Guide for Families
Searching for a board & care home can feel overwhelming. This guide walks you through what to look for, what questions to ask, and how to navigate costs — including Medi-Cal.
What is a board & care home?
A board & care home is a Residential Care Facility for the Elderly (RCFE) — a licensed private residence that provides housing, meals, and personal care assistance to typically 6 to 15 residents. Because of the smaller size, the staff-to-resident ratio is higher than at a large assisted living facility, and the environment is more homelike and personal.
Board & care vs. assisted living
| Board & Care | Assisted Living | |
|---|---|---|
| Residents | 6–15 residents | 50–200+ residents |
| Setting | Homelike, residential | More institutional, more amenities |
| Cost | Generally lower | Generally higher |
| Attention | More personal, higher ratio | More anonymous, more staff total |
What to look for
- CDSS license is active and current
- Violation history and substantiated allegations from inspections
- Languages spoken by staff (important for residents and family communication)
- Medi-Cal accepted — if you need financial assistance
- Awake night staff — is someone on duty overnight?
- Hospice-friendly — can residents receive hospice care without moving?
- Location and proximity to family
- Cleanliness and overall condition of the home
Questions to ask the operator
- What is the staff-to-resident ratio during the day? At night?
- Are staff awake at night, or do they sleep on-site?
- What does the monthly fee include? What costs extra?
- How do you handle a medical emergency?
- Can we visit unannounced once my family member is a resident?
- What happens if my family member's care needs increase?
- How long have the primary caregivers worked here?
- What activities or programming do residents have access to?
Using Medi-Cal for board & care
Medi-Cal (California's Medicaid program) can cover room and board costs at qualifying RCFEs. Look for the Medi-Cal accepted badge on any listing in our directory.
Eligibility depends on income, assets, and care level. We strongly recommend contacting the California Department of Health Care Services (DHCS) or working with a licensed social worker to determine your eligibility and navigate the enrollment process. The facility can also often guide you to local resources.