Compare the two settings
Start with the person’s preferred routine, room, social life, and places they want to spend time. Use these differences to prepare questions for each visit.
Physical setting
Smaller residential home
Often a house shared by a small number of residents, sometimes called a board-and-care or group home.
Larger community
Often a building or campus with apartments and shared dining and activity spaces.
Daily routine
Smaller residential home
Ask how the household schedule fits the person’s preferences.
Larger community
Ask which scheduled activities the person would choose and what help is available to participate.
Space to check
Smaller residential home
Inspect the actual room, shared areas, and outdoor access.
Larger community
Walk the routes from the actual room to dining, activities, and outdoor areas.
In California, both settings can be licensed as a Residential Care Facility for the Elderly (RCFE). The California Department of Aging describes small board-and-care homes and larger facilities under this category. RCFEs provide non-medical care and supervision and are distinct from nursing homes. Licensing terms vary by state.
What to verify at either setting
A building’s size does not tell you how much help is available. Ask each home:
- Who is present on each shift — day, evening, overnight, and weekends — and who is awake versus on call.
- How a resident requests help, including from a bathroom or outdoor area, and how simultaneous requests are handled.
- Who assesses needs before a move and how the agreed support is recorded.
- What medical support is arranged and which tasks require an outside professional. Both settings provide non-medical care; arrangements for nurses, medication help, and visiting clinicians vary by home, not by size.
- What the home cannot handle, and how it would tell you if the person’s needs changed.
Ask how staff would handle a specific situation: “If someone needs help in the bathroom while another resident is being assisted, what happens?” Follow up on any part of the answer that is unclear.
Dementia and memory needs
If the person has Alzheimer’s or another form of dementia, do not rule a setting in or out by its size. Ask each specific home about:
- Staff training in dementia care and how it is kept current.
- Environment and safety, including how the home supports someone who may become disoriented or tend to wander, and whether it offers a secured area if that is needed.
- Staffing levels at the times of day the person needs the most support.
The California Department of Aging describes RCFE care as non-medical and needs-based; a home’s ability to support dementia depends on its equipment, staff training, and capacity to meet the resident’s needs. Whether a particular home is a good fit is a question for that home and the person’s health care provider — not a conclusion you can draw from the building’s size. If clinical suitability is uncertain, ask the person’s clinician.
Compare cost on the same basis
Do not assume a smaller home is cheaper or an all-inclusive deal, or that a larger community always costs more. Prices depend on the room, the assessed care needs, and which services are bundled. To compare fairly:
- Ask each home for a written, itemized quote for the same room type and the same assessed needs.
- Have each home label every service as included, priced separately, or not yet assessed.
- Compare the recurring monthly total and any one-time fees side by side.
For a broader budgeting benchmark, the CareScout 2025 survey reported a national assisted living median of $6,200/month and a California median of $7,000/month (fieldwork July–November 2025, private one-bedroom). These are national and statewide survey medians for planning. A specific home may charge more or less. See the companion cost guide for how to read them.
Build your shortlist
Keep both settings on your list when they fit the person’s needs. Use the same questions for each home, and take the tour checklist with you so you can compare written answers rather than impressions. Circle any unresolved care or cost question and agree who will get a written answer before you decide.
Frequently asked questions
Are board-and-care homes a different California license from assisted living?
Often not. In California, both small board-and-care homes and larger assisted living communities can be licensed as Residential Care Facilities for the Elderly (RCFEs), which provide non-medical care and supervision. The California Department of Aging describes both under this licensing. Confirm each specific home’s license and services directly.
Does a smaller home mean more staff time per resident?
Not necessarily. Staffing depends on the individual home’s arrangements, not on building size. Ask each home who is present on each shift, who is awake or on call overnight, and how it handles more than one request for help at the same time.
Can either setting support a person with dementia?
It depends on the specific home, not its size. Ask about staff training, the environment and any secured areas, and staffing at the times the person needs the most support. Discuss clinical suitability with the person’s health care provider.
Are smaller homes always less expensive?
No. Cost depends on the room, the assessed care needs, and which services are included. Ask each home for a written, itemized quote for the same room and needs, and compare the recurring monthly total and one-time fees on the same basis.