RCFE Staffing Requirements Overview – A Quick Reference

In California, one option for seniors 60 years or older requiring long term care is a “social model” that provides room, meals, personal care assistance, supervision, observation, housekeeping and planned activities. A Residential Care Facility for the Elderly (RCFE) can care for one or more persons and must be licensed by the State of California to provide care services.

RCFEs operate as a bridge for those who require some level of assistance that prevents them from living on their own but who do not require 24-hour medical care, service, or supervision.

RCFE’s vary in size but there are basically two models: 16+ residents or 1-15 residents. The 16+ are owned or operated by Sunrise, Brookdale and Atria to name a few. The 1-15 model is typically a home in a residential area and often called a “board and care”. Unlike nursing homes, RCFEs may have licensed professionals as personnel, but it is not required to do so.

RCFE Administrator Certification and Licensing

The Administrator is responsible for the care and supervision of residents, staff management, and adhering to regulations, policies and procedures. Regulations require the Administrator to complete an 80-hour certification course and pass a 100 question state examination with a score of 70% or better to receive a certificate.

The Administrator must complete 40 hours of continuing education units (CEUs) every two years. Fortunately, Assisted Living Education (ALE) is one of very few reputable vendors that provide RCFE Administrator certification classes. Additionally, the RCFE itself must be licensed by the California Department of Social Services (CDSS). The licensing process includes completing an RCFE license application and meeting CDSS licensing requirements. ALE offers assistance with your RCFE application and licensing. Once licensed, RCFEs are subject to ongoing monitoring and unannounced inspections by CDSS to ensure compliance with California laws and regulations.

RCFE Staff Requirements

California regulations require RCFE facilities to have sufficient staff at all times who are competent to provide the services necessary to meet residents’ needs. The required staffing level is based on factors such as the number of residents, their individual care needs, the services provided by the facility, and the physical layout of the facility. CDSS may require additional staff when necessary to adequately meet residents’ needs. 

California does not establish one universal caregiver-to-resident ratio that applies to every RCFE. Instead, staffing must be sufficient to meet the needs of the residents at all times. Facilities with 16 or more residents are subject to additional staffing provisions under Title 22. . 

The facility must also have appropriate Administrator coverage in accordance with California regulations, including a qualified designated substitute when the Administrator is absent. 

California regulations require the following:

• Age requirements: Employees who provide direct care to the residents and employees who supervise employees must be 18 years or older. The Administrator must be 21 years or older.
• Administrator education requirements: The Administrator must have a high school diploma or GED for 1-15 residents; 15 college units and one year of experience for 16-49 residents; 2 years of college and three years experience for a community with 50 or more residents.
• Certifications: At least one staff member must be CPR certified and on the premises 24 hours per day. Any personnel who provide care to the residents must have first-aid certification.
• Clearances: All personnel and some volunteers must have a Criminal Record Clearance before employment approval. All personnel must have a health screen and negative TB test.
• Support personnel: Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds.

RCFE Staff Training Requirements

All personnel assisting residents with ADL’s must complete 20 hours of initial training prior to assisting a resident and an additional 20 hours of training within the first four weeks of employment.

The topics include: the aging process; personal care; physical limitation; ADL’s; resident rights; medication policies and procedures; psychosocial needs of the elderly; recognizing signs and symptoms of dementia; 12 hours of dementia training; postural supports; hospice care; restricted health conditions; LGBT; elder and dependent adult abuse reporting; theft and loss; disaster training; food service and safety; and care of a bedridden resident.

Staff also receive training on workplace health and safety topics, including universal precautions, Hepatitis B, bloodborne pathogens, personal protective equipment (PPE), and Safety Data Sheets (SDS), as required by applicable OSHA standards. 

All staff assisting residents with self-administration of medications must receive 10 hours of training for 1-15 residents and 24 hours of training for 16 or more residents.All communities must provide an additional 8 hours training each year.

ALE provides online training that allows employees to complete their coursework at their own pace. The following link will provide information about ALE’s training products for staff training.

RCFE Policies and Procedures

Once the facility is licensed, RCFEs are required to have a Plan of Operation that includes: policies and procedures for admissions; staffing plan, qualifications and duties; plan for training staff; organizational chart; sketches of the floorplan and the yard; policy for family visits and communication. ALE has created an assisted living policies and procedures manual.

Thank you for the essential care RCFE delivers to the aging community, and we hope the information provided in this article will help you continue to achieve that goal.

RCFE Staffing Frequently Asked Questions (FAQ)