In California, facilities range from small 6-resident "board & care" facilities to larger 100- to 400- resident communities.

Although exceptions exist, small and large facilities are generally distinguished by three things:

  1. Whether the facility was built as an assisted living facility.
    Nearly all the small facilities with less than seven residents were not built as facilities, but were built as residential homes and are in residential neighborhoods. These "board and care" homes have been remodeled or modified to accommodate elderly residents with amenities such as grab bars, ramps and wider doorways and hallways. The larger facilities generally have been originally designed and built as assisted living facilities.

  2. Staff-to-resident ratios.
    In smaller facilities, there are generally higher staff-to-resident ratios. This is not always a reliable indicator of quality of care, however, as larger facilities have more flexibility to hire staff based on the level of care their clients need.

  3. Activities.
    Larger facilities tend to have the resources to organize more activities more often. Don't assume, however, that the number of activities available means that all the residents participate. Many small facilities, due to more personal contact, can be more effective working with individuals who would otherwise isolate themselves from a larger group.


San Diego Elder Care