New Jersey adult family care caregiver license: three clients, your own home, and a sponsor agency

A license for a person, tied to a sponsor agency

New Jersey does not license “adult family homes” as businesses the way many states do. It licenses the caregiver as an individual. The Department of Health (DOH) describes the setting as a contractual arrangement in which no more than three people receive room, board, personal care and other health care services in the home of an unrelated person who has been approved by a sponsor agency and trained for the work ⁠³.

Two licenses are involved, and they are held by different parties:

• AFC caregiver license. You hold this one personally. It names you and the address of your home ⁠¹.
• AFC sponsor agency license. A separate organization holds this one. It recruits, trains and supervises a network of caregivers and gives each client a nurse or social worker as care manager ⁠¹.

The caregiver application is not complete without a copy of your contract with a licensed sponsor agency, signed by you and by someone authorized to sign for the agency ⁠¹. In practice, then, the first step is finding a sponsor agency that will take you on, not filing with DOH. DOH said when it proposed the rules that it expected sponsor agencies to be mostly home health agencies or health care facilities, because the model depends on registered nurses monitoring clients’ health ⁠¹. If you want to run the agency yourself, the sponsor license is a different and larger undertaking; see the section on it below.

The rules also exempt one arrangement. People who take adults into their homes through placements made by a nonprofit religious or charitable organization, on a voluntary or informal basis, are outside N.J.A.C. 8:43B, and so is the organization that arranges those placements. Neither may advertise or present itself as an AFC caregiver or sponsor agency ⁠¹.

Why the license is new even though the program is not

New Jersey first wrote rules for “alternate family care” sponsor agencies in 1996. That chapter expired on February 20, 2001 ⁠¹. The New Jersey Adult Family Care Act (P.L. 2001, c. 304, N.J.S.A. 26:2Y-1 through 26:2Y-11) took effect April 2, 2002 and directed DOH to license caregivers and set standards for their homes ⁠¹, but the licensing rules did not follow for two decades. DOH proposed N.J.A.C. 8:43B in November 2022 ⁠⁵⁠¹, at the request of the Division of Medical Assistance and Health Services, which had already put the service in New Jersey’s Medicaid State Plan ⁠¹.

The rules took effect on March 6, 2023 and expire on March 6, 2030 unless readopted ⁠². Caregivers already working through a licensed sponsor agency on March 6, 2023 had until June 4, 2023 to get licensed ⁠². That is why DOH’s facility list still uses the older name “Alternate Family Care” ⁠³, while the rule and statute say “adult family care.” The rule text was adopted with only non-substantial changes, which filled in those dates ⁠². A search on 2026-10-12 turned up no later amendment notice.

How it differs from the other New Jersey options

Founders often confuse AFC with three other New Jersey licenses:

• Assisted living. If you want more than three residents, or a facility that is not your own home, you are looking at the DOH assisted living residence or comprehensive personal care home licenses. See the New Jersey assisted living residence guide.
• Home care in the client’s own home. Sending aides to clients’ homes is a different business. DOH lists the home health agency as its own facility type ⁠³; see the New Jersey home health agency guide and, for non-medical care, the health care service firm guide. Neither is an AFC license.
• Daytime programs. Care during the day only, with clients going home at night, falls under the DOH adult day care services facility license, which DOH describes as medical and nursing supervised care for functionally impaired adults ⁠³ (see the adult day health services guide).

Capacity is a hard cap. The Act’s penalty provisions, as written into N.J.A.C. 8:43B-2.9, set a specific fine for keeping more clients than the license allows: the daily charge collected from the extra clients, plus $25 per day for each client over the limit, except in an emergency ⁠¹.

Who can qualify as the caregiver

N.J.A.C. 8:43B-4.1 lists eleven qualifications ⁠¹. You must:

• clear a criminal record background check (see below);
• be at least 21 years old;
• complete an orientation to AFC given by the sponsor agency you contract with;
• have a written statement from your physician, advanced practice nurse or physician assistant, based on an exam, that you are physically, emotionally and mentally able to meet the program requirements and care for a client;
• have adequate oral and written communication skills;
• own or lease the home you will use, and live there full time;
• have lived in that municipality for at least one year immediately before applying for your first license;
• carry homeowner’s or renter’s insurance;
• have a contract with an AFC sponsor agency;
• show that any vehicle you will use to transport clients meets New Jersey Motor Vehicle Commission safety and licensing rules; and
• meet the training requirement through one of the routes in the next section.

The one-year municipal residency rule is unusual. If you are planning to buy a house in a new town to open a care home there, you would not be eligible for an AFC license in that municipality until you had lived there a year.

The application also asks for proof of your housing stability. You must submit payment verification from your mortgage lender or landlord covering the 12 months before you apply. If you have had no mortgage or lease in that time, you submit proof that you own the home ⁠¹.

Training: the sponsor’s course or an existing credential

You meet the training requirement if any one of these applies ⁠¹:

• you completed your sponsor agency’s caregiver training program, which must cover the curriculum in the rule’s Appendix A;
• you hold a nurse aide in long-term care certificate and are in good standing on the New Jersey Nurse Aide Registry;
• you hold a New Jersey homemaker-home health aide certificate in good standing; or
• you are a registered professional nurse or licensed practical nurse.

The sponsor agency develops its own training program and delivers it under the direction of a registered nurse ⁠¹. Appendix A sets the minimum content in eight modules: an overview of the AFC program; working with elderly and disabled adults (communication, dementia and memory loss, relocation, recognizing common diseases); personal care, including vital signs and dressing changes; nutrition and special diets; rehabilitation and restorative care (body mechanics, transfers, range of motion); accident prevention, fire safety and first aid; agency procedures, including client rights and handling client funds; and medication ⁠¹.

Module VIII, on medication, matters most. If you will help clients take their own medications, or will give medications, the sponsor agency’s policies must require training that includes at least Module VIII. That module covers the five rights of medication administration, reading prescription labels, side effects and interactions, documenting refusals and errors, and storage and disposal ⁠¹.

Substitute caregivers and other adults in the house

Anyone who cares for a client for an average of at least three hours in a 24-hour period, or at least 20 hours a week, must be a substitute AFC caregiver ⁠¹. A substitute must clear the background check, be at least 18, communicate adequately and be capable of giving appropriate care. Certified nurse aides, certified homemaker-home health aides, LPNs and RNs are exempt from the training program ⁠¹.

Every adult who lives in the home and is not a client must also pass a criminal record background check. You may not let an adult move in until they have ⁠¹. You must tell your sponsor agency 30 days before a change in caregiver or before another adult moves in, and send written notice to DOH. If an emergency makes advance notice impossible, notify the sponsor within five calendar days ⁠¹.

Background checks and rehabilitation review

The applicant and each adult non-client resident are fingerprinted at initial licensure, and the applicant is fingerprinted again at each renewal ⁠¹. Fingerprinting follows New Jersey State Police procedures. DOH’s fingerprinting page says applicants who live or work in New Jersey, or within 20 miles of its border, use Idemia, the State Police vendor, and receive a form with the correct codes for their license type ⁠⁴.

A conviction for any offense listed in N.J.S.A. 26:2Y-5.b disqualifies the applicant, or disqualifies the home if the conviction belongs to another adult living there. The exception is when the person proves rehabilitation by clear and convincing evidence and DOH issues a written determination of rehabilitation ⁠¹. You have 30 days from the notice of disqualification to submit that evidence. It must include a personal statement about the offense and, if you were on probation or parole, proof that you were discharged ⁠¹. If the disqualified person is another adult in the household, you can instead have that person move out and file again. If you do neither within 30 days of a denial, the denial becomes final ⁠¹.

The rule does not list the disqualifying offenses itself. It points to N.J.S.A. 26:2Y-5.b, and the statute’s official text could not be retrieved on 2026-10-12, so this guide does not reproduce the list. Before you spend money on training or fingerprints, ask DOH’s Certificate of Need and Healthcare Facility Licensure Program for the current list and, if you or another adult in the household has a conviction, how it would be treated ⁠¹.

What the home must have

Subchapter 11 of N.J.A.C. 8:43B sets the physical standards. DOH says it wrote them to keep the setting a home rather than impose facility-grade construction ⁠¹. The home must meet local and state law, including the Uniform Construction Code (N.J.A.C. 5:23) for occupancy, health and fire standards ⁠¹. Beyond that, the rule spells out specifics.

You also need a written fire plan that lays out escape routes and is reviewed with clients regularly. Escape routes must be kept clear ⁠¹. Linens must be changed at least weekly. You either launder clients’ bedding, towels and washable clothing or give them a washer to use ⁠¹.

Before a client moves in, and every year after, you and every other resident of the home need a tuberculosis screen: an IGRA blood test or a two-step Mantoux skin test. Exemptions apply for a documented negative result within the last year, a positive result with completed treatment, or a medical contraindication ⁠¹. Your application must also show that you are up to date on influenza, pneumococcal and COVID-19 vaccines under the CDC’s ACIP schedules for health care personnel ⁠¹.

Applying to DOH, in order

1. Sign on with a licensed sponsor agency

   The agency interviews you and everyone in your household, checks personal and employment references, and evaluates whether your home is safe and suitable ⁠¹.

2. Complete orientation and training

   You take the sponsor’s orientation, plus its caregiver training unless you are a CNA, certified homemaker-home health aide, LPN or RN ⁠¹.

3. Get your health statement and screenings

   This means the written capability statement from your health care professional, proof of vaccinations, and TB screening before placement ⁠¹.

4. Assemble the DOH application

   The application uses form LCS-9, the Application for a Long-Term Care Facility License, on DOH’s forms page. Attach the signed sponsor contract, proof of the 8:43B-4.1 qualifications, the 12-month mortgage or rent payment verification, and vaccination proof ⁠¹. The LCS-9 asks for an EIN, ownership details, whether the building is owned or leased (attach a lease if leased), and a registered agent who must be a New Jersey resident. It also asks about past denied or revoked health facility applications, findings of resident abuse or fraud, and felony indictments or convictions ⁠¹.

5. Pay both fees and mail the package

   Send it to the Certificate of Need and Healthcare Facility Licensure Program, Certificate of Need and Licensing Division, NJ Department of Health, PO Box 358, Trenton, NJ 08625-0358 ⁠¹.

6. Fingerprints

   Fingerprinting is required for you and every adult non-client in the household ⁠¹⁠⁴.

7. DOH inspection

   DOH inspects you and the home before you start providing AFC services, and sends you and the sponsor a written report. If it finds deficiencies, you submit a written plan of correction to both, notify them when the work is done, and DOH comes back to check ⁠¹.

8. Written approval, then the license

   You may not provide AFC services until DOH notifies you in writing that it accepts your plan of correction and approves the application ⁠¹.

9. After issuance

   DOH sends a copy of your license to your municipality. You must notify the local police, fire department and emergency medical service, and your sponsor agency must confirm you did. Post the license near the main entrance ⁠¹.

The rules set no processing time for caregiver applications.

Fees as published on 2026-10-12

The caregiver inspection fee is refunded if DOH denies the application before inspecting your home, either because you do not meet the 8:43B-4.1 qualifications or because of a background check disqualification. Not paying the inspection fee means denial of a first license or non-renewal of an existing one ⁠¹.

Working inside the sponsor agency’s system

Once you are licensed, the sponsor agency does much of the client-facing work, and the rule limits what you decide alone.

Placement. The sponsor’s administrator or a designee meets the prospective client first. The agency then arranges a meeting between you and the client so each side can decide whether the placement works ⁠¹. Each placement requires a written residency agreement signed by the sponsor, you, and the client or client representative. The agreement covers each party’s rights and responsibilities, the services, and the payment arrangements and charges, and the client must get it before moving in ⁠¹. Clients get 30 days’ written notice of any change to it ⁠¹. The agreement must also include eviction and appeal protections comparable to those New Jersey tenants have ⁠¹.

Care management. A care manager, who is a registered nurse or social worker, is assigned before placement and comes to your home on placement day to finalize the client service plan with you and the client. After that, the care manager visits weekly for the first month and at least monthly afterward ⁠¹. Different rules apply when the client is enrolled in an NJ FamilyCare program that has its own care manager. In that case the AFC care manager coordinates with the NJ FamilyCare care manager, and the weekly and monthly schedule does not apply ⁠¹.

Assessments and the service plan. The sponsor’s RN assesses each client. If the client needs health care services, the RN completes a full health assessment within 14 days of placement and reassesses every six months ⁠¹. The service plan must be in place by placement day and signed by the client, you and the sponsor. You take part in writing it, but you may not reject needs the RN has identified ⁠¹. The plan states, among other things, whether and for how long the client may be left alone ⁠¹.

Your daily duties. Under N.J.A.C. 8:43B-5.2 you provide supervision and help with activities of daily living as the plan specifies. You also provide three nutritionally balanced meals a day, laundry, shopping, prescription pickups and refills, and cleaning; make sure transportation is provided, directly or by arrangement; get prompt medical care when a client is ill; and tell the care manager and the client’s representative about any significant change ⁠¹. At the onset of any client illness, you call the sponsor’s RN or the client’s health care professional ⁠¹.

Money. You may manage a client’s funds only with the client’s written authorization, witnessed by a sponsor representative and a family member or representative. You must then give a quarterly written accounting backed by receipts. You may not accept gifts or bequests from a client, or be named as a beneficiary of a client’s insurance, trust or will ⁠¹.

Discharge. A client can be found ineligible or involuntarily discharged for only three reasons: medical needs beyond what you can provide, being a danger to self or others after the care manager’s assessment, or not complying with the residency agreement. Except in an emergency, the client gets 30 days’ notice, and the sponsor notifies the Long-Term Care Ombudsman ⁠¹.

Risky choices. If a client’s choices put the client or others at risk, the rule calls for a written managed risk agreement negotiated among the client, you and the sponsor. It records the concern, the likely consequences, the alternatives and what was agreed ⁠¹.

Postings, records and client rights

In the home you must post your license near the main entrance and your most recent inspection report at the entry or another equally prominent spot. Give a copy of the report to clients and prospective clients who ask; you may charge only your actual copying cost ⁠¹. Post emergency numbers near a phone where possible: 911, the DOH complaint hotline (1-800-792-9770), the Office of the State Long-Term Care Ombudsman (1-877-582-6995), and your sponsor agency ⁠¹.

For each client you keep a record with identification and emergency contacts, the signed residency agreement, the signed statement of client rights, any funds authorization with the quarterly accountings, the current service plan, and a log of visits by outside physicians and health care providers ⁠¹. The client rights in N.J.A.C. 8:43B-10.1 include freedom from chemical and physical restraints, a private phone at the client’s own expense, unopened mail, a quarterly account of funds, practicing or declining religion freely, and the right to competitive integrated employment ⁠¹.

Inspections, renewal and closing

DOH inspects every AFC home annually, and its representatives may enter and inspect at any time, interview clients privately and review your client records ⁠¹. The license runs two years. DOH sends a renewal notice and fee request at least 30 days before it expires and will not renew without payment ⁠¹. The license cannot be transferred to another person or address, and it becomes void if you stop operating or move. A new address means a new license ⁠¹.

Enforcement can include civil penalties, denial or non-renewal, probationary or provisional status, suspension or revocation, and relocation of clients ⁠¹. Penalties reach up to $2,500 a day for operating without a license, and up to $2,500 a day for violating client care or physical plant rules ⁠¹. You can request a hearing in writing within 30 days of an adverse notice. DOH may offer a settlement conference before sending the case to the Office of Administrative Law ⁠¹. If a rule creates a hardship, you can request a waiver on DOH form CN-28. The request names the rule, describes the hardship and proposes an alternative that keeps clients safe ⁠¹.

To close voluntarily, give written notice at least 60 days ahead to each client, your sponsor agency and DOH. Submit a termination plan for DOH approval 30 days before carrying it out, and return the license within seven business days ⁠¹.

If you want to be the sponsor agency instead

Some founders, often owners of a home health agency, want to build a caregiver network rather than host clients themselves. The AFC sponsor agency license calls for ⁠¹:

• a $1,500 non-refundable filing fee and a $200 inspection fee, each charged at first licensure and again every two years at renewal;
• proof of liability insurance;
• an AFC program administrator with a bachelor’s degree;
• a designated registered nurse with at least one year of experience serving older adults or people with physical disabilities, with an RN on call at all times;
• a designated social worker with the same one-year experience requirement;
• a policy and procedure manual;
• a registry of caregivers and clients, sent to DOH every quarter; and
• immediate phone reporting of abuse, serious injuries and absences over 24 hours to DOH and the Ombudsman.

DOH’s 2022 economic impact statement described the sponsor fee differently, as $1,500 covering the first year plus $500 a year for renewal ⁠¹. The rule text, which governs, says $1,500 every two years.

Sources

1. 1
   New Jersey Department of Health, N.J.A.C. 8:43B, Standards for Licensure of Adult Family Care Caregivers and Sponsor Agencies (notice of proposal with full rule text, PRN 2022-140, 54 N.J.R. 2038(a)) Checked 12 Oct 2026 · Back to text ↑
2. 2
   New Jersey Department of Health, Adopted New Rules: N.J.A.C. 8:43B (R.2023 d.031, 55 N.J.R. 3(1), effective March 6, 2023) Checked 12 Oct 2026 · Back to text ↑
3. 3
   New Jersey Department of Health, Health Facility Types Checked 12 Oct 2026 · Back to text ↑
4. 4
   New Jersey Department of Health, Fingerprinting Checked 12 Oct 2026 · Back to text ↑
5. 5
   New Jersey Department of Health, New Jersey Department of Health Proposes New Rules Establishing Standards for Licensure of Adult Family Caregivers and Sponsor Agencies at N.J.A.C. 8:43B (November 2022) Checked 12 Oct 2026 · Back to text ↑

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