How to open an RCFE in California

Step 1: Get administrator certification

Every RCFE administrator must be certified before starting work, including an owner who runs the home. The initial program is at least 80 hours, with at least 60 hours live or interactive, followed by an open-book state exam of at least 100 questions taken within 60 days of finishing the course. CDSS charges $100 for the exam and $140 for the certificate application. Certification renews every two years with 40 hours of continuing education, including 8 hours on dementia care.

Step 2: Complete the online orientation

Applicants complete the CDSS pre-licensing orientation online. The fee is $50 plus a $4.85 processing fee, and you have 30 days of access. The orientation certificate goes in your application package.

Step 3: Prepare the home and your plans

• Fire clearance: CDSS sends the request to your local fire authority, so the building must meet fire and life-safety rules for the residents you plan to serve
• Emergency and disaster plan, submitted with the application: 72 hours of self-reliance including power failures, two evacuation sites (one outside the area) and quarterly drills on every shift
• Start-up funds covering at least three months of operating costs, which CDSS reviews along with a credit check
• Insurance quotes, so liability and workers' comp can be bound before you open

Step 4: Submit the application and fee

Mail the application (LIC 200), orientation certificate, administrator certificate and fee to the CDSS Adult and Senior Care Program Centralized Applications Bureau in Sacramento. The initial license fee depends on capacity: $495.60 for 1 to 3 beds, $990 for 4 to 6, $1,486.80 for 7 to 15, $1,980 for 16 to 30 and $2,476.80 for 31 to 49. An annual fee follows each year. CDSS estimates 90 to 120 days to process a complete application, ending with a pre-licensing inspection.

Step 5: Bind insurance before residents move in

• Liability covering injury to residents and guests of at least $1M per occurrence and $3M aggregate (Health and Safety Code 1569.605)
• Workers' compensation for every employee under class 9070(1), including part-time and relief caregivers
• A resident cash bond, starting at $1,000, if you will safeguard residents' money
• Abuse and molestation, property and non-owned auto coverage to round out the program

Step 6: Clear and train your staff

The licensee, administrator and staff with resident contact need Live Scan fingerprint clearances. Direct care staff complete 40 hours of initial training, 20 before working without supervision (including 6 hours of dementia care) and 20 more within four weeks, plus 16 hours of hands-on training. After that, 20 hours every year, including 8 on dementia care. Licensed nurses and CNAs follow a shorter orientation track.