Frequently asked questions

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).

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.

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.

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).

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.

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.

A citation is the first level of enforcement used by Community Care Licensing (CCL) to encourage a facility to comply with Title 22 regulations. A citation can be issued to a facility for its failure to comply with a Title 22 regulation. 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 resident’s 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.

Just because we may give up some of our independence as we age, does not mean we also give up our personal rights. Every person living in an assisted living facility has rights. It is important to learn what they are. Resident Rights for assisted living residents are preserved in a) Title 22 Regulations, Section 87468, and b) also in the 2014 legislation which now appears as law in the Health and Safety Code 1569.261 - 1569.269. There is overlap between the two, but we provide you with both. Resident Rights must be posted in a prominent place in any facility having over 7 residents. Resident Rights must be published in languages understood by all facility residents. And at admission, each resident and his/her responsible party must be given a copy of these Resident Rights. Facilities can be cited for violating a resident's rights. If you feel a resident's rights are being violated, speak with the facility administrator and file a complaint with the Department of Social Services, Community Care Licensing.

Under Section 87468 residents have the right to:

1. Dignity in relationships with staff, residents and others.
2. Safe, healthful and comfortable accommodations.
3. Be free from actions of a punitive nature including freedom from intimidation, abuse, and neglect.
4. Be informed how to file a complaint against the facility.
5. Freedom to attend religious services or activities.
6. Free to leave the facility at any time and to not be locked into any room, day or night.
7. To visit the facility prior to placement.
8. To have the resident's responsible party regularly informed of resident's care, activities and needs.
9. To have prompt and private communications and visits from family and friends.
10. To have access to private storage space.
11. To wear and maintain all personal items (clothing, hygiene supplies, money, etc).
12. To have access to telephones.
13. To receive or reject medical care, or other services.
14. To receive assistance to vote.
15. To move from the facility.

Residents have the right to:

1. Dignity in personal relationships with staff, residents and others.
2. To be granted personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, internet use and meetings of resident and family groups.
3. To confidential treatment of records and personal information.
4. To be free from interference, coercion, discrimination and retaliation in exercising their right to vote.
5. To be accorded safe, healthful, and comfortable living quarters, furnishing and equipment.
6. To care, supervision and services meeting individual needs to be delivered by staff in sufficient in numbers, qualifications and competency to meet their needs.
7. To be served food of the quality and quantity necessary to meet their nutritional needs.
8. To make choices concerning their daily life in the facility..
9. To fully participate in planning their care, including attending and participating in meetings regarding care, and involving persons of their choice in the planning process.
10. To be free from neglect, financial exploitation, involuntary seclusion, punishment humiliation, intimidation and verbal, mental, physical or sexual abuse.
11. To present grievances, recommend policy, procedures and service changes to staff, the facility's management and governing authority, and to any other person, without restraint, coercion, discrimination, reprisal, or other retaliatory actions.
12. To contact the State Department of Social Services, long-term care ombudsman, or both regarding grievances against the licensee.
13. To be fully informed, evidenced by the resident's written acknowledgement, prior to or at time of admission, of rules governing residents' conduct and responsibilities.
14. To receive in the admission agreement a comprehensive description of the method for evaluating residents' service needs and the fee schedule for items and services provided, and to receive written notice of any rate increases.
15. To be informed in writing at or before admission of any resident retention limitations set by the state or licensee, including any limitations or restrictions on the licensee's ability to meet residents' needs.
16. To reasonable accommodation of the person’s needs and preferences in all aspects of life in the facility except when the health or safety of the person or other residents would be endangered.
17. To reasonable accommodation of resident preferences concerning room and roommate choices.
18. To written notice of any room changes at least 30 days in advance unless the request is agreed to by the resident, required to fill a vacant bed, or necessary due to an emergency.
19. To share a room with the resident's spouse, domestic partner, or a person of resident's choice when both spouses, partners, or residents live in the same facility and consent to the arrangement.
20. To select resident's own physician, pharmacy, privately paid personal assistance, hospice agency, and health care providers in a manner consistent with resident's admissions contract or other rules of the facility.
21. To have prompt access to review of their records and to purchase copies. Copies shall be promptly provided, not to exceed 2 business days, at a cost of not to exceed the community standard.
22. To be protected from involuntary transfers, discharges, and evictions in violation of state laws and regulations. An RCFE shall not involuntarily transfer or evict residents for grounds transfer or evict residents for grounds other than those specifically stated in state law or regulations, and shall comply with eviction and relocation protections for residents. "Involuntary" means a transfer, discharge, or eviction initiated by the licensee, not by the resident.
23. To move from a facility.
24. To consent to have relatives and other people of the resident's choosing visit during reasonable hours, privately and without prior notice.
25. To receive written information on the right to establish an advanced healthcare directive and pursuant to Section 1569.156, the licensee's written policies on honoring those directives.
26. To be encouraged to maintain and develop their fullest potential for independent living by participation in activities designed and implemented for this purpose in accord with Section 87219 of Title 22 of the California Code of Regulations.
27. To organize and participate in a resident council established under Section 1569.157.
28. To protection of property from theft or loss in accord with Sections 1569.152, 1569.153, and 1569.154.
29. To manage their financial affairs. A licensee shall not require residents to deposit their personal funds with the licensee. Except as provided in approved continuing care agreement, a licensee, or a spouse, domestic partner, relative or employee of a licensee shall not do any of the following:

1.Accept appointment as a guardian or conservator of the person or estate of a resident.

2.Become or act as representative payee for any payments made to a resident without the written and documented consent of the resident or resident's representative.

3.Serve as an agent for a resident under any general or special power of attorney.

4.Become or act as a joint tenant on any account with a resident.

5.Enter into a loan or promissory agreement, or borrow money from a resident without a notarized written agreement outlining terms for repayment being given to the resident.

30. To keep, have access to, and use their own personal possessions, including toilet articles, and to keep and be allowed to spend their money, unless limited by a law.

The Long Term Care Ombudsman helps residents living in long term care settings such as skilled nursing homes, assisted living facilities. The Ombudsman listens to a resident's concerns, provides information and assistance when requested and will investigate and resolve complaints related to care or personal rights. A resident's conversations and communications with an Ombudsman are confidential.

Region II - Van Nuys WISE & Healthy Aging LTC Ombudsman Program 16461 Sherman Way, Suite 177 Van Nuys, CA 91406 (818) 444-0315 Fax (818) 444-031

The representatives of the WISE & Healthy Aging Long-Term Care Ombudsman Program serve as advocates for the residents occupying the more than 76,000 beds in long-term care facilities in the city and county of Los Angeles. The program oversees ombudsman services in the city and county of Los Angeles as part of the California Long-Term Care Ombudsman Program. This program is authorized under the federal Older Americans Act and its California companion, the Older Californians Act. The goal of the Long-Term Care Ombudsman Program is to investigate and attempt to resolve complaints made by or on behalf of individual residents in long-term care facilities. These facilities include nursing homes; residential care facilities for the elderly (also known as assisted living or board and care facilities).

The WISE & Healthy Aging Long-Term Care Ombudsman Program provide the following services:

1. o Advocacy by voicing residents' concerns to a facility's administration.
2. o Investigation of complaints made by or on behalf of residents.
3. o Informal conflict resolution to help parties involved reach agreements and settle conflicts, with the resident's satisfaction as the main focus.
4. o Elder abuse investigation. Ombudsmen are trained to investigate and report suspected cases of elder and dependent adult abuse in long-term care facilities.
5. o Education to make residents and caregiver more aware of residents’ rights under State and federal regulations.
6. o Witnessing of residents’ signatures on documents such as Advance Health Care Directives in skilled nursing facilities.
7. o Conducting regular unannounced visits to skilled nursing facilities and assisted living or board and care facilities

If you know or believe a facility is breaking licensing laws, or not caring for residents like they should, you should file a complaint with Community Care Licensing (CCL). When you report a complaint to CCL, you can remain anonymous, unless you give CCL permission to disclose your name. When you report problems in assisted living, you help protect not only your own family member, but the other individuals in the same care facility.

You can make a complaint to CCL in two ways: by phone and by the mail.

1. • 1-844-LET US NO (1-844-538-8766), or
2. • Write your complaint, including the facility name, what happened, the date when this happened, who was there, if anyone was hurt, and mail it to your local CCL Regional Office. In San Diego County, the complaint report should be mailed to: Department of Social Services Community Care Licensing Division 7575 Metropolitan Drive, Suite 109 San Diego, CA 92108
3. Attention: Kimberly Lyon, Regional Manager
4. Reporting Elder Abuse: If You Think Sexual, Physical, Neglect or Financial Abuse has or is occurring:
5. • If there is active harm being done, immediately call 9-1-1.
6. • Long Term Care Ombudsman's office at 800-640-4661.
7. • Call local law enforcement