Insurance for California assisted living and board and care homes

What California requires

Health and Safety Code section 1569.605 requires every RCFE to maintain liability insurance covering injury to residents and guests caused by the negligence of the licensee or its employees, at no less than $1,000,000 per occurrence and $3,000,000 in total annual aggregate. The only exception is a facility that is an integral part of a continuing care retirement community. There is no exception for small homes, so a four-bed board and care home needs the same limits as a 100-bed community. The license application only asks whether you will carry insurance, but licensing inspectors cite section 1569.605 when proof is not on file, so have the policy bound before residents move in.

Workers' comp for RCFE caregivers

California classifies residential care facilities for the elderly under class 9070(1), with an approved advisory pure premium rate of $5.213 per $100 of payroll for policies starting on or after September 1, 2026. That is nearly double the rate for in-home care, because lifting, transfers and overnight shifts drive injuries. Office staff who never work on the floor may qualify for clerical class 8810, and correct payroll reporting between the two is one of the biggest savings we find. Workers' comp is required from your first employee, including part-time and relief caregivers.

Coverage we build for RCFEs

• General and professional liability at $1M / $3M or higher, written to cover resident care, not just premises slips and falls
• Abuse and molestation coverage, which basic policies often exclude or cap
• A resident cash bond if you safeguard residents' money: California requires $1,000 for up to $750 a month, rising by schedule (22 CCR 87216)
• Property and business income, including equipment breakdown and food or medication spoilage during power outages
• Hired and non-owned auto for staff driving residents to appointments
• Employment practices liability for wage, scheduling and harassment claims

Emergency planning is now an insurance issue

As of January 1, 2026, Health and Safety Code section 1569.695 requires RCFE emergency plans to provide at least 72 hours of self-reliance, including during a short- or long-term power failure, with procedures for emergency power, refrigerated medications and powered devices such as oxygen. Plans must name at least two evacuation sites, one outside the immediate area, and staff must drill at least quarterly on each shift. In wildfire and power-shutoff regions, we review evacuation transport, generator and spoilage coverage alongside the plan.