Frequently Asked Questions

RCFE means "Residential Care Facility for the Elderly." It is the term California state laws use to refer to assisted living facilities. The terms 'RCFE' and 'assisted living' mean the same thing.  All RCFEs are licensed by the Department of Social Services (DSS), Community Care Licensing Division (CCL) and must comply with Title 22 regulations. RCFEs can be as small as 2 beds, or as big as 2,000 beds. 

Yes.  A 'Board and Care' facility is an RCFE.  Board and care is an out-dated term used to describe a small RCFE, located in a residential home, caring for 2 to 6 residents. An RCFE can be as small as 2 beds, and as large as 2,000:  each of them is a residential care facility for the elderly (RCFE). 

No. Independent living means a place where a person lives independently, making independent choices about how they live, what they do, and when they do it. A person living independently can have services such as care, supervision, help with medications, food preparation, or help in handling money from a third-party provider. The independent living setting is usually a house where several people live together. They share common rooms, but they have private or shared bedrooms. Independent living facilities are not licensed. When independent living units are attached to a Continuing Care Retirement Community (CCRC), they become part of the licensed RCFE.

Basic services provided by an RCFE include help with dressing, grooming, bathing, toileting, feeding and medications. In California, the assisted living facility cannot provide medical services. If a resident requires some types of medical services,  the resident will have to hire a skilled medical professional to provide those services in the RCFE. Third party services are not included in the monthly cost of the RCFE.

Yes, RCFEs are state licensed care facilities. To be licensed, a facility applies to Department of Social Services, Community Care Licensing Division (DSS/CCL) for a license. After the facility is licensed, it has to comply with all legal requirements and the Title 22 regulations for owning and operating an assisted living facility.

Assisted living facilities are licensed by Department of Social Services, Community Care Licensing Division (DSS/CCL).

To file a complaint about a facility call the HOTLINE of Department of Social Services, Community Care Licensing Division (DSS/CCL):

  • 1-844-LET-US-NO
  • 1-844-538-8766

You don't need to give your name when making a complaint. Just clearly tell what happened, and who at the facility was involved.

If you want to give your name and contact information, the State is supposed to send you a copy of the findings of the State's complaint investigation.  If they don't send you a copy of the complaint investigation findings, you can call CCL and ask that it be sent to you. 


If you See Something, Say Something.

For elder abuse or neglect of a resident occurring inside a licensed RCFE, you should immediately call a) 9-1-1, b) report the situation to local law enforcement, and c) call the DSS/CCL Hotline at 1-800-LET-US-NO.

Title 22 regulations refer to regulations contained in Title 22 of the California Code of Regulations.  These regulations implement the California Residential Care Facilities for the Elderly Act (Health and Safety Code section 1569 et seq.).  These are some of are the rules that RCFEs have to comply with when owning and operating an RCFE.  If a facility does not comply with a regulation, Community Care Licensing (CCL) can issue a citation to the facility. 

Health and Safety Codes (H&SC) are the California laws covering the subject areas of health and safety. It is in the Health & Safety Code where new statutes regarding residential care facilities for the elderly (aka assisted living) can be found. As of 1/15/2018, the Choose Well Scoring Device contains 14 H&SC specific to residential care facilities for the elderly.

A citation is the first level of enforcement used by Community Care Licensing (CCL) to encourage a facility to comply with Title 22 regulations or the relevant Health & Safety Codes.  A citation can be issued to a facility for its failure to comply with a Title 22 regulation or a relevant Health & Safety Code.  The facility is required to submit a plan of correction for the cited deficiency. 

A Civil Penalty is a monetary fine.  CCL issues fines to facilities for certain serious offenses which violate the regulations.  Serious offenses include causing a resident to get sick, to be injured, or to die.  There are other reasons that fines could be issued including not having criminal background checks done on employees before they work with residents.  Issuing a Civil Penalty to a facility is the tool the CCL uses to enforce the Title 22 regulations. 


A Non-Compliance Conference (NCC) is a mandatory meeting called by Community Care Licensing, and it is held between CCL and the RCFE.  If a facility has caused serious harm, or if a facility's compliance with Title 22 represents risks to residents health and safety, the state will call the meeting to discuss the provider's seriously harmful behavior.  The NCC sometimes leads to administrative action to place a facility on probation or to revoke the facility license. 

The Assisted Living Waiver Program (ALWP) is managed by California's Department of Health Care Services.  The program is designed to help Medi-Cal recipients stay in an assisted living facility instead of living in a skilled nursing facility; Medi-Cal funding pays for care delivered in the assisted living setting.

RCFEs must be enrolled in the program to receive payment from the government for the services they provide to the resident.  And residents must be enrolled in the program to received care from the ALWP provider.  

The ALWP pays for care delivered by the RCFE, but residents are responsible for paying for their room and board costs. Resident's receiving Supplemental Security Income (SSI) can use their SSI money to help pay for room and board.  To find out more about eligibility, enrollment and a list of approved facilities in San Diego County,  click here.

To assist you in locating San Diego facilities participating in the ALWP,  Choose Well site provides participating ALWP facilities with the opportunity to provide this important information on their Facility Profile Page.

SSI is a benefit paid to qualifying blind and/or disabled adults, or individuals 65+ years and older.  Some RCFEs accept residents who only receive SSI benefits.  RCFEs accepting residents who receive SSI can't charge more than the SSI facility rate set by the state of California for out-of-home care. To learn more about current SSI rates, eligibility, additional provisions, or to locate a local office click here.

To help you find San Diego facilities accepting SSI residents, look for the SSI box on the Facility Profile Page of each Choose Well volunteer facility.