Alcohol, Smoking and Cannabis in California Assisted Living: The Rules

It depends on the home. Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs). The RCFE regulations in Title 22 do not contain a general rule that permits or forbids a resident's glass of wine or a cigarette on the patio. They deal with storage and safety, and they leave the rest to each home's written policies.

Those policies have limits. The Resident's Bill of Rights, Health and Safety Code section 1569.269, gives residents the right to make choices concerning their daily life in the home, to keep and use their own personal possessions, and to reasonable accommodation of individual needs and preferences, except when the health or safety of the individual or other residents would be endangered.

The same section gives a resident the right to be fully informed of all rules governing residents' conduct, shown by a written acknowledgment before or at admission. Section 1569.885 adds that facility rules must be reasonable, that there must be a procedure for suggesting changes, and that a rule may not violate a resident's rights. The full list of rights is in our guide to resident rights in a California RCFE.

The storage regulation, Title 22 section 87309, names these items directly. It says:

• The home must take reasonable steps so that alcohol, cigarettes and other potentially toxic substances are stored in a way that does not pose a hazard to residents.
• Matches belong with the items that are kept in locked storage because they could pose a danger.
• Residents may have access to these items for personal use, unless the pre-admission appraisal or a later reappraisal documents that the resident's safety, or other residents' safety, would be at risk.
• Because of the physical layout of the home, or the condition or habits of other residents, the home may require these items to be centrally stored.

The starting point in that regulation is access for personal use. A home that holds a resident's cigarettes or locks up a bottle should be able to point to the appraisal that documents the risk, or to the conditions in the house that call for central storage. If your relative is living with dementia, ask how the home decides this and how often it reviews the decision.

One smoking rule in the RCFE regulations is absolute. Under Title 22 section 87618, when a resident uses oxygen, smoking is prohibited where the oxygen is in use and the home must post "No Smoking-Oxygen in Use" signs. More on that rule is in our guide to oxygen in assisted living.

California's workplace smoking law also matters, because a care home is a workplace for its staff. Labor Code section 6404.5 prohibits smoking tobacco products in enclosed places of employment. The section lists exceptions, including private residences, and it says an employer may prohibit smoking in an enclosed place of employment for any reason. How the law applies to a resident's own room is a legal question, not one this page can answer.

In practice, ask each home three things: whether smoking is allowed anywhere on the property, where the outdoor smoking area is, and whether a resident who needs help or supervision to smoke can get it. Ask too whether the home accepts residents who smoke. Get the smoking policy in writing before move-in.

The RCFE regulations do not mention cannabis, so this too comes down to the home's written policy. Two state laws shape that policy.

First, Health and Safety Code section 11362.3 says California's adult-use cannabis law does not permit anyone to smoke cannabis in a location where smoking tobacco is prohibited. The section counts electronic smoking devices that create an aerosol or vapor as smoking.

Second, families sometimes hear about Ryan's Law, the Compassionate Access to Medical Cannabis Act. It requires a "health care facility" to permit certain patients to use medicinal cannabis. The definition in Health and Safety Code section 1649.1 points to listed kinds of licensed health facilities and to home health agencies. It does not name residential care facilities for the elderly. Do not assume that law gives a resident of an assisted living community or board and care home a right to use cannabis there.

If your relative uses cannabis products, ask the home whether it allows them, in what form, where they are stored, and whether staff will handle them. Ask the doctor how cannabis or alcohol may interact with your relative's medications.

House rules have teeth. Under Title 22 section 87224, one of the listed reasons a home may evict a resident is failure to comply with the general policies of the facility. The regulation sets conditions: the policies must be in writing, must be for the purpose of making it possible for residents to live together, and must be made part of the admission agreement. Thirty days' written notice is required for that ground.

This is why the rules on alcohol and smoking are worth reading before signing, not after. Our guide to the admission agreement explains what the contract must contain, and the notice and court steps are in California's assisted living eviction rules. This page is general information, not legal advice. The Long-Term Care Ombudsman or an elder law attorney can look at a specific dispute.

Hamssa Benrekia is a senior living placement specialist in Torrance. She helps families in the South Bay and Harbor area of Los Angeles County find licensed assisted living communities, board and care homes and memory care. If your dad smokes or your mother likes a drink with dinner, tell her at the start, so the short list includes only homes whose policies fit. She does not write or enforce a home's rules. More topics are in the California Assisted Living Placement Guide. To talk about a search, contact Hamssa.