Senior Living Guide
Residential Care Homes
Residential care homes — also called board and care homes, adult family homes, or in California, RCFEs with six beds or fewer — provide assisted-living-style care in a single-family house. A small number of residents, usually two to ten, live together with caregivers who are on site around the clock.
The appeal is intimacy. Meals are home-cooked, caregivers know each person's habits, and the day is less structured than in a large community. The trade-off is fewer amenities and activities, and quality that depends heavily on the individual owner.
Who it fits
- Someone who would be overwhelmed by a large community and does better in a quiet, familiar setting.
- A person with higher personal-care needs who benefits from a caregiver who is rarely more than a room away.
- Those with moderate dementia who don't need a locked unit but need steady supervision.
- Families looking for a lower price point than a large assisted living community.
What's typically included
- A private or shared bedroom in a residential house.
- All meals, cooked in the home, plus snacks.
- Help with bathing, dressing, medications, and mobility.
- Laundry and housekeeping.
- Simple activities — games, TV, garden time, outings — rather than a full program.
What it costs
Residential care homes are often 20–40% less than a comparable assisted living community, commonly $3,500–$6,000 a month, with a private room and higher care levels at the top of the range. Pricing is usually simpler — one monthly rate rather than tiered add-ons.
Payment sources mirror assisted living: private pay, long-term care insurance, VA benefits, and in some states a Medicaid waiver or supplemental payment program.
How to choose
- Check the license and inspection history — in California every RCFE, regardless of size, has a public CDSS record.
- Meet the owner and the caregivers who work overnight; in a small home they are the whole experience.
- Ask how many residents share each caregiver, awake and overnight.
- Look at the other residents. A good match in care level and temperament matters more in a house of six than a building of 100.
Questions to ask on a tour
- 1.How many residents live here, and how many caregivers are on duty during the day and overnight?
- 2.Is the overnight caregiver awake or asleep?
- 3.Who cooks, and can I see a week of menus?
- 4.What do residents do during the day? Are there outings?
- 5.Can I see the most recent state inspection report and any citations?
- 6.What would cause you to ask a resident to move out?