Residential Board and Care Homes
 Residential Board and Care Homes are usually
considered to be small family homes in residential neighborhoods
licensed to provide care to four to six residents. All custodial
care, meals, and activities are provided by live-in staff. The
administrator/owner, who generally does not live at the home,
normally picks up the medication, does the shopping and provides
the transportation to the doctor. Most are licensed to accept
non-ambulatory residents and have been constructed with these
residents needs in mind (e.g., wheelchair accessible bathrooms
and inside/ outside ramps). Residential Board and Care homes are
allowed to provide assistance to residents who need help
transferring from bed to wheelchair, but they are not permitted
to accept or provide care for residents who are completely
immobile, bedridden or unable to turn in bed. The high
staff-to-resident ratio (usually two staff to six residents)
make this an ideal setting for residents who are incontinent,
have advanced dementia, Parkinson's disease, Alzheimer's disease,
or who have a high level of physical care needs. The homes can
also accept "wanderers" as long as they are equipped with alarms
on the doors and are gated. Normally, Residential Board and Care
homes will also accept respite (short-term) clients if a room is
available.
 Although Residential Board and Care homes are not permitted to
accept residents with skilled nursing needs, there are times,
however, when Community Care Licensing will grant exemptions to
this rule. For example, depending on the nature of the condition
and care required, administrators can frequently obtain waivers
for residents who have catheters or colostomies (e.g. when
working in conjunction with an outside home health agency which
can clean the catheter as needed). Community Care Licensing
evaluates each exemption request on a case-by-case basis. The
administrator must be granted a waiver before the resident
actually moves into the home.
It is important to note that both Residential Care and Assisted
Living facilities operate under the same regulations regarding
care services and the differences if any are due to a particular
facilities program and not differences in Community Care
Licensing regulations.
Licensing Regulations for Residential Care Facilities
 Residential Care facilities operate
under the supervision of Community Care Licensing, a sub agency
of the California Dept. of Social Services. In California in the
early 1970's the residential care system was established to
provide non institutional home based services to dependent care
groups such as the elderly, developmentally disabled, mentally
disordered and child care centers under the supervision of the
Department of Public Social Services. At that time homes for the
elderly were known as Board and Care Homes and the name still
persists as a common term to describe a licensed residential
care home. In the vernacular of the State, these homes are also
known as RCFE's (Residential Care Facilities for the Elderly).
Residential care facilities can provide assistance with all
daily living activities, such as bathing, dressing, toileting,
urinary or bowel incontinency care. Most elderly people find
that there needs fall beneath having to access skilled nursing
services and therefore don't need to be housed in a nursing
home. The small residential care home, licensed for 2 to 6
people provides a safe, comfortable and dignified environment
for those who need help intermittently throughout the day and
night.
Residential Care and the Alzheimer's Patient
 For those elderly suffering from Alzheimer's disease
or other kinds of dementia the small residential care facility
can be an ideal care setting. There are few people for the
resident to have to deal with, the number of staff is small, one
or two people, and there is a lot of close supervision and
support for the Alzheimer's patient which can lower anxiety and
stress. The only negative is that small facilities very often
have limited activities, which for some Alzheimer's patients can
be a detriment to their well being if they are active or very
restless. Some residential care facilities utilize community
resources such social day care programs for their residents,
which addresses the need for stimulating activity, both mental
and physical.
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