Memory Care Staffing and Dementia Training Rules in California

Health and Safety Code section 1569.626 sets the hours, and it opens with the words "all residential care facilities for the elderly." That is the license held by assisted living communities and board and care homes, also called residential care facilities for the elderly (RCFEs). The training is owed to all direct care staff, whether or not the home markets itself as memory care.

The dementia hours sit inside the general caregiver training in section 1569.625: 40 hours at the start and 20 hours each year. The general rules, including the administrator's qualifications, are in our guide to assisted living staffing requirements.

The dementia care hours are:

The statutes and Title 22, section 87705, name the subjects. The yearly training must be developed with people or organizations that have specific expertise in dementia care.

One more statute speaks to late-day confusion. Health and Safety Code section 1569.7 says homes that serve residents with Alzheimer's disease and other dementias should include information on sundowning in direct care staff training. Our guide to sundowning and behavior changes explains what that looks like in a home.

The required subjects include:

• Hydration, nutrition and skin care.
• Communication and therapeutic activities.
• Behavior, the environment and help with activities of daily living.
• Recognizing things that can set off or worsen behavior, such as dehydration, urinary tract infections and swallowing problems.
• The effects of medications commonly used to reduce behavior, and the use and misuse of antipsychotics.
• Person-centered approaches to dementia care that do not rely on medication.

Not quite. Section 1569.625 treats licensed and certified health professionals differently. A registered nurse, licensed vocational nurse or certified nurse assistant with a valid license or certificate receives eight hours of training on resident characteristics, resident records and the home's practices and procedures before giving direct care.

A certified nurse assistant must also complete the 12 hours of dementia care training and the yearly training. California does not require a memory care home to employ nurses at all, so ask each home whether it has one and during which hours.

No. In its August 2025 questions and answers on the dementia care regulations, the California Department of Social Services states that the requirements for sufficient staffing were not changed by the 2025 update. Title 22, section 87411, still requires that facility personnel be sufficient in numbers at all times, and competent, to provide the services residents need. The department may require a home to add staff when residents' needs, the services offered or the building layout call for it.

The dementia rules add two points. When a resident who needs supervision still wants to go outside after staff try to redirect them, the home must let the resident go with staff supervision. The department's answer is that the home must have enough staff for that walk and for the residents who stay inside. Section 87705 also says delayed-egress devices, locked doors and locked gates may not substitute for trained staff in sufficient numbers.

It depends on the size of the home and the needs of its residents. Title 22, section 87415, requires a home with 16 to 100 residents to have at least one employee awake and on duty at night. A home with fewer than 16 residents needs a qualified person on call on the premises. That rule does not say the person must be awake.

Section 87705 changes that for small homes with residents who have dementia. At least one night staff person must be awake and on duty if any resident with dementia is found, through a pre-admission appraisal, a reappraisal or observation, to need awake night supervision. The department confirms the 2025 update kept this rule and did not make awake staff automatic in every six-bed home.

So the answer for one home can change when one resident's needs change. If your father is up and walking at night, say so during the appraisal and ask how the home will staff for it.

The law gives hours and a standard, not a number of caregivers. The home's own answers fill the gap. A home that advertises dementia care must describe its staff training in its plan of operation, and that information is available to the public on request. More tour questions are in questions to ask a memory care home.

If you believe a home is leaving residents without supervision and someone is in immediate danger, call 911. Concerns about staffing in a licensed home can be reported to California's Community Care Licensing Division.

• How many caregivers are on each shift in the memory care area, and for how many residents?
• Is the night caregiver awake? Who decided that, and when was it last reviewed?
• Who provides your dementia training, and how do you record the 12 initial hours and 8 yearly hours?
• How long have the caregivers on this unit worked here?
• When a resident wants to go outside, who goes with them, and who stays with the others?
• May I read the staff training part of your dementia program description?

Hamssa Benrekia is a senior living placement specialist in Torrance who holds an RCFE Administrator Certificate, so she knows these training rules from the operator's side. She helps families in the South Bay and Harbor area of Los Angeles County compare licensed homes and goes on tours with them, where staffing questions get asked in person. To talk about memory care placement, contact Hamssa. For the full set of rules, see California's dementia care rules and the California Assisted Living Placement Guide.