By the year 2035 it’s projected that there will be more than 78 million person ages 65 and older living in the United States, up almost 60% from the 46 million in 2016, according to population data. Every state is expected to see massive growth as baby boomers age into retirement, but none will see an increase quite like California: by 2036 the state will see more 10,000,000, and comprise 23% of our population.
Planning for an aging population is no longer conjecture. It is an absolute necessity. Doing so requires that we have the infrastructure in place to care for those who will need it, which means more licensed care facilities, more available beds, and more trained and certified RCFE administrators.
Getting there will not be easy, and setting out to open your own RCFE is not for the faint of heart. It’s a significant business decision, but one that carries with it one of the most rewarding acts of service one can provide: caring for those who came before us. Here’s how you go about opening and RCFE in the state of California.
1. Find a qualified, certified Administrator.
The first and most important step. Without having a qualified, certified administrator on your team, none of the rest can follow. In all likelihood, you’re probably intent to become certified yourself, but how do you go about doing that?
To become certified you must first take the DSS-required 80 hour Certification Course, and then take and pass the DSS-administered 100 question test with a minimum passing score of 70%. This test must be taken within 60 days of you completing the 80-hour course, after which you must submit the required paperwork and fee within 30 days of passing the test.
Not everyone is qualified to be an administrator of your facility. The general requirements call for a high school diploma or equivalent and being at least 21 years of age. For a 16-49 bed facility, you must have passed at least 15 college units and have at least 1 year of experience working in an RCFE or equivalent. To be an administrator of a 50+ bed facility, you’ll need to have a minimum of 2 years of college under your belt, and have at least 3 years of experience working in an RCFE or equivalent.
Are you qualified, and ready to take the DSS-required RCFE initial certification course for administrators?
2. Secure the physical plant.
It will sound obvious in hindsight, but you can’t be the administrator of a residential facility for the elderly if you don’t have the actual facility part locked down. In order to submit a license application for your facility, you must show “control of property” — that is, proof that you either own the property outright, that you are either in the process of buying the property or that you will be leasing/renting the property.
3. Contact your local fire marshal for a pre-inspection.
The sooner you do this, the better! It’s possible that the fire marshal will charge you a nominal fee, but this inspection will let you know early on if you will need to make costly modifications to your home/facility in order to be compliant with local fire codes and state regulations. Money well spent! If you don’t make these modifications, you won’t be able to get the maximum number of non-ambulatory rooms or apartments out of your facility. You’ve already come this far! Maximize your investment by making these modifications, or find another location!
4. Take the online Orientation course with DSS.
You must take the DSS RCFE course. You only need to take this course once. The DSS RCFE orientation course falls into two categories: adult care and senior care. There is a registration fee and access to the courses is limited to 30 days once the fee is purchased. This is all done through the DSS website. When finished submit a copy of your orientation certificate. The orientation is the beginning of the process. Stay informed about future regulation changes and updates through a certified regulation service.
5. Submit a license application to DSS.
Now we’re getting to the fun stuff. The next step in this process is to prepare and submit an RCFE license application for DSS, including parts A and B, along with the applicable fee. We won’t sugarcoat it: this is not like filling out an application for a driver’s license. The Applications Instructions alone are 22 pages in length, and all told you’re looking at hundreds of pages to gather information for, prepare, and fill out. Attempting this on your own is a recipe for disaster — just one error could delay your facility’s opening by months! Instead, it’s smart to consider having yours completed by a professional. Our team has licensed hundreds of small and large RCFE’s, and worked with DSS licensing personnel for over 15 years. We have never had an application rejected due to error!
Do you have the required 3 months’ of operating costs in the bank? You must open a bank account in your facility name and deposit at least 3 months’ operating costs into it. The DSS will verify this in the process of reviewing your application.
Be patient. This process may take 4-5 months.
6. Market your Facility.
Congratulations, you’ve submitted your application! Now it is time to start meeting with the potential residents who fill your facility once you are licensed. You are NOT allowed to move residents into your facility until you secure the license from DSS. But DO start looking for residents. Don’t wait until you secure the license, because that will just be time lost! In our post detailing 6 Steps for a Successful RCFE we talked about the importance of choosing your residents wisely. Remember, your first resident is your benchmark and will set the tone for your facility in ways you might not expect.
7. DSS will schedule a Component II (face to face) meeting at their office.
This is step two in a three-part component process that must be completed by all new licensees. Once your application has been reviewed, you will be contacted by the DSS for a one-on-one with the the reviewing analyst.
Component I was the orientation course you took in #4 on this list, and Component III involves “category specific training and discussion in areas not often understood by new licensees intended to promote successful facility operation.” Both components II and III will be done once DSS accepts your license application, but prior to actual licensure. These are all essential aspects of the license application process.
8. DSS will schedule a pre-licensing visit to inspect your facility.
You’re so close! You’re almost there! A pre-licensing inspection is by the DSS as the last step in the RCFE license application review process. DSS will send you a checklist for you to complete prior to this visit. Make sure you complete this checklist fully, and have it available for their review when they come to visit. Note: the DSS will NOT conduct a pre-licensing until your fire marshal grants their approval.
9. Hire staff and train them accordingly.
Putting together your team and training them accordingly is arguably the most important step in this entire process. We’ve discussed before the perils of fire-drilling the hiring process in our post about The 10 Biggest Mistakes RCFE’s Make. You aren’t just looking for warm bodies to fill these important caretaking positions. You want a passionate team of people who want to come in every single day intent one making the lives of your residents better. Remember, you don’t want to wait until you are licensed to build your team, because you will not be able to move in and care for residents without staff! Once you’ve found the right people, make sure that they are properly trained and meet all the state requirements. And don’t forget the importance of ongoing CEU training for RCFE administrators and staff as well!
10. DSS issues you a facility license.
You did it! Yes, you! Let that feeling of pride wash over you. You are now the proud administrator of a fully licensed RCFE. This is everything you’ve worked so hard toward, and it’s time to open your doors. Now you can move in your residents that are on your waiting list!
The process to opening an RCFE facility in California may be long, but it’s rewarding. It’s okay if it takes you a year or more to get your facility off the ground — it’s not a race, and in the end it will all be worth it. The senior care industry is among the fastest growing industries in the country, and California is no different. We must be prepared to meet the needs of seniors with the best care possible. More growth, means more new facilities.
Update for 2020 RCFE Regulations & Operations During COVID-19
Given the population’s nature of an RCFE facility, the threat of contracting and spreading the coronavirus proves a tremendous challenge. Beyond the “new normal” operating procedures of enforced social distancing, mask and glove wearing, and ongoing temperature checks to better protect the residents, the staff must also take even greater precautions for their own protection.
At the end of May, 2020, the Center for Disease Control released enhanced guidelines for every RCFE administrator and staff member to follow in the face of the pandemic. These include:
- New regulations about visitor restrictions and updated outlines on group activities, especially as some facilities start to relax their previously mandated restrictions.
- In addition, new information was released regarding the best practices for tracking infections and preventing infection of others in a systematic way.
This current contagion of COVID-19 presents unprecedented challenges both for aspiring RCFE administrators and long-standing ones. But never has the need for dedicated RCFE workers been more urgent. Getting your RCFE license now will go a long way to helping our senior population today and tomorrow.
The need is there. Are you ready to provide it?
Assisted Living Education is the leading provider of RCFE certification classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative.