What is a board and care home, and how is it different from assisted living?
A board and care home is a licensed care home in an ordinary house, usually six beds or fewer. It holds the same California licence as a 140-bed community and is inspected the same way, but it is invisible on the big referral sites.
In California both are Residential Care Facilities for the Elderly. Same licence category, same inspectors, same citation system. The difference is scale, and scale changes almost everything about the experience and the economics.
| Board and care | Larger community | |
|---|---|---|
| Typical size | 4 to 6 residents | 40 to 200 residents |
| Setting | An ordinary house on an ordinary street | Purpose-built |
| Staff ratio | Often 1 to 3 or better | Varies by shift and acuity |
| Typical monthly cost | $3,000 to $4,500 shared | $5,000 and up |
| Currently published | 12,392 | 1,618 |
Why you have probably never seen one advertised
80% of the care homes we publish have six beds or fewer. You will rarely find them on the large referral sites, and the reason is arithmetic rather than quality: those sites are typically paid $3,500 to $12,000 when a resident moves in, and a six-bed home cannot pay that on one room. So it does not get shown, and families never learn the option exists.
What to check that is specific to a small home
- Who is awake overnight, and are they awake or on call? In a six-bed home this is one person.
- What happens when that person is sick. A large community has a rota; a small home may have the owner.
- The licence limits for non-ambulatory and bedridden residents — in a small home these numbers are small.
- Whether the licensee lives on site. Common, and often a good sign, but you should know.
Every one of the 17,808 providers we publish gets the same page, at the same depth, in the same position, whether it has four beds or four hundred.
Figures on this page are computed from California Department of Social Services licensing records and update when the underlying data does. Methodology · Report a correction