care and supervision.⁠¹⁠²⁶

Arrangements that do not need a license

Section 1569.145 exempts a short list of arrangements, including these:⁠³

• Housing without care. A house, hotel or congregate housing project that offers only housing, meals, transportation, housekeeping or social activities is exempt, as long as no resident needs care and supervision or protective supervision.
• Family care. Care given by a family member. The statute’s list of relatives runs from spouses and stepchildren to first cousins and in-laws.
• A friend caring for one family. The friendship must predate the care, the care happens in a home the recipient chooses, and the arrangement is “not of a business nature.”
• Federally assisted senior housing (HUD Section 202, 811, 236 or 221(d)(3), low-income housing tax credit and Section 8 properties), where supportive services are optional and the owner neither provides nor contracts for them.

Running an unlicensed RCFE draws a civil penalty under section 87768 of $100 per resident per day. It becomes $200 per resident per day from the 16th day after a Notice of Operation in Violation of Law if you have not filed a complete application, and if you keep operating after a denial.⁠²⁶

Neighboring licenses

Before you choose a building, make sure an RCFE is the license you need:

• Adult Residential Facility (ARF). 24-hour non-medical care for adults 18 to 59 with mental, physical or developmental disabilities. ARFs can also serve people 60 or older under specified conditions.⁠⁵ ARF administrators take a separate 35-hour certification program.⁠⁷
• RCFE-Continuing Care Retirement Community. A separate facility type for providers that sell long-term continuing care contracts covering housing, residential services and nursing care.⁠⁵
• Medical Foster Home for Veterans. A CDSS type run in collaboration with the U.S. Department of Veterans Affairs, for up to three veterans aged 18 or older.⁠⁵
• Day services only. Daytime care without overnight stays is an adult day program license. Non-medical care in clients’ own homes needs a home care organization license.

What state law does for the six-bed home

The RCFE Act gives homes serving six or fewer residents protections that larger facilities do not get.

• Zoning. A six-or-fewer RCFE “shall be considered a residential use of property,” and its residents and operators count as a family under any zoning law. A city or county may not call it a boarding house, rest home or similar business use. It may not require a conditional use permit, variance or other zoning clearance that a family dwelling of the same type in the same zone would not need.⁠²⁰ “Family dwelling” includes apartments, duplex units, condominiums, townhouses and mobilehomes, as well as single-family houses.⁠²⁰
• What still applies. Local rules on height, setbacks, lot dimensions and signs still apply, but only if they are identical to the rules for other family dwellings in that zone. The same goes for local health, safety and building standards.⁠²⁰
• Who counts toward six. The count is residents only. “Six or fewer persons” does not include the licensee, the licensee’s family or facility staff.⁠²²
• No local business taxes. A six-or-fewer home is exempt from business taxes, local registration fees and use permit fees that other family dwellings do not pay. No one may charge it a fee for enforcing fire inspection rules.⁠²¹ The fee statute adds that no local jurisdiction may impose a business license, fee or tax for the privilege of operating one.⁠²³
• Building occupancy and covenants. Using a family dwelling as a six-or-fewer RCFE “shall not constitute a change of occupancy” under state housing law or local building codes, although Health and Safety Code sections 13143 and 13143.6 (fire and life safety) still apply.⁠²⁰ For property contracts, deeds and covenants signed on or after January 1, 1979, it counts as residential, single-family use, “notwithstanding any disclaimers to the contrary.”⁠³⁶
• Fire officials. A local fire official may not impose requirements on a home caring for six or fewer that are stricter than the State Fire Marshal’s rules for that facility type or the local rules for any other single-family dwelling, whichever is stricter.⁠²⁶ A fire clearance or permit cannot be denied because the home does not meet a local ordinance it is exempt from.⁠³⁵

These protections stop at six residents. For larger facilities, CDSS’s application review includes “ensuring that a conditional use permit is obtained,” and it tells applicants to have the permit before they file.⁠⁵

CDSS’s 300-foot overconcentration rule, which keeps some residential facilities apart, does not apply to RCFEs. It covers ARFs, social rehabilitation facilities, group homes and small family homes.⁠⁸

If you will not live in the home

Section 1569.175, quoted in the regulations, applies to any RCFE serving six or fewer where the owner does not live. It must have a CDSS-approved procedure for responding at once to incidents and complaints. It must also set a fixed weekly time when the owner, licensee or a designee will be there to meet residents and neighbors.⁠²⁶ This “neighborhood complaint policy” goes in the application packet.⁠⁷

Where the regulations treat small facilities differently

Sources: ⁠¹⁹⁠²⁶

Two more small-home rules: if you have well water, a home licensed for six or fewer needs a bacteriological analysis only at initial licensing and afterwards when there is evidence of need.⁠²⁶ And at one to six beds, CDSS does not verify the applicant’s experience.⁠⁷

Certification comes before the application

California requires the license applicant, not only the administrator, to be certified. As a condition of licensure, you must complete an approved certification program of 80 hours of coursework, at least 60 of them attended in person. You must also pass a state exam of at least 100 questions.⁠¹² If the applicant is a company, the chief executive officer, someone in a like role, or the designated administrator meets this requirement. There are two exceptions. One is a current license for another RCFE first licensed before July 1, 1989. The other is completion of an approved program within the past five years.⁠¹²

The administrator certification process under section 1569.616 works like this:

• The 80 hours must include at least 60 hours of interactive instruction. They cover 13 subject areas, including medication management, dementia care, residents’ rights, and postural supports and hospice care.⁠¹⁴
• You take the exam within 60 days of finishing the course. You may use the RCFE Act and regulations during the test.⁠¹⁴ The regulations allow three attempts.⁠²⁶
• You submit the certification application (LIC 9214) within 30 days of being told you passed. Fingerprints and a criminal record clearance are part of it.⁠¹⁴⁠²⁶
• The certificate is renewed every two years with 40 hours of continuing education. At least 8 hours must be on dementia care, and no more than half may be self-paced.⁠¹⁴

A licensed nursing home administrator can instead take 12 hours of RCFE-specific classroom instruction and skip the exam.⁠¹⁴ CDSS’s Administrator Certification Bureau lists the fees as $140 for the initial application, $140 for renewal and $100 for the exam (as published on 2026-10-12).⁠¹⁵ Since August 17, 2026, administrators apply through the new CCLD Public Portal instead of the old online application portal.⁠¹⁵

The administrator must be at least 21, hold a high school diploma or GED, and have a criminal record clearance.⁠¹³ Larger buildings add college and experience requirements (see the table above).⁠²⁶ The licensee and administrator can be the same person. If the administrator is also the facility manager, that person may manage only one facility.⁠¹⁶ The application booklet (LIC 281, revised 11/25) still says to send proof of registration in a “40-hour” RCFE program. The statute sets 80 hours, so plan on 80.⁠⁷⁠¹²

Secure the property and the money first

CDSS will not start an application without a facility address. You do not have to own the property, but a lease or rental agreement must include the owner’s acknowledgement that the property will be used as a community care facility.⁠⁸ A lease that bars that use, or bars business use for more than six people, means the license “must be denied/withdrawn.”⁠⁷ Statute requires evidence of your right to possess the facility, such as the entire lease or the deed.⁠¹⁰

The financial test is specific. Start-up funds must cover at least three months of operating costs.⁠²⁶ Only cash and cash equivalents count. A verifiable line of credit from a bank, credit union or major credit card is acceptable, and CDSS says start-up funds should not be spent on renovation or repair work.⁠⁷ Your bank sends the verification form (LIC 404) directly to CDSS, and “the licensee cannot hand carry it.”⁠⁷ CDSS also pulls your credit report.⁠⁵ The monthly operating statement (LIC 401) must show staff paid at least minimum wage and, normally, about 25 percent added for fringe benefits.⁠⁷ If construction is needed to meet licensing requirements, you must also show financing for it.⁠²⁶

Statute widens the disclosure to owners and history. You must list everyone with a beneficial ownership interest of 10 percent or more. You must also disclose every RCFE or health facility role held in the past 10 years, any disciplinary actions, and any bankruptcy involving a care facility filed within five years.⁠¹⁰ Afterwards, changes to this information are due within 30 calendar days. A material violation can bring a $1,000 civil penalty.⁠¹⁰

From orientation to license: the CDSS sequence

All RCFE applications go to the Adult and Senior Care Program’s Centralized Applications Bureau (CAB) in Sacramento, not to a regional office.⁠⁵ CDSS lays out the process in 11 steps.⁠⁶ In practice it runs like this:

1. Component I orientation

   Register for the online Senior Care orientation. It costs $50 plus a $4.85 processing fee, must be taken on a computer (not a phone or tablet), and stays available for 30 days.⁠⁹ Every applicant takes it. For an entity, the person authorized by the board resolution or articles attends.⁠⁸

2. Certification

   Finish the 80-hour program and exam (above). You can apply before the certificate arrives, but CDSS will not license the facility without it.⁠⁸

3. Build and mail the packet

   Send the forms and policies listed in LIC 281 with the non-refundable application fee. Write the proposed facility address on the check. Mail it to CAB at 744 P Street, MS 9-14-8201, Sacramento, CA 95814.⁠⁵ Do not use sheet protectors.⁠⁵

4. Completeness review

   By statute CDSS decides whether the application is complete within five working days of filing.⁠¹¹ CAB then sends an acceptance letter naming your analyst and listing missing documents.⁠⁶

5. Background checks

   The applicant, administrator, designee and any adult living in the facility (other than residents) need a criminal record clearance or exemption before licensure.⁠⁸ Since September 18, 2026, the statute also names board members of an entity applicant and anyone with a 10 percent or greater financial interest in it (see recent changes below).⁠³⁷ CDSS suggests starting the record in its Guardian system before you get fingerprinted through LiveScan.⁠⁶

6. Fire clearance

   Once the application is complete, CDSS requests a fire clearance.⁠¹¹ CAB sends the request (STD 850) to the fire authority you named on form LIC 9054, and the fire inspector calls you to schedule.⁠⁶⁠⁸

7. Component II interview

   A one-on-one interview by phone or video with you and the administrator about the packet and your understanding of the rules.⁠⁹⁠⁸

8. Pre-licensing inspection

   After the fire clearance is approved, the regional office inspects the site.⁠⁸ Bedrooms must be furnished and ready, and with no residents in care CDSS checks for a seven-day supply of non-perishable food.⁠⁸

9. Component III

   An in-person session on operations and record keeping, held after the pre-licensing inspection.⁠⁹

10. Corrections and decision

    Fix any items by the due date the analyst sets.⁠⁶ Within 60 days of finding the file complete, CDSS must either issue the license or explain the deficiencies.⁠¹¹

CDSS’s stated expectation is 90 to 120 days for the whole process. It warns that fire clearance, construction, background checks and staff workload can stretch that.⁠⁵⁠⁸ If the facility has no life safety risks, is in substantial compliance and there is an “immediate need” (closing it would endanger a resident), CDSS can issue a provisional license. It lasts up to six months, or up to 12 months when delays are beyond your control, and cannot be renewed.⁠²⁶

What goes in the packet

LIC 281 lists the RCFE forms. They are the application (LIC 200), applicant information (LIC 215), designation of facility responsibility (LIC 308), administrative organization for entities (LIC 309), the cash-resources affidavit and surety bond (LIC 400, LIC 402), the financial forms (LIC 401, 401a, 403, 403a, 404), personnel forms (LIC 500, 501, 503), the RCFE emergency disaster plan (LIC 610E), a facility sketch (LIC 999) and the fire authority form (LIC 9054).⁠⁷ Supporting documents for an RCFE include job descriptions, personnel policies, an in-service training plan, a program description, admission policies, a one-week sample menu and proof of property control. LIC 281 also asks for two items it marks RCFE only: an insurance statement and a theft and loss policy. If you carry no insurance, a statement saying so is enough.⁠⁷

RCFE-specific details in the packet rules:

• The health screening (LIC 503) for an RCFE applicant must be less than six months old. Other facility types allow one year.⁠⁷
• The emergency disaster plan must name two relocation sites that can hold all your residents.⁠⁷
• Every application must include an Infection Control Plan (LIC 9282).⁠⁵
• If you will handle residents’ money, you need a surety bond: $1,000 for up to $750 a month held, $2,000 for $751 to $1,500, $3,000 for $1,501 to $2,500, and $1,000 more for each further $1,000 or fraction.⁠²⁶
• First aid cards for the applicant and administrator, and your orientation certificate, go in with the packet.⁠⁷

The plan of operation behind these documents must include your admission agreement, staffing plan, training plan, floor plans marking rooms for nonambulatory and bedridden residents, and a description of how you will handle residents’ behavioral expression.⁠²⁶ If you plan to advertise dementia care, the plan must describe the facility’s special features.⁠¹⁰

Fire clearance, the building and who you can admit

Every RCFE must keep a fire clearance from the local fire authority or the State Fire Marshal. You must get an appropriate clearance, and tell CDSS, before accepting even one nonambulatory or bedridden resident.⁠²⁶ When a resident becomes bedridden, the fire authority must be notified within 48 hours. Keeping a bedridden resident beyond a temporary illness (14 days or less) brings added requirements.⁠²⁶ Rooms approved only for ambulatory residents may not house nonambulatory ones.⁠²⁶ CDSS says multi-level homes can be licensed if they pass the extra fire requirements, which may limit who can live upstairs.⁠⁸

Title 22 sets the physical standards:⁠²⁶

• No more than two residents per bedroom. CDSS says more is “generally” not permitted, though you can request a waiver in writing.⁠⁸ No bedroom may be a passageway, and no hall, garage or shed may be used as a bedroom.
• At least one toilet and washbasin for every six people and one bathtub or shower for every ten. The count includes family and staff.
• Rooms heated to at least 68°F and cooled to between 78°F and 85°F.
• Hot water for residents between 105°F and 120°F, grab bars at every toilet, tub and shower, and slip-resistant surfaces.
• A building permit before any construction or alteration.

The license covers non-medical care, and some residents cannot be admitted or kept. Those include anyone with active tuberculosis or who needs 24-hour skilled nursing or intermediate care.⁠²⁶ Title 22 also prohibits stage 3 and 4 pressure injuries, gastrostomy and nasogastric tubes, tracheotomies, staph or other serious infections, and total dependence on others for all activities of daily living. A licensee can ask for a written exception.⁠²⁶ A facility hospice waiver lets a terminally ill resident stay with a licensed, Medicare-certified hospice.⁠²⁹

Staffing and training once you are open

California sets no daytime staffing ratio for RCFEs. CDSS can require more staff when documentation shows residents’ needs are not being met.⁠²⁶ The fixed rules are about presence and training:

• The administrator must be on site during normal working hours. Someone at least 21 with the authority to run the facility must be on the premises 24 hours a day.⁠¹⁶
• At least one person trained in CPR and first aid must be on duty and on the premises at all times.⁠¹⁶
• Anyone who supervises or cares for residents must be at least 18. Staff need a physician health screening, including a chest x-ray or an intradermal TB test, done no more than six months before or seven days after they start.⁠²⁶
• Night coverage depends on capacity (see the table above).⁠²⁶

Direct care staff training is set by statute. Each person who helps residents with personal activities of daily living needs 40 hours of training. Twenty hours, including 6 on dementia and 4 on postural supports, restricted health conditions and hospice care, come before they work independently. The other 20, including 6 more on dementia, come within the first four weeks. After that, 20 hours a year are required, with 8 on dementia and 4 on postural supports and hospice.⁠¹⁷⁠¹⁸ Licensed nurses and certified nurse assistants follow a shorter track that starts with 8 hours of facility training.⁠¹⁷ Staff who help with medications add the size-based medication training. They must pass an exam and complete 8 hours of medication in-service every year.⁠¹⁹

Fees, as published on 2026-10-12

RCFE fees are written into Health and Safety Code section 1569.185, last amended by SB 1382, effective January 1, 2015.⁠²³ CDSS’s fee schedule, revised January 9, 2015, shows the same figures, and the application page still links it as the schedule “effective January 1, 2015.”⁠²⁵⁠⁵

Source: ⁠²³. The statute lists further bands between 151 and 700.

The annual fee is due on each anniversary of the license’s effective date.⁠²³ Paying late adds 50 percent of the annual fee. Other fees include 50 percent of the application fee to move the facility, $25 to change capacity, $50 per person for orientation, and $200 if you miss a plan-of-correction deadline.⁠²³ CDSS says fees cannot be waived and are refunded only on documented proof of a Department error or overpayment; partial payments are not accepted. Only annual fees can be paid online.⁠²⁴

After licensure: inspections, changes and selling

Since January 1, 2019, CDSS must make an unannounced inspection of every RCFE every year. Unless a plan of correction says otherwise, deficiencies must be fixed within 10 days.⁠²⁷ Inspection reports, deficiency lists and plans of correction are open to the public.⁠²⁷ Every advertisement, including online ones, must show the license number.⁠²⁶

The license belongs to one entity at one address.⁠⁸ Moving, changing the licensee, raising capacity (CDSS may grant minor increases without a new application) or a corporate organizational change (such as a sale of most of the stock) requires a new application, and a corporate change must be reported to CDSS within 48 hours.⁠²⁶ To sell a licensed RCFE, the seller gives CDSS and residents at least 30 days’ notice. The buyer files a full license application within five days of the offer being accepted. CDSS gives these applications priority and decides within 60 days of a complete file.⁠²⁸ Notify CDSS of a new administrator within 30 days.⁠¹⁴

How RCFEs get paid

Most RCFE revenue is private pay. CDSS does not set private rates, but the admission agreement must state the basic rate and the price of each optional service.⁠⁸ For residents on SSI/SSP, you may charge only the government rate.⁠⁸ CDSS’s estimated 2026 standard for non-medical out-of-home care is $1,626.07 a month. Of that, $1,444.07 is payable for basic services and at least $182.00 must go to the resident for personal needs.⁠³²

Medi-Cal reaches RCFEs through the Assisted Living Waiver (ALW), a home and community-based services waiver approved from March 1, 2024, through February 28, 2029.⁠³⁰ It operates only in 15 counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.⁠³⁰ Participants must be 21 or older, have full-scope Medi-Cal with no share of cost, and need the level of care of a nursing facility resident. They pay the facility directly for room and board.⁠³⁰ The 2026 maximum per diem for assisted living services ranges from $95.69 (Tier 1) to $270.80 (Tier 5).⁠³⁰ Slots are limited and there is a waitlist.⁠³⁰ Only a facility already licensed by CDSS can enroll. Applications go to the DHCS Provider and Facility Site Review Unit, not the Medi-Cal Provider Enrollment Division.⁠³¹

Recent and pending changes

• Civil penalties. A regulation package aligning the Title 22 follow-up visit, penalty and appeal sections (87759, 87761, 87763) with statute took effect May 18, 2026. CDSS says it adds no new requirements.⁠³⁴
• Disasters and inactive status. SB 582 (2025) lets licensees whose facilities are destroyed or closed by a declared emergency request inactive license status. The request is due within 90 days of the declaration, the status lasts up to two years, and CDSS may waive annual fees during it. This took effect January 1, 2026. A general inactive-status option for other closures starts January 1, 2028.⁠³³ RCFEs are now encouraged to send their emergency plan to the local medical health and operational area coordinator.⁠³³
• Online systems. The CCLD Public Portal replaced the administrator certification portal on August 17, 2026.⁠¹⁵
• Background checks. AB 2796 (Stats. 2026, ch. 313), an urgency statute effective September 18, 2026, amended section 1569.17, the RCFE criminal record clearance law.⁠³⁷⁠³⁸ The list of people who need a clearance or exemption now expressly includes any administrator, supervisor, manager or director (or anyone acting in those roles) and any adult responsible for operating the facility; for an applicant that is a firm, partnership, association, limited liability company or corporation, the chief executive officer, board members and governing body; officers of the governing body; anyone with a 10 percent or greater financial interest in the applicant; and staff, volunteers or employees with client contact, whether adults or minors.⁠³⁷ Ask the Centralized Applications Bureau which owners and board members of your entity must be fingerprinted under the amended section.

California’s other licensing guides are on the California state page, including the home health agency license, the child care center license and the family child care home license.

Sources

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   California Legislative Information, Health and Safety Code section 1569.2 (definitions) Checked 12 Oct 2026 · Back to text ↑
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28. 28
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