Delaware family care home license: two or three residents, and you must live there

What Delaware means by a family care home

Delaware licenses this home type under its own short rule, 16 DE Admin. Code 3315. It defines a family care home (FCH) as a home, meaning the structure and its equipment, that “provides beds and personal care services for 2 or 3 residents who cannot live independently and who need or could benefit from a family living situation.” The home supplies shelter, housekeeping, meals and personal care.⁠¹ The license holder is the “family care provider,” the person who personally supervises and cares for the residents.⁠¹ The state’s Business First Steps listing calls the same license a “rest (family care) home.”⁠⁷

The rule turns on three facts:

• Number of residents. Two or three. The statute uses the same definition and lists the family care home as one of nine types of long-term care facility under 16 Del.C. Chapter 11.⁠²
• Who lives there. “The holder of the license must be living in the home full-time.”⁠¹ This license is not for an investor who staffs a house with employees.
• Who you may admit. Only people whose needs can be met with moderate, standby or hands-on help with activities of daily living; help with taking medications, or giving them; handling occasional behaviors; and scheduling treatments or therapies, with transportation if needed.⁠¹ Residents must be 18 or older unless DHCQ grants a waiver for specific medical or social needs.⁠¹

Under the statute, a long-term care facility provides shelter and food to more than one person who needs care and who is “not related within the second degree of consanguinity” to the facility’s controlling person.⁠² Under that definition, a parent, child, grandparent, grandchild or sibling you care for does not make your house a licensed facility. Your household still counts toward space and bathroom minimums, though. The rule defines “occupants” as residents, the provider and the provider’s family members who live in the home more than 48 hours a week or more than 30 days a year.⁠¹

When you need a different Delaware license

A fourth resident takes you outside 3315. The two nearest options are much heavier:

Scroll the table sideways to see every column.

The rest home and the family care home also serve different people. A rest home is for residents who are “normally able to manage” their own daily activities.⁠²⁠⁶ A family care home admits people who need hands-on help.⁠¹ If you plan to grow beyond three residents, read the Delaware assisted living facility guide before you buy or lease a house. Care given in clients’ own homes instead falls under the personal assistance services agency license, and daytime programs fall under the adult day care facility license.

Being the provider: residence, absences and backup

3315 has no education, certification or age requirement for the family care provider. The obligations fall on how you run the household:

• Absences. You may not leave the home while residents are there unless you hand care duties to a responsible adult, or unless a resident’s level-of-care document states how long that resident can be left unsupervised. Either way, 12 hours is the most you may be away. The alternate adult’s name and contact details must be on file with DHCQ.⁠¹
• Longer absences. Tell DHCQ in advance, when possible, about any absence of a week or longer.⁠¹
• Changes. Give DHCQ at least 30 days’ notice before any change in the family care provider or in ownership.⁠¹ The license cannot be transferred to another person or another address,⁠¹ and by statute it ends on a transfer to another person or controlling person.⁠²
• Dementia training. If you serve anyone diagnosed with Alzheimer’s disease or another dementia, you need annual dementia-specific training. It must cover communication, the residents’ psychological, social and physical needs, and safety measures.⁠¹
• Pets. Household pets need up-to-date yearly vaccinations, and no vicious or dangerous animal may live in the home.⁠¹

If you hire anyone to work in the home, Delaware’s background check law applies. An employer may not hire an applicant to work in a facility before getting the applicant’s criminal history through the Background Check Center, which is based on State Bureau of Identification fingerprints. You may hire someone conditionally for up to 60 days, but only after confirming they have been fingerprinted.⁠³ You must also have the applicant’s mandatory drug screen results before hiring.⁠³ Each failure can bring a civil penalty of $1,000 to $5,000.⁠³ The implementing rule, 3105, applies to “a nursing facility or similar facility licensed pursuant to 16 Del.C. Ch. 11.” The definition of “applicant” in both the statute and the rule also covers self-employed people and agency staff who work in a facility.⁠³⁠⁴ Neither 3315 nor the statute says whether DHCQ fingerprints the license holder or adult household members as part of the application. Ask DHCQ when you request the packet.

The house: space, bedrooms and bathrooms

The space minimums count every occupant, not only residents. That is where a family’s own size can limit the home.

Table source: ⁠¹.

Some layout rules catch people who are converting an ordinary house:

• A resident’s bedroom must be separate from the bedrooms of the provider and the provider’s family,⁠¹ and it must open directly into a corridor.⁠¹ Walls must run floor to ceiling, and the door must close.⁠¹
• If residents regularly use wheelchairs, you need an ADA-compliant ramp at the primary exit. You also need a second exit, independent of and remote from the first, that leads outside at street or ground level or onto an exterior balcony.⁠¹
• Bedrooms below grade need a direct exit to the outside from that level.⁠¹
• Each resident’s furniture must include a reading light, a framed bed, a mattress with a non-porous cover, a bedside stand, a chair, a chest of at least two drawers, and at least 2 linear feet of closet hanging space.⁠¹
• Stairs need non-slip surfaces, sturdy handrails, and working light switches at the top and bottom. Hallways need working night-lights. Interior doors in resident areas must open from either side.⁠¹
• Cameras or monitoring devices are not allowed in resident bedrooms or bathrooms unless written permission from the resident or guardian is on file.⁠¹

The kitchen must have a refrigerator that holds 42°F or below, with a thermometer, and a freezer. It also needs a four-burner range, an oven, and either a dishwasher with a sanitizing cycle or bleach-based dish detergent. Poisons and pesticides go in locked storage.⁠¹

The home must meet local and state building codes for its occupancy.⁠¹ A private well needs DHSS approval, and a private septic system needs approval from the Department of Natural Resources and Environmental Control (DNREC).⁠¹ Once licensed, you must send DHCQ plans and specifications for any construction, renovation or extensive remodeling. You need written approval before work starts, and DHCQ visits the site when the work is done.⁠¹

Fire safety

3315’s fire rules are short:

• A working UL-approved smoke detector on every level and in the hall next to the resident bedrooms.⁠¹
• At least one working, readily accessible fire extinguisher on each floor of living space.⁠¹
• If the State Fire Marshal notifies DHCQ in writing of a fire hazard in the home, that can be grounds for revoking the license.⁠¹ DHCQ may also require an inspection by a certified electrician at any time for good cause.⁠¹

Health screening before the first resident

Delaware’s TB rule covers the whole household. All occupants need a baseline two-step tuberculin skin test. The “original home occupants,” meaning you and your family, must finish it before you accept any resident. Each new resident needs baseline testing within the six months before admission.⁠¹ Each resident also needs a physical exam within 90 days before placement and every year after.⁠¹ You must keep evidence on file that each resident had an annual flu vaccination, unless they refused it or it is medically contraindicated.⁠¹ No one with an active communicable disease may be admitted until they are no longer contagious.⁠¹

Before placement, every resident also needs a written level-of-care determination. It covers how much help they need with daily activities, medications, treatments, mobility and behavior, and how long they can be left unsupervised.⁠¹ For a resident sponsored by an “affiliated social agency/program” (an agency with an agreement with DHSS), the agency or a licensed independent practitioner with the placement agency sets the level of care. A private-pay resident arranges it with a licensed independent practitioner: a physician, physician assistant or nurse practitioner.⁠¹ The level of care is redone every year, and you keep a copy.⁠¹

Applying to DHCQ, in order

Rule 3315 says applicants “shall request a licensure application from the Department.”⁠¹ The state’s Business First Steps page lists the long-term care licensing contact at 302-421-7400.⁠⁷ The 3315 rule is posted on DHCQ’s regulations page.⁠⁸

1. Request the application

   Ask DHCQ’s long-term care licensing office for the family care home packet.⁠¹⁠⁷ Getting a form does not mean your application will be accepted or a license issued.⁠¹

2. Assemble what the rule and statute require

   List the name, age and relationship to you of every person living in the home.⁠¹ Include financial documents, which DHCQ uses only to judge financial capability,⁠¹ and evidence that you can meet the minimum care standards and other applicable laws.⁠² DHCQ may look at the background of you, any partner or officer, whoever owns the property, and any controlling person. It can require a sworn affidavit of satisfactory compliance history covering any facility you ran in the past five years.⁠²

3. Finish household TB testing

   before you plan to accept anyone.⁠¹

4. Pay the $50 fee

   with the application.⁠²

5. Inspection and initial approval

   DHCQ grants initial approval to applicants who meet the requirements. Once you have it, you may accept residents.⁠¹

6. First resident moves in: six-month initial license

   The initial license is issued when the first resident moves in and runs six months. DHCQ does a follow-up inspection during that time. If you meet the requirements then, you get an annual license for the rest of the licensure year.⁠¹

7. Post the license

   where people can see it on the premises.⁠¹

If an inspection finds you are not in substantial compliance but you show you can fix things, DHCQ may issue a provisional license for 90 days, with conditions it sets.⁠¹ A provisional license cannot be renewed unless DHCQ has approved your Plan for Corrective Action and you have carried it out.⁠¹ Under the statute, a facility on a provisional license must pay the application fee again for re-inspection before it gets an annual license.⁠²

3315 does not set a processing time, and no official DHCQ source checked on 2026-10-12 gives one.

Fees as published on 2026-10-12

Rule 3315 says fees follow 16 Del.C. Chapter 11.⁠¹ Section 1106(a)(1) sets the higher schedule for nursing facilities, assisted living, rest residential facilities and ICF/IID homes. Family care homes fall under § 1106(a)(2), the catch-all for other facilities of 16 or fewer beds.⁠²

Table source: ⁠². The last row comes from § 1107(b).⁠²

Money, rights and records once residents arrive

Before admission, you must give each resident a full written statement of every charge for services, materials and equipment. The resident or their legal representative signs an agreement to it before moving in.⁠¹ Beyond the agreed rate and approved incidental expenses, you may not have financial dealings with a resident. Any change to the financial agreement must be coordinated with the affiliated agency, the placement agency, or the State Long-Term Care Ombudsman.⁠¹ Residents manage their own money unless they or their representative ask you in writing to do it. If you do, keep a monthly accounting available for inspection and send a quarterly statement.⁠¹

Daily operations under 3315:

• Medications. Kept locked in a cabinet or lock box used only for that purpose. Refrigerated medications go in a separate locked box inside the refrigerator. Residents take medications themselves, or you hand them out directly from the prescription container as directed.⁠¹
• Meals. Three meals a day, no more than 14 hours between the evening meal and breakfast unless you provide a snack in between, special diets only on a physician’s written prescription, and a three-day emergency supply of food and water.⁠¹
• Housekeeping. Bed linens and towels changed at least weekly. You do laundry for residents who cannot do their own.⁠¹
• Rights. Residents may not be required to work for the home. They are free from restraints used for discipline or convenience, may receive visitors privately at reasonable hours, and get their mail unopened. They may see the home’s most recent survey results, and you knock before entering their room.⁠¹
• Records. For each resident: name and Social Security number, admission date, physicians, next of kin, a medication list, the level-of-care certificate, and burial plans.⁠¹ DHCQ and the affiliated agency may inspect all required records.⁠¹
• Infection control. A written infection prevention and control program based on Centers for Disease Control and Prevention guidelines, with a designated lead, and orientation and annual training for any staff.⁠¹

Inspections, renewal and enforcement

Every licensed family care home is inspected periodically.⁠¹ The statute requires each long-term care facility to be inspected within 15 months of its previous inspection, and DHSS staff may enter without notice at any time.⁠² Apply for renewal at least 30 days before the license expires.⁠¹ If you refuse DHCQ access for a survey or investigation, it can suspend or revoke your license.⁠¹

Before suspending or revoking a license, or taking other disciplinary action, DHCQ must give you 10 calendar days’ written notice. You have those 10 days to ask in writing for a hearing before the DHSS Secretary or a designee.⁠¹ Breaking the rule brings a fine of $100 to $1,000 plus costs.⁠¹ Running a long-term care facility without a license brings a civil penalty of up to $10,000 per violation.⁠²

Rule history and open points

Rule 3315 was last amended in 25 DE Reg. 766, published February 1, 2022. Earlier amendments appeared in 2011 and 2015.⁠¹ Section 11 requires an infection prevention and control program. Section 11.4 requires COVID-19 testing of new staff, vendors and volunteers “in accordance with Division of Public Health guidance,” and section 11.5 requires related policies, such as work exclusion for staff who test positive.⁠¹ The text on the state’s regulations site on 2026-10-12 still contains those provisions. Ask DHCQ which Division of Public Health testing guidance it applies today.

Neither 3315 nor 16 Del.C. Chapter 11 says whether Delaware Medicaid long-term care programs pay family care homes for room, board or personal care, and no official source checked on 2026-10-12 does. The rule does refer to residents sponsored by an “affiliated social agency/program,” an agency with an agreement with DHSS.⁠¹ Ask DHCQ which agencies place residents in family care homes, and ask the Delaware Medicaid office whether any program pays for care in one.

Sources

1. 1
   Delaware Department of Health and Social Services, Division of Health Care Quality (Delaware Administrative Code), 16 DE Admin. Code 3315, Family Care Homes Checked 12 Oct 2026 · Back to text ↑
2. 2
   Delaware General Assembly, Title 16, Chapter 11, Subchapter I, Delaware Code: Licensing by the State (Long-Term Care Facilities and Services) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Delaware General Assembly, Title 16, Chapter 11, Subchapter IV, Delaware Code: Criminal Background Checks; Mandatory Drug Screening Checked 12 Oct 2026 · Back to text ↑
4. 4
   Delaware Department of Health and Social Services (Delaware Administrative Code), 16 DE Admin. Code 3105, Criminal History and Drug Testing for Nursing and Similar Facilities Checked 12 Oct 2026 · Back to text ↑
5. 5
   Delaware Department of Health and Social Services (Delaware Administrative Code), 16 DE Admin. Code 3225, Assisted Living Facilities Checked 12 Oct 2026 · Back to text ↑
6. 6
   Delaware Department of Health and Social Services (Delaware Administrative Code), 16 DE Admin. Code 3230, Rest (Residential) Home Regulations Checked 12 Oct 2026 · Back to text ↑
7. 7
   State of Delaware, Business First Steps, Long Term Care Facilities (licenses for nursing homes, assisted living, group homes, neighborhood homes and rest homes) Checked 12 Oct 2026 · Back to text ↑
8. 8
   Delaware Department of Health and Social Services, Division of Health Care Quality, DHCQ Regulations Checked 12 Oct 2026 · Back to text ↑

Was this information accurate? Report an errorPrint or save as PDF