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Small residential care home licensing by state

Adult family, foster and care homes for a few residents in a home setting

A small residential care home gives housing, meals and personal care to a few unrelated adults, usually in a family house. Some states have a dedicated small-home license with a bed cap, some license small homes as assisted living, and a few only certify homes that serve Medicaid residents. First find out which of these your state does, and at what resident count it starts.

Bed caps and the count that triggers a license

Nevada licenses a home caring for just 1 or 2 unrelated adults, and Florida’s adult family-care home covers 1 to 5 residents. Delaware’s family care home takes 2 or 3. New Jersey and Kentucky cap theirs at 3, and Montana, North Dakota, New York and South Dakota at 4. Idaho allows 4, but only 2 without a variance. Oregon and Wyoming stop at 5. North Carolina’s family care home and Washington’s adult family home take 2 to 6, and Washington can approve up to 8. Connecticut and Georgia set no upper limit. Watch for gaps: in Kentucky, exactly 4 residents fits neither the family care home cap of 3 nor the assisted living minimum of 5.

States with no separate small-home license

Many states use one license for a six-bed house and a large facility. California uses its RCFE license for homes of 6 or fewer, Colorado its assisted living residence license from 3 residents, Texas its assisted living license from 4, and Maryland and Utah theirs from 2. Maine requires its residential care facility license at any size. Below the threshold, as with 3 residents in Texas, no license applies.

Certification instead of a license

Indiana treats adult family care as a Medicaid waiver service, and FSSA lists state licensure as not required. New Hampshire certifies adult family care residences for 1 or 2 waiver residents. Virginia’s local social services departments approve adult foster care providers for up to 3 adults. In Pennsylvania, the Area Agency on Aging certifies domiciliary care homes for adults it places there. West Virginia only registers homes for 1 to 3 residents, free of charge. Wisconsin licenses adult family homes at 3 or 4 beds, while counties, managed care organizations or IRIS certify 1- and 2-bed homes. The certifications in Idaho, Iowa and New York, by contrast, are mandatory to operate.

Many names for the same business

Washington and Wisconsin say adult family home; Michigan, Minnesota, Montana, Mississippi and Wyoming say adult foster care; North Carolina, Delaware and Kentucky say family care home. Others are harder to spot: Kansas’s Home Plus, Ohio’s Class Two Residential Facility and Illinois’s Shared Housing Establishment.

Who may hold the license

Some states tie the license to the person who lives in the home. Florida requires the provider to live there, and Arizona’s adult foster care home needs a live-in sponsor or manager. New Jersey licenses the individual caregiver, who must also work through a separately licensed sponsor agency. Rhode Island’s adult supportive care home is open only to an existing licensed home nursing care provider, nursing facility, assisted living residence or adult day services provider.

Closed doors and recent changes

Arkansas has barred new residential care facility beds since July 1, 2005, so you enter by buying a licensed facility. A Minnesota moratorium limits new adult foster care licenses mainly to homes that are the provider’s own residence, and from July 1, 2026 a new home may not sit on the same or an adjoining lot as another small setting. Alabama stopped issuing licenses for family assisted living homes of 2 or 3 adults on October 1, 2015. New Jersey has required its caregiver license since March 6, 2023. North Carolina requires no certificate of need for a family care home, while Kentucky requires one for a personal care home.

Across the 50 states and DC

What each state requires to operate, at our last review

46 of 51
License required
1 of 51
Registration required
4 of 51
Medicaid/Medicare certification only
Guides
35 below

Small residential care home rules in every state

All states
Small residential care home licensing in each state: requirement, official license name, agency and size threshold
Alabama License required Group Assisted Living Facility license (same assisted living license) Alabama Department of Public Health (ADPH), Bureau of Health Provider Standards No small-home license; smallest new option is 3 to 16 adults (group ALF)
Alaska License required Assisted Living Home license (same license; no separate small-home type) Alaska Department of Health, Division of Health Care Services, Health Facilities Licensing and Certification Same Assisted Living Home license; 3-5 residents pay a lower fee
Arizona License required Adult Foster Care Home (an assisted living facility license) Arizona Department of Health Services (ADHS), Bureau of Assisted Living Facilities Licensing 1 to 4 adults (long-term care system or VA) in the sponsor's home
Arkansas License required Residential Care Facility (RCF) license Arkansas Department of Human Services, DPSQA, Office of Community Services Board-and-care for mobile adults; no small-home license; new beds frozen
California License required Adult Residential Facility (ARF) license for adults 18 to 59; RCFE license for people 60 and older California Department of Social Services (CDSS), Community Care Licensing Division, Adult and Senior Care Program ARF (adults 18 to 59) or RCFE (60+); no separate small-home license
Colorado License required Assisted Living Residence (ALR) license (same license as assisted living) Colorado Department of Public Health and Environment (CDPHE), Health Facilities and Emergency Medical Services Division Same ALR license: 3 or more unrelated adults; no separate small-home license
Connecticut License required Residential Care Home (RCH) license Department of Public Health (DPH), Facility Licensing and Investigations Section Food, shelter and services for 2 or more unrelated residents; no set maximum
Delaware License required Family Care Home license Delaware Department of Health and Social Services (DHSS), Division of Health Care Quality (DHCQ) Home with beds and personal care for 2 or 3 residents
District of Columbia License required Community Residence Facility (CRF) license DC Department of Health (DC Health), Health Care Facilities Division Sheltered living for adults 18+; ID group homes 4 to 8 (new ones closed)
Florida License required Adult Family-Care Home (AFCH) license Agency for Health Care Administration (AHCA) 1 to 5 residents in a home the provider lives in
Georgia License required Personal Care Home permit Department of Community Health, Healthcare Facility Regulation Division (HFRD) 2 or more unrelated adults; personal care home permit
Hawaii License required Adult Residential Care Home (ARCH) license Department of Health (DOH), Office of Health Care Assurance (OHCA) Type I: up to 5 residents (6 with DOH approval); Type II: 6 or more
Idaho License required Certified Family Home (CFH) certification Idaho Department of Health and Welfare, Certified Family Home Program 1 to 4 adults in the provider's home; 2 without a variance
Illinois License required Shared Housing Establishment license Illinois Department of Public Health (IDPH), Division of Assisted Living Free-standing home for 16 or fewer residents, 80% age 55 or older
Indiana Medicaid/Medicare certification only Adult Family Care (Medicaid waiver service) Indiana FSSA, Office of Medicaid Policy and Planning (HCBS certification) Up to 4 waiver participants with an unrelated live-in caregiver; no license
Iowa License required Elder group home certification Iowa Department of Inspections, Appeals, and Licensing (DIAL), Health Facilities Division 3 to 5 unrelated elders in a single-family home; manager on site 24/7
Kansas License required Home Plus (adult care home license) Kansas Department for Aging and Disability Services (KDADS), Adult Care Home Licensure Up to 12 unrelated adults needing personal care; no minimum size
Kentucky License required Family Care Home License Cabinet for Health and Family Services (CHFS), Office of Inspector General, Division of Health Care No more than 3 unrelated residents; certificate of need exempt
Louisiana License required Adult Residential Care Provider (ARCP) License, Level 1 Louisiana Department of Health (LDH), Health Standards Section 2 to 8 unrelated residents in a home-style setting
Maine License required Residential Care Facility License Maine DHHS, Division of Licensing and Certification (DLC), Assisted Housing Program Assisted living services to unrelated adults in bedrooms; any size
Maryland License required Assisted Living Program License Maryland Department of Health (MDH), Office of Health Care Quality (OHCQ) Same assisted living license as larger facilities, from 2 residents
Massachusetts License required Rest Home license Department of Public Health (DPH), Division of Health Care Facility Licensure and Certification Rest home: 4+ ambulatory people; 3+ unrelated adults is assisted living
Michigan License required Adult Foster Care (AFC) facility license Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems, Adult Foster Care Family home 3-6 adults; group homes 3-12 or 13-20; over 20 congregate
Minnesota License required Adult Foster Care License (family adult foster care) Minnesota Department of Human Services (DHS), with county licensing agencies Foster home for 1-4 adults (5-6 if approved); moratorium applies
Mississippi License required Adult Foster Care Facility license Mississippi State Department of Health, Health Facilities Licensure and Certification Home-style personal care; no set limit, license states the bed count
Missouri License required Residential Care Facility (RCF) license Missouri Department of Health and Senior Services (DHSS), Section for Long-Term Care Regulation 3 or more unrelated residents, 24-hour care; no separate small-home license
Montana License required Adult Foster Care Home license Montana DPHHS, Office of Inspector General, Licensure Bureau 4 or fewer unrelated disabled or aged adults; light care only
Nebraska License required Assisted Living Facility (ALF) license (no separate small-home license) Nebraska DHHS, Licensure Unit, Health Care Facilities Licensing Same ALF license from 4 unrelated residents; no separate small-home license
Nevada License required Home for Individual Residential Care (HIC) license Nevada Health Authority, Health Care Purchasing and Compliance Division (HCQC) 1 or 2 unrelated aged, infirm or disabled residents in your own home
New Hampshire Medicaid/Medicare certification only Adult Family Care Residence (AFCR) certification DHHS, Health Facilities Administration (certification under He-P 813 for the Choices for Independence Medicaid waiver) 1 or 2 residents in the provider's home; certified, not licensed
New Jersey License required Adult Family Care (AFC) caregiver license Department of Health (DOH), Certificate of Need and Licensing Division No more than 3 residents in a licensed, trained caregiver's own home
New Mexico License required Assisted Living Facility license (same license as larger facilities) New Mexico Health Care Authority (HCA), Division of Health Improvement Same assisted living license from 2 adults; no separate small-home license
New York License required Family type home for adults certification Office of Children and Family Services (OCFS), Bureau of Adult Services, with applications filed through the county department of social services 4 or fewer unrelated adults in your own home
North Carolina License required Family Care Home License NC DHHS, DHSR Adult Care Licensure Section (application through the county department of social services) Adult care home with 2 to 6 residents; no certificate of need
North Dakota License required Foster home for adults license (adult foster care) North Dakota HHS, Adult and Aging Services Up to 4 unrelated adults in an owned or leased private home
Ohio License required Class Two Residential Facility license Ohio Department of Behavioral Health (DBH) Housing and personal care for 3 to 16 unrelated adults
Oklahoma License required Residential Care Home license Oklahoma State Department of Health (OSDH), Protective Health Services, Health Facility Systems Unrelated residents needing supportive help only; no statutory bed cap
Oregon License required Adult Foster Home (AFH) license Oregon Department of Human Services (ODHS), Aging and People with Disabilities, APD Adult Foster Home Licensing (local licensing authorities) 1 to 5 adults not related to the provider, in a family home
Pennsylvania Medicaid/Medicare certification only Domiciliary care home certification Department of Aging, through the local Area Agency on Aging No small-home license; 4+ adults need a personal care home
Rhode Island License required Adult Supportive Care Home license Rhode Island Department of Health (RIDOH) 2 to 5 unrelated adults; only existing licensed providers may operate
South Carolina License required Community Residential Care Facility (CRCF) license South Carolina Department of Public Health (DPH), Healthcare Quality Same CRCF license from 2 unrelated adults; no separate small-home license
South Dakota License required Adult Foster Care Home license or Community Living Home license Department of Health (DOH), Office of Health Facilities Licensure and Certification Family-style home for up to 4 adults (foster care or community living)
Tennessee License required Home for the Aged license (Adult Care Home - Level 2 license for ventilator-dependent or brain-injured residents) Tennessee Health Facilities Commission (HFC), Division of Licensure and Regulation Home for the Aged: 4+ unrelated residents, mostly older adults
Texas License required Assisted Living Facility license (no separate small-home license) Texas Health and Human Services Commission (HHSC), Long-term Care Regulation Same assisted living license from 4 residents
Utah License required Limited Capacity Assisted Living Facility (same Assisted Living Facility license, Type I or Type II) Utah Department of Health and Human Services (DHHS), Division of Licensing and Background Checks, Office of Licensing 2 to 5 residents, under the assisted living license
Vermont License required Residential Care Home license (Level III or Level IV) Vermont Department of Disabilities, Aging and Independent Living (DAIL), Division of Licensing and Protection Room, board and personal care for 3 or more unrelated residents
Virginia Medicaid/Medicare certification only Adult Foster Care (approved provider of a local department of social services) Local departments of social services, under VDSS Adult Services Up to 3 adults in the provider's home; 4+ needs assisted living license
Washington License required Adult Family Home License Department of Social and Health Services (DSHS), Residential Care Services 2 to 6 unrelated adults in a home; up to 8 with DSHS approval
West Virginia Registration required Legally Unlicensed Health Care Home registration West Virginia Office of Inspector General, Office of Health Facility Licensure and Certification (OHFLAC) 1 to 3 residents; free registration, 4+ need a license
Wisconsin License required Adult Family Home license (3-4 beds) Department of Health Services (DHS), Division of Quality Assurance, Bureau of Assisted Living 3 or 4 unrelated adults in a home; up to 7 hours nursing a week
Wyoming License required Adult foster care home license Wyoming Department of Health, Healthcare Licensing and Surveys (HLS) Home caring for up to 5 unrelated adults needing long-term care

License names link to our guide where we have one, otherwise to the agency’s own page. Agency names and size thresholds are shortened here; state hubs give them in full.

Small residential care home guides

All guides

  1. Georgia personal care home permit: from two residents to 25 beds and beyond

    How to get a Georgia personal care home permit from DCH: the two-resident trigger, the 25-bed line, sprinklers at 7 beds, GAHLES application, fees and staffing.

    Georgia · Small residential care homeUpdated

  2. Maine residential care facility license: one license from a single bed up, under Ch. 113 Part B

    Maine residential care facilities: who needs the DLC license, the $10-per-bed fee, fire marshal approval by bed count, RN visits, staffing ratios and the 2025 rule.

    Maine · Small residential care homeUpdated

  3. Oregon adult foster home license: classes, the live-in rule and the local licensing office

    Oregon adult foster homes for up to five older or physically disabled adults: Class 1-3 rules, EQC training, the $20 bed fee, evacuation drills and Multnomah County.

    Oregon · Small residential care homeUpdated

  4. Rhode Island adult supportive care homes: 2 to 5 residents, existing providers only

    Rhode Island adult supportive care homes: the 2-5 resident range, which existing RIDOH license you need first, the manager and staffing rules, inspections and fines.

    Rhode Island · Small residential care homeUpdated

  5. Wisconsin adult family home license: the 3-4 bed DHS 88 license, step by step

    How to license a 3-4 bed adult family home in Wisconsin: DHS 88 rules, the $171 fee, ambulatory designations, the DQA Provider Portal and the pending rule rewrite.

    Wisconsin · Small residential care homeUpdated

  6. California Adult Residential Facility (ARF) license: board and care for adults 18 to 59

    How CDSS licenses board and care homes for adults 18 to 59 with disabilities: the 35-hour administrator certificate, zoning, the 300-foot rule, fees and regional centers.

    California · Small residential care homeReviewed

  7. Arkansas residential care facility license: the 2005 bed moratorium and the buy-in route

    Arkansas RCF licensing: the bed moratorium since 2005, buying an existing RCF, the $5-per-bed fee, staffing by census, room sizes and Medicaid personal care.

    Arkansas · Small residential care homeReviewed

  8. Connecticut residential care home license: DSS certificate of need first, then DPH

    Opening a Connecticut residential care home: the DSS certificate of need, DPH licensing under 19-13-D6, the 1:25 attendant rule, room sizes, med certification and fees.

    Connecticut · Small residential care homeReviewed

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

    Delaware family care homes: the 2-3 resident limit, the live-in rule, the $50 DHCQ fee, the six-month initial license, room sizes, TB testing and fines.

    Delaware · Small residential care homeReviewed

  10. DC community residence facility license: three regulators, an old rulebook, an online application

    Licensing a community residence facility in Washington, DC: which CRFs are still licensed, Residence Director rules, bed-based fees, insurance and fire safety.

    District of Columbia · Small residential care homeReviewed

  11. Florida adult family-care home license: the live-in rule, five residents, and AHCA approval

    Florida adult family-care homes: the live-in provider rule, the five-resident cap, the $226.34 AHCA fee, fire drills, zoning, training and admission rules.

    Florida · Small residential care homeReviewed

  12. Hawaii adult residential care home (ARCH) license: Type I, Type II and the expanded ARCH

    How to license a Hawaii ARCH: Type I and Type II capacity, nurse aide caregiver rules, ARCH modules, $350 fee, building and fire rules, and the expanded ARCH route.

    Hawaii · Small residential care homeReviewed

  13. Idaho certified family home: certification to care for up to four adults in your own home

    Idaho certified family homes: who must be certified, the two-resident limit and variance, the $150 fee and $25 monthly fee, training, home standards and steps.

    Idaho · Small residential care homeReviewed

  14. Illinois shared housing establishment license: the 16-resident senior home under IDPH

    How to license a shared housing establishment in Illinois: the 16-person and 80%-over-55 tests, the $1,000 IDPH fee, staffing, bathroom ratios and the steps.

    Illinois · Small residential care homeReviewed

  15. Iowa elder group home certification: three to five elders, a 24-hour manager, and DIAL approval

    Iowa elder group homes: the 3-to-5-elder rule, 24/7 on-site manager, $750 DIAL certification fee, room sizes, fire approval, tenant limits and renewal.

    Iowa · Small residential care homeReviewed

  16. Kansas Home Plus license: the 12-resident adult care home, its operator, and KDADS approval

    How to license a Kansas Home Plus: the 12-resident cap, operator registration, K.A.R. 26-42 care rules, fire marshal review, the $100 + $30 per bed fee and steps.

    Kansas · Small residential care homeReviewed

  17. Kentucky family care home license: three residents, a $42 fee and no certificate of need

    Kentucky family care homes: the three-unrelated-resident cap, operator rules, house standards, the $42 OIG fee, inspections and state supplementation payments.

    Kentucky · Small residential care homeReviewed

  18. Michigan adult foster care license: family homes, group homes and LARA approval

    How Michigan licenses adult foster care homes: the four size classes, the November 2025 rules, LARA fees, the seven-bed fire approval, zoning, staffing and steps.

    Michigan · Small residential care homeReviewed

  19. Minnesota adult foster care license: the live-in rule, four beds and county-led licensing

    Minnesota adult foster care: the moratorium that limits new licenses to live-in homes, the four-bed cap, the $2,100 DHS fee, the 2026 colocation ban, and county steps.

    Minnesota · Small residential care homeReviewed

  20. Mississippi adult foster care facility license: rules on the books, no homes listed

    Mississippi adult foster care facilities: the three license classes, MSDH Chapter 83 rules, staffing, sprinklers, admission limits and the Residential Living alternative.

    Mississippi · Small residential care homeReviewed

  21. Missouri residential care facility license: the five-minute evacuation rule and the CON check

    How to license a Missouri residential care facility: the 3-resident threshold, RCF vs ALF, sprinklers, staffing, the $100 DHSS fee, CON letter of intent and Medicaid.

    Missouri · Small residential care homeReviewed

  22. Montana adult foster care home license: four residents, light care, and the DPHHS steps

    Montana adult foster care homes: the four-resident cap, light-care limits, background checks, bedroom and fire rules, the six-month provisional license and waiver pay.

    Montana · Small residential care homeReviewed

  23. Nevada home for individual residential care license: two residents, one director, full HCQC rules

    Nevada licenses even a one- or two-resident care home. Who needs an HIC license, director rules, surety bond, training, zoning, the $1,764 fee and HCQC steps.

    Nevada · Small residential care homeReviewed

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

    How New Jersey licenses adult family care caregivers under N.J.A.C. 8:43B: the three-client cap, the sponsor agency contract, $200 fees, home standards and inspections.

    New Jersey · Small residential care homeReviewed

  25. New York family-type home for adults: certification through your county and OCFS

    How to get certified to run a New York family-type home for adults: the four-resident limit, county DSS application, OCFS approval, room sizes, fire rules and timelines.

    New York · Small residential care homeReviewed

  26. North Carolina family care home license: two to six residents, county DSS first, no CON

    Licensing a North Carolina family care home: county DSS intake, DHSR construction review, the 120-hour administrator path, building rules, fees and the first license.

    North Carolina · Small residential care homeReviewed

  27. North Dakota foster home for adults: licensing a live-in home for up to four adults

    How North Dakota licenses adult foster care homes: the four-resident cap, live-in and QSP rules, background checks, bedroom sizes, relief-care limits and the daily rate.

    North Dakota · Small residential care homeReviewed

  28. Ohio Class Two residential facility license: the behavioral health route for 3-16 adults

    How to license an Ohio Class Two residential facility with the Department of Behavioral Health: who needs one, the $75 fee, inspections, room sizes, staffing and RSS.

    Ohio · Small residential care homeReviewed

  29. Oklahoma residential care home license: probation first, a licensed administrator, no nursing

    Licensing an Oklahoma residential care home: who qualifies, the 120-day probationary license, $50 fee, Tier 2 administrator, fire marshal approval and Chapter 680 rules.

    Oklahoma · Small residential care homeReviewed

  30. South Dakota adult foster care home license: four adults, a resident owner, and DOH approval

    How to license a South Dakota adult foster care home: the 4-adult cap, the live-in owner rule, ARSD 44:77 admission limits, fire code, training and the DOH application.

    South Dakota · Small residential care homeReviewed

  31. Tennessee home for the aged license: Tier 1 through DDA, Tier 2 through the HFC

    Tennessee residential homes for the aged: the 2026 five-resident Tier 1 line, DDA versus HFC licensing, fees, administrator certification, surveys and building rules.

    Tennessee · Small residential care homeReviewed

  32. Vermont residential care home license: Level III or Level IV, from three residents up

    How DAIL licenses Vermont residential care homes: the three-resident threshold, Level III vs Level IV, room and bath rules, manager rules, staffing and the application.

    Vermont · Small residential care homeReviewed

  33. Washington adult family home license: six beds, a live-in manager and DSHS approval

    How to license a Washington adult family home: the 2-6 resident cap, provider training and 1,000-hour rule, building and evacuation standards, and DSHS fees.

    Washington · Small residential care homeReviewed

  34. West Virginia legally unlicensed health care home: registering a 1-to-3 resident care home

    How West Virginia registers care homes for one to three adults: the free OHFLAC registration, WV CARES fingerprints, the one-home rule, nursing limits and penalties.

    West Virginia · Small residential care homeReviewed

  35. Wyoming adult foster care home license: a capped pilot program for five residents

    How Wyoming licenses adult foster care homes: the pilot-project cap, the five-resident limit, the $250 HLS fee, RN contract, fire rules and the 2008 Chapter 13 rule.

    Wyoming · Small residential care homeReviewed

Beyond the state licenseEntity and EIN, caregiver pay rules, NPI, Medicaid or Medicare enrollment, EVV and background checks.Certificate of need by stateWhich states make home health, assisted living or adult day founders prove need before licensing.

Other care business types

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