Adult Residential Facilities in San Diego: Care for Adults Under 60

Quick answer: An adult residential facility (ARF) in San Diego is a California-licensed home that provides 24-hour non-medical care and supervision for adults 18 through 59 with physical, developmental or mental health conditions. ARFs are the under-60 counterpart to residential care facilities for the elderly (RCFEs), which serve people 60 and older. Many ARFs are small, home-based settings similar to board and care homes.

Most assisted living and board and care homes in California are licensed to serve seniors. So what happens when a 45-year-old after a stroke, a 52-year-old with multiple sclerosis, or a 30-year-old with a developmental disability needs 24-hour care? An adult residential facility in San Diego is often the answer. This guide explains what ARFs are, how they differ from senior care homes, who they serve, how much they cost, how to pay, and how to find and evaluate one.

What is an adult residential facility?

An adult residential facility is a residential home licensed by the California Department of Social Services, Community Care Licensing Division, to provide care and supervision for adults ages 18 through 59 who cannot live independently. ARFs provide:

• A room and three meals a day
• Help with daily activities, such as bathing, dressing and grooming
• Assistance with medications
• 24-hour supervision
• Activities and, in some homes, transportation

ARFs are non-medical, like senior assisted living, so they do not provide skilled nursing care.

How is an ARF different from assisted living or board and care for seniors?

• Age: ARFs serve adults 18 to 59. Residential care facilities for the elderly (RCFEs), including assisted living and board and care, generally serve people 60 and older, with limited exceptions for younger residents with compatible needs.
• Population: ARFs often serve adults with developmental disabilities, mental health conditions, brain injuries or physical disabilities. RCFEs mainly serve older adults with aging-related needs and dementia.
• Funding: many ARFs work with regional centers or county behavioral health programs, while RCFEs are mostly private pay.
• Setting: like many board and care homes in San Diego, most ARFs are small homes in residential neighborhoods.

Our guide to what a residential care home for seniors is explains RCFE licensing in more detail.

Who is an adult residential facility for?

• Adults with developmental or intellectual disabilities
• Adults with serious mental illness who are stable but need supervision
• Younger adults after a stroke, brain injury or spinal cord injury
• Adults with progressive conditions such as multiple sclerosis or early-onset dementia
• Adults with physical disabilities who need daily help and supervision

Some ARFs specialize in one population, so ask what types of residents each home serves.

What about someone who turns 60 in an ARF?

Residents who turn 60 may be able to stay in an ARF depending on licensing rules and their needs, or they may transition to an RCFE such as assisted living, board and care, or memory care. Planning ahead avoids a rushed move. Our guides to assisted living in San Diego and types of senior care explain senior options.

How much does an adult residential facility cost?

Costs vary widely by care needs and funding source:

• Regional center funded: for eligible adults with developmental disabilities, the regional center pays a service rate and the resident usually contributes SSI.
• County behavioral health: some ARFs serving adults with mental illness are funded through county programs, sometimes with a supplemental rate.
• SSI/SSP rate: low-income residents may pay with the SSI/SSP non-medical out-of-home care rate, currently $1,626.07 a month, at homes that accept it.
• Private pay: families pay a monthly rate that varies by care level, often comparable to San Diego board and care homes.

For general guidance on paying for care, see how to pay for a senior care home and our Medi-Cal eligibility guide.

How do you find an adult residential facility in San Diego?

1. Start with funding. If your loved one has a developmental disability, contact the San Diego Regional Center. For mental health needs, contact County behavioral health services.
2. Search licensed facilities. Use the California Department of Social Services facility search to find licensed ARFs and review inspection reports.
3. Ask referral sources. Hospital social workers, rehab case managers, and placement advisors often know which homes serve younger adults.
4. Tour more than one home. Visit at different times of day.
5. Confirm the license type. Make sure the home is licensed as an ARF if your loved one is under 60.

What questions should you ask an ARF?

• What types of residents do you serve, and what ages?
• How many staff are on duty during the day and at night?
• How do you handle medication assistance and doctor visits?
• What activities, day programs or work opportunities do residents attend?
• How do you handle behavioral challenges?
• Do you accept regional center, county or SSI funding?
• What happens when a resident turns 60?

Our family checklist for how to choose a board and care home includes many questions that apply to ARFs too, and our post on common assisted living license citations explains how to read inspection reports.

Frequently asked questions

What is an adult residential facility? A California-licensed home providing 24-hour non-medical care and supervision for adults 18 through 59.

What is the difference between an ARF and an RCFE? ARFs serve adults 18 to 59. RCFEs, including assisted living and board and care, generally serve people 60 and older.

Can a younger adult live in assisted living in California? Sometimes, if their needs are compatible with other residents. Otherwise, an ARF is the usual option.

Who pays for an adult residential facility? Regional centers, county programs, SSI, private funds, or a combination.

Do ARFs provide nursing care? No. ARFs are non-medical, though residents can receive home health or outside medical services.

Are adult residential facilities inspected? Yes. They are licensed and inspected by the California Department of Social Services.

Conclusion: adult residential facilities in San Diego

An adult residential facility in San Diego provides licensed, 24-hour non-medical care for adults 18 through 59 who cannot live on their own. Start with the right funding source, confirm the license type, review inspection reports, tour several homes, and plan for the transition at age 60. For loved ones 60 and older, a free senior care assessment can help find the right senior care home.