What Is a Board and Care Home?
A clear guide for Bay Area families navigating elder care options.
Last updated: March 2026
The Simple Definition
A board and care home — officially called a Residential Care Facility for the Elderly (RCFE) in California — is a state-licensed home that provides room, meals, and personal care assistance to elderly adults. Unlike a nursing home or assisted living community, a board and care home is typically a regular neighborhood house that has been licensed to care for 2 to 6 elderly residents.
The name "board and care" comes from old boarding-house terminology: "board" means meals, and "care" means personal assistance. Together they describe what these homes offer: a safe place to live with meals provided and staff available to help with daily activities.
In the Bay Area, there are over 1,500 licensed board and care homes spread across Santa Clara, Alameda, Contra Costa, San Mateo, San Francisco, Sonoma, Marin, Napa, and Solano counties. They range from basic homes providing meals and supervision to specialized memory care facilities with trained dementia staff.
What Services Are Included?
All California-licensed RCFEs are required to provide these core services:
- Room and board: A private or semi-private bedroom plus shared living spaces
- Three meals daily: Prepared to meet resident dietary needs
- 24-hour supervision: Staff are always on site, even overnight
- Medication management: Staff help residents take medications on schedule
- Personal care assistance: Help with bathing, dressing, grooming, and toileting (ADLs)
- Housekeeping and laundry: Common areas are maintained; linens are laundered
- Social activities: Operators provide activities to support social engagement
Beyond these basics, many homes offer specialized services like memory care for dementia residents, hospice-friendly accommodations, awake night staff, and language-specific care for non-English speakers.
How California Licenses and Inspects These Homes
The California Department of Social Services (CDSS) licenses all RCFEs through its Community Care Licensing Division. To become licensed, an operator must pass a background check, complete training, meet facility safety standards, and pass an initial inspection.
CDSS conducts unannounced inspections to check for compliance with health and safety regulations. When inspectors find problems — like medication errors, staffing issues, or unsafe conditions — they issue citations. These are recorded as substantiated allegations in the public database.
Bay Area Board & Care makes this data transparent: every listing shows the facility's total inspection visits and confirmed violations, so families can make informed decisions.
Who Typically Lives in a Board and Care Home?
Board and care homes are best suited for seniors who:
- Need help with daily activities (bathing, dressing, medications) but don't require skilled nursing
- Would benefit from a small, home-like environment rather than a large institution
- Have dementia or cognitive decline and need close supervision
- Prefer care from staff who speak their language (Spanish, Tagalog, Vietnamese, Cantonese, Mandarin)
- Are on Medi-Cal and qualify for the Assisted Living Waiver program
- Want to stay in their familiar city or neighborhood
Ready to find a home?
Browse 1,500+ CDSS-licensed board and care homes across 9 Bay Area counties — with violation history shown, Medi-Cal filters, and no spam calls.
Browse listings →Frequently Asked Questions
What is a board and care home?+
A board and care home, also called a Residential Care Facility for the Elderly (RCFE), is a licensed home that provides room, meals, supervision, and personal care assistance to elderly adults — typically in a private home with 2 to 6 residents.
How much does a board and care home cost in California?+
In the Bay Area, board and care homes typically cost $2,500 to $6,500 per month depending on location, room type, and level of care. This is significantly less than assisted living, which averages $6,000–$9,000/month in the Bay Area.
Does Medi-Cal pay for board and care?+
Yes. Medi-Cal's Assisted Living Waiver (ALW) program can help pay for room and board in participating RCFEs for eligible seniors. Not all board and care homes accept Medi-Cal, so filter for homes that participate in the program.
Who regulates board and care homes in California?+
The California Department of Social Services (CDSS) licenses and inspects all RCFEs in California. Inspection records, violations, and facility status are publicly available through CDSS.
How many residents can a board and care home have?+
Most board and care homes in California are licensed for 2 to 6 residents, making them intimate alternatives to large assisted living communities.
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David Dennis
Founder, Bay Area Board & Care
“David built Bay Area Board & Care after seeing how difficult it was for families to find transparent information about licensed care homes.”