Key points
- Assisted living communities and board and care homes hold the same California licence, called an RCFE.
- Skilled nursing facilities are medical facilities with a different licence. Independent living that offers only housing and meals is generally not licensed as care.
- Look up any home's licence and inspection history on the state's facility search before you visit.
- Most people pay for assisted living themselves. Medicare does not pay for long-term care.
- Costs vary by home, room and care level, so compare written quotes for the same level of care.
What types of senior living are there in California, and who licenses each?
The names on the brochures overlap, so it helps to sort homes by licence. Families say "assisted living" or "board and care". The state calls both an RCFE, its licence category for residential care homes that serve older adults.
| Type | What it provides | Who licenses it |
|---|---|---|
| Assisted living community or board and care home (RCFE) | Non-medical care: supervision, meals, help with dressing, bathing and taking medication, activities. Sizes run from six residents or fewer to more than a hundred. | California Department of Social Services, Community Care Licensing Division |
| Memory care | An RCFE set up for people living with dementia. It is not a separate licence. | Same as other RCFEs |
| Continuing care retirement community (CCRC) | Independent living, assisted living and skilled nursing, usually on one campus, under a long-term contract. | Department of Social Services for the contract and the assisted living; Department of Public Health for the skilled nursing unit |
| Skilled nursing facility (nursing home) | Health care: nursing, 24-hour supervision and rehabilitation therapy. | California Department of Public Health |
| Independent living | Housing, often with meals and housekeeping, and no personal care. | Generally not licensed as a care facility |
How do you check an assisted living licence and inspection reports?
A licensed home must post its licence where the public can see it. The Community Care Licensing Division also runs a public facility search that shows each home's licence status, the date it was licensed, visits, complaints and licensing reports. For the full public file, including citations and civil penalties, you can contact the division's regional office.
It is worth doing for every home on your list. Our step-by-step guide shows how to check an RCFE licence and how to read the reports.
What does assisted living cost?
CareScout's Cost of Care Survey, carried out from July through November 2025, put the national median cost of an assisted living community at $6,200 a month. That is a national midpoint for 2025, not a quote for any home in California. Costs vary by home, by room type and by care level.
Most homes charge a base rate and add to it as care needs rise, so two quotes are only comparable if they cover the same level of care. Dementia care usually costs more. See board and care costs in California for how rates are built, and memory care vs. assisted living for what the extra pays for.
How do families pay for assisted living?
The National Institute on Aging says most people pay the full cost of assisted living themselves. These are the four sources families ask about most. Each has its own rules, so confirm the details with the insurer, the VA, the county or an elder law attorney.
- Private funds. This is how most residents pay, from income and savings.
- Long-term care insurance. The National Institute on Aging notes that some long-term care policies partly cover assisted living. Read the policy or call the insurer to find out what triggers benefits and how much it pays per day.
- VA Aid and Attendance. The VA describes this as a monthly payment added to a VA pension for qualified Veterans and survivors who, for example, need help with daily activities such as bathing and dressing. The VA decides who qualifies.
- Medi-Cal Assisted Living Waiver. According to California Advocates for Nursing Home Reform, as of 2026 this program pays for care in participating RCFEs for people with full-scope Medi-Cal who need a nursing facility level of care. It operates in 15 counties, including Los Angeles, residents pay their own room and board, and wait times are long. Our Assisted Living Waiver guide has the details.
Does Medicare cover assisted living?
No. Medicare states plainly that it does not pay for long-term care, and it lists care in an assisted living facility as an example of long-term care. You pay all costs for services Medicare does not cover.
Medicare also notes that long-term care is different from skilled nursing facility care. Medicare explains that benefit on a separate page. If your parent is in a hospital or rehab now, ask the discharge planner what Medicare is covering and until when.
What should you ask on an assisted living tour?
A tour is where the brochure meets the building. Watch how staff talk with residents, and ask about four things: staffing on each shift, how care levels are assessed and priced, how and when rates go up, and what happens if your parent needs more care than the home can give.
Ask for a blank copy of the admission agreement to read at home. Our assisted living tour checklist has the full list of questions.
When does a senior placement agency help?
A placement agency, also called a referral agency, is most useful when time is short, when you live far from your parent, or when you do not know the local homes. Hamssa Benrekia is a senior living placement specialist in Torrance who works with families across the South Bay. She starts with a conversation about care needs, preferences and monthly budget, shortlists homes that fit, and goes on the tours with you.
She helps families find assisted living, board and care homes, memory care and independent living, and refers only to homes licensed by the State of California that she has toured herself, after checking each one’s licensing record for citations and complaints. Contact Hamssa to talk through your situation.
Common questions
What is the difference between assisted living and a board and care home in California?
Size and feel, not the licence. Both are licensed by the California Department of Social Services as RCFEs and must provide the same basic services. A board and care home is small, often around six residents, and rooms may be shared. Larger assisted living communities usually offer private apartments and often have different fee options depending on the care needed.
Who regulates assisted living in California?
The Community Care Licensing Division of the California Department of Social Services licenses and oversees RCFEs, which include assisted living communities and board and care homes. It carries out inspection visits, investigates complaints and requires staff background checks. Skilled nursing facilities are overseen separately by the California Department of Public Health.
Does Medi-Cal pay for assisted living in California?
Not in the ordinary way. According to California Advocates for Nursing Home Reform, Medi-Cal pays for assisted living care only through the Assisted Living Waiver, which as of 2026 operates in 15 counties including Los Angeles, has limited capacity and a waitlist, and does not cover room and board. The Department of Health Care Services runs the program. Ask a Care Coordination Agency in your county about eligibility.
How much does assisted living cost per month?
It depends on the home, the room and the level of care. For a national reference point, CareScout's 2025 Cost of Care Survey put the median for an assisted living community at $6,200 a month. Individual California homes can be well above or below that, so ask each home for a written quote based on an assessment of your parent.
Sources
Official pages this page relies on. Rules and programs change, so check the source for the current version.
- California Department of Social Services: Choosing a Residential Care Facility for Seniors in California, A Guide for Consumers
- California Advocates for Nursing Home Reform: Overview of Assisted Living/Residential Care Facilities for the Elderly (RCFEs)
- CareScout: Cost of Care Survey (July through November 2025)
- National Institute on Aging: Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care
- U.S. Department of Veterans Affairs: VA Aid and Attendance Benefits and Housebound Allowance
- California Advocates for Nursing Home Reform: Assisted Living Waiver (ALW) (updated February 24, 2026)
- Medicare.gov: Long-Term Care Coverage
This guide is general information, not medical, legal or financial advice. Program rules and costs change; confirm details with the agency named in the sources.