What Is an RCFE? Residential Care Homes in California Explained

What an RCFE is

An RCFE, or Residential Care Facility for the Elderly, is California’s license category for what most people call assisted living or a board and care home. The state’s own consumer guide uses all three names for the same thing. An RCFE provides housing, meals and help with daily life for older adults. It is not a medical facility.

You’ll see the term on state records, on the license posted inside each home, and on every listing in our California directory. This guide explains what the license covers, what it doesn’t, and what to check before you visit.

What the law says

California’s regulations (Title 22, section 87101) define an RCFE as “a housing arrangement chosen voluntarily by the resident,” or by a guardian, conservator or other responsible person, “where 75 percent of the residents are sixty years of age or older and where varying levels of care and supervision are provided.” The level of care is agreed at admission and can change when the resident is reassessed later.

So the home is mainly for people 60 and older. Younger residents can live there too if their needs are compatible with the other residents’.

The 75 percent figure comes from the regulation. The Health and Safety Code, the law that sets up the licensing program, describes the same kind of home for people 60 or older but doesn’t repeat that number.

“Care and supervision” means non-medical help

The phrase at the center of the license is “care and supervision.” Under state law, it means the home takes responsibility for ongoing help with activities of daily living, without which the resident’s physical health, mental health, safety or welfare would be at risk. That help includes taking medications, managing money and personal care.

The regulations get specific. Care and supervision covers help with dressing, grooming and bathing; help taking medication, and central storage and distribution of medications; arranging medical and dental care, which can include transportation; house rules; supervision of schedules and activities; looking after residents’ money or property; and monitoring food intake or special diets.

None of that is medical treatment. Title 22 places RCFEs among community care facilities, which provide “nonmedical care and supervision.” The California Department of Social Services (CDSS) draws the line the same way: skilled nursing facilities are licensed to provide health care, and RCFEs are licensed for non-medical care. An RCFE may allow incidental medical services from a licensed home health agency when certain conditions are met. If you’re weighing the two settings, see RCFE vs. nursing home.

A place that rents a room and serves meals but offers no care and supervision isn’t an RCFE. Title 22 calls that “room and board.”

What every RCFE must provide

CDSS lists the basic services that all RCFEs must provide, citing Title 22:

• Care and supervision
• Safe and healthful living accommodations and services
• Three nutritionally well-balanced meals and snacks every day, including low-salt or other modified diets a doctor prescribes as medically necessary
• Personal help as needed with activities like dressing, eating, bathing and taking prescribed medications
• Regular observation of the resident’s physical and mental condition
• Arrangements to meet health needs, including transportation
• A planned program of social and recreational activities

These are minimums. When you compare homes, ask each one what its monthly rate covers and what it charges for separately. Paying for assisted living in California has a list of cost questions.

Who licenses them

RCFEs are licensed by the Community Care Licensing Division of CDSS. Its authority comes from the Health and Safety Code, starting at section 1569, and from Title 22. Inside that division, the Senior Care Licensing Program licenses and monitors RCFEs and Continuing Care Retirement Communities. CDSS says the program has 14 regional offices around the state.

No one may operate an RCFE in California without a current valid license or special permit. By law, the state’s inspection reports on licensed homes are open to the public. How to check a California care home’s license and inspection reports shows how to find and read them.

Most RCFEs are six-bed homes

CDSS notes that some RCFEs care for six residents or fewer and others for more than a hundred. The state’s licensing data shows how the homes are spread across that range. As of May 25, 2025, according to state licensing data, California had 7,939 licensed RCFEs with a combined licensed capacity of 207,618 beds. Of those, 6,265 homes, or 79%, were licensed for six beds or fewer.

Licensed capacity	Licensed RCFEs
6 beds or fewer	6,265
7 to 15 beds	320
16 to 49 beds	292
50 to 99 beds	368
100 beds or more	694

So most of the licensed options in a California search are small homes. Size doesn’t change the license, though. A six-bed home and a 100-bed community hold the same type of license, must provide the same basic services, and face the same limits on the health conditions they can accept. What does vary from one home to the next, such as staffing, activities and the daily routine, is worth asking about directly and seeing for yourself on a visit.

The same data shows licensed RCFEs in 48 counties and 557 cities. The counties with the most are Los Angeles (1,648), Orange (1,054), Sacramento (634), San Diego (581) and Riverside (530).

Continuing Care Retirement Communities

An RCFE can also be part of a larger setting called a Continuing Care Retirement Community (CCRC). CDSS describes a CCRC as a place that can combine independent living, assisted living and skilled nursing. The assisted living part is the RCFE. The skilled nursing units provide medical services and are licensed separately by the California Department of Public Health.

What makes a CCRC different is the contract. By statute, a CCRC is where the services promised in a continuing care contract are provided, and a continuing care promise covers care for life or for more than one year. CDSS says most of these contracts charge an entrance fee plus monthly fees. Its Continuing Care Contracts Bureau approves applications to operate a CCRC and oversees financial and contract compliance.

The state’s licensing data lists 132 facilities as RCFE Continuing Care Retirement Communities.

What an RCFE can’t take on

Because an RCFE is non-medical, Title 22 limits the health conditions it can handle. A home may not admit or keep a resident who has, or needs care for, any of these:

• Stage 3 or 4 pressure injuries
• Gastrostomy tubes
• Naso-gastric tubes
• A staph infection or other serious infection
• Dependence on others for all activities of daily living
• Tracheostomies

The regulation says “including, but not limited to,” so the list isn’t complete. A home also may not accept or keep someone with active communicable tuberculosis, or someone who needs 24-hour skilled nursing or intermediate care. Care at the end of life follows its own rules, covered in hospice care in a California residential care home.

Other conditions are allowed under specific rules. Title 22 calls them “restricted health conditions.” They include oxygen, catheter care, colostomy or ileostomy care, contractures, diabetes, enemas and suppositories, incontinence, injections, breathing machine (IPPB) use, stage 1 and 2 pressure injuries, and wound care. Residents can also get medical care outside the home or from a visiting nurse. The regulations say the aim is to let residents “age in place in the least restrictive environment when appropriate.”

If your parent has one of these conditions now, or is likely to, ask each home whether it accepts residents with it before you go further.

What to check next

Start with the license. Every listing in our directory shows the license number, and the license check guide explains how to look up the home’s inspection and complaint reports.

Then match the home to your parent’s health, using the limits above. After that, look at cost with the questions in the payment guide.

Our directory is built from state licensing data. Data sources explains where it comes from.