A beautiful tour and a friendly administrator do not tell you how a care home performs when no one is watching. RCFE inspection reports do. Every licensed assisted living community, memory care community and board and care home in California has a public record of inspections, complaints and citations, and anyone can read it for free.
This guide shows San Diego families how to look up a care home’s license, how to read RCFE inspection reports, the difference between Type A and Type B citations, how complaints are handled, and what to ask a home about anything you find. It draws on Elder Answers’ practice of reviewing the licensing history of every home we recommend in San Diego County.
In California, assisted living communities, memory care communities and small board and care homes all hold the same license: a Residential Care Facility for the Elderly, or RCFE. A 6-bed home on a quiet street in Clairemont and a 150-apartment community in Mission Valley follow the same rules. Whatever a home calls itself (board and care, elder care home, home for elderly adults or assisted living), if it provides residential senior care to people 60 and older in California, it needs an RCFE license.
RCFEs are licensed and inspected by the California Department of Social Services (CDSS), Community Care Licensing Division. The rules they must follow are in California Code of Regulations Title 22 and the California Health and Safety Code. Licensing staff from the regional office inspect homes, investigate complaints, and issue citations when a home falls short.
Nursing homes are different. Skilled nursing facilities are medical facilities licensed by the California Department of Public Health, and their records live in a separate system. If you are comparing both, see our overview of nursing homes in San Diego.
If you are new to these terms, our explainer on what a residential care home for seniors is covers the basics.
California schedules routine, unannounced inspections of RCFEs, and since 2019 the goal has been to visit each licensed home at least once a year. Licensing also visits whenever a complaint is filed, when a home reports a serious incident, and to follow up on earlier citations. Homes with a history of problems may be visited more often or placed on a compliance plan.
Because visits are unannounced, an inspection report is a reasonable snapshot of what a home looks like on an ordinary day. But it is still only a snapshot. That is why the pattern across several years matters more than any single visit.
The tool you need is the CDSS Care Facility Search. It is free, public and covers every licensed senior care home in California.
If you cannot find a report online or want older records, you can ask the regional licensing office for public copies. If a home you are touring does not show up at all, ask for its license number. Every legitimate RCFE has one, and the license must be posted in the home.
A tip for board and care homes: many owners run two or three homes under similar names. Make sure the report you are reading matches the exact address your parent would live at, then look at the owner’s other homes too. A good operator usually has a clean record across all of them.
A facility’s file can include several kinds of documents:
Reports are written in plain, sometimes blunt language. Read the narrative, not just the codes. It usually tells you exactly what the evaluator saw.
California sorts deficiencies by how serious they are.
Type A citations are the serious ones. They involve a condition that poses an immediate or substantial risk to a resident’s health, safety or personal rights. Examples include residents left without enough supervision, medication errors that could cause harm, unsafe dementia care, a resident left without needed medical care, or staff working without a criminal background clearance. Type A problems usually must be fixed right away.
Type B citations are less serious. They cover rules that, if left alone, could eventually affect residents, such as missing paperwork, an expired staff training record, or a minor repair. They come with a longer deadline to correct.
When you read RCFE inspection reports, weigh citations this way:
Over the years, a handful of issues show up in licensing reports again and again. Knowing them helps you look for the same things on a tour.
Not clean, safe and in good repair. Homes must be kept clean, safe, sanitary and in good repair at all times. This is one of the first things our advisors look (and smell) for. A dirty, cluttered or smelly home with broken fixtures is almost always a red flag. But old is not the same as poor. Some of the best senior care homes in San Diego are not new or shiny, and some brand-new buildings fall short on care.
Dementia care paperwork. Residents with dementia must have a medical assessment and a reappraisal of their needs at least once a year. Make sure your parent’s doctor sees them regularly and that the home updates the care plan as things change.
Hot water temperature. California requires hot water in resident areas to stay between 105 and 120 degrees Fahrenheit. It sounds small, but scalding is a real danger for seniors with dementia or poor sensation.
Unsafe items within reach. Over-the-counter medications, vitamins, cleaning supplies, knives, tools and some plants must be kept away from residents with dementia.
Medications. Medications must be locked and given exactly as the physician ordered. Citations here deserve close attention.
Staffing and training. Homes must have enough trained staff to meet every resident’s needs, including someone with first aid training on duty at all times.
The good news is that the majority of RCFEs in San Diego County have few or none of these problems. Most homes are run by caring people working hard, and many that receive a citation fix it quickly.
Anyone can file a complaint with Community Care Licensing: residents, families, staff, doctors or neighbors. Licensing investigates and reports one of three findings:
A single unfounded complaint means very little. A string of substantiated complaints about the same issue, such as residents not being changed or call bells going unanswered, is a serious warning sign. Larger assisted living communities naturally have more complaints than a 6-bed home because they have more residents, families and staff, so compare homes of similar size.
Bring what you found to the tour. A good home will answer openly. Defensiveness is a red flag.
Remember that care homes are run by people, often under difficult conditions. No home is perfect. Ask about anything that worries you before you draw conclusions.
RCFE inspection reports are one of the best free tools families have, but they leave gaps. A clean record does not prove a home is a good fit for your parent, and a quiet home may simply have had fewer visits. Reports also do not show the warmth of the caregivers, the quality of the food, or how long staff have worked there.
Round out your research by:
Our guide on how to choose assisted living in San Diego includes a full tour checklist, and our family guide to board and care homes in San Diego explains what good care looks like in a small home.
If you see something wrong after your parent moves in, start by raising it with the administrator. If that does not fix it, or if a resident is in danger, contact Community Care Licensing. CDSS runs a complaint hotline at 1-844-538-8766 and an online complaint form, and you can ask that your name be kept confidential. San Diego County’s Long-Term Care Ombudsman program also advocates for residents in care homes. For suspected abuse or neglect, call 911 if there is immediate danger and read our guide to recognizing elder abuse.
Reading RCFE inspection reports takes time, and the reports only tell part of the story. Elder Answers has helped San Diego families for well over a decade. We review the licensing history of every home we recommend, and our advisors personally visit board and care homes, assisted living and memory care in San Diego, from La Mesa to Oceanside.
Our help is free for families because care homes pay us after a resident moves in, and that does not change the rate you pay. We share your information only with the homes you choose, and when the need is urgent a move can often happen within a few days. Learn how a senior placement agency works, or contact Elder Answers to talk with a local advisor about board and care homes in San Diego.
Use the CDSS Care Facility Search, a free public database run by Community Care Licensing. Search by facility name, license number, city or ZIP code, then open the facility profile to see inspection reports, complaint investigations and citations.
Yes. Licensing reports for California RCFEs, including board and care homes, assisted living and memory care, are public records. Recent reports are usually online, and you can request older records from the regional licensing office.
A Type A citation is for a serious deficiency that poses an immediate or substantial risk to a resident’s health, safety or personal rights. A Type B citation is for a less serious issue, such as paperwork or minor repairs, that could affect residents if not corrected. Type A citations deserve close attention.
California schedules unannounced routine inspections, with a goal of visiting each RCFE at least once a year. Licensing also visits when complaints are filed, after serious incidents and to follow up on citations.
Usually not. Most homes receive an occasional citation. Look at how serious it was, whether it repeated, how recent it was and how quickly the home fixed it, then ask the home about it directly.
Yes. Board and care homes are licensed RCFEs, so they are inspected under the same rules and have the same public records as large assisted living communities.
Search the home in the CDSS Care Facility Search and check the license status on its profile. You can also ask the home for its license number, which must be posted in the facility. Avoid any home that cannot show a current RCFE license.
Substantiated means licensing found the complaint was true. Inconclusive means there was not enough evidence to decide. Unfounded means the complaint was false or did not happen as described. Patterns of substantiated complaints are the biggest concern.
Call the Community Care Licensing complaint hotline at 1-844-538-8766 or use the CDSS online complaint form. You can ask to keep your name confidential. If a resident is in immediate danger, call 911 first.
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