Nursing Home or Assisted Living Regulators

"Nursing home," "assisted living" and "memory care" sound alike, but California law treats them as different things. Our nursing home abuse and neglect page covers claims against care facilities in general. This guide explains how to tell which kind of facility your parent lives in, which state agency oversees it, and what that changes if something goes wrong.

The short version: a skilled nursing facility is a medical setting, licensed as a health facility. A residential care facility for the elderly (the legal name for most assisted living) is a non-medical home that provides care and supervision. Both can be held responsible for neglect under the elder abuse laws, but the rules that measure their care, and some of the remedies, are different.

How do we find out which kind of facility it is, step by step?

Look at the license. The admission agreement and the facility's state license name the license type and number; ask to see the license if you do not have a copy. "Skilled nursing facility" or "intermediate care facility" means a health facility. "Residential care facility for the elderly" means assisted living, whatever the marketing calls it.
Confirm it with the state. Health facilities can be looked up on the Department of Public Health's Cal Health Find database, which is also where you can file a complaint online. Community care facilities appear in the Department of Social Services' care facility search.
Find the local office. For Sonoma and Marin County health facilities, it is the Department of Public Health's Santa Rosa office at 2170 Northpoint Parkway, (707) 576-6775 or toll free (866) 784-0703. For assisted living in both counties, it is the Department of Social Services' Santa Rosa Adult and Senior Care Regional Office at 1450 Neotomas Avenue, Suite 100, (707) 588-5026.
Call the ombudsman either way. The Long-Term Care Ombudsman helps residents of both kinds of facilities. In Sonoma County the program is reached at (707) 526-4108; in Marin County, at (415) 473-7446. The statewide ombudsman hotline, 1-800-231-4024, answers 24 hours a day.
Read the rights that apply. A nursing home resident's rights come from Health and Safety Code 1599.1 and federal rules; an assisted living resident's rights are listed in Health and Safety Code 1569.269. The table below compares them.
Keep the answer in your notes. The license type decides where a complaint goes, which records rules apply and which legal claims a lawyer will look at.

How do the two kinds of facilities compare?

Question	Skilled nursing facility (nursing home)	Residential care facility for the elderly (assisted living)
What the law calls it	A health facility providing skilled nursing and supportive care to patients whose primary need is skilled nursing care on an extended basis (Health and Safety Code 1250(c))	A housing arrangement chosen voluntarily by people 60 or older where care and supervision, protective supervision or personal care are provided based on their needs (Health and Safety Code 1569.2)
Who licenses and inspects it	Department of Public Health, Licensing and Certification; its survey teams also apply federal rules when the facility takes Medicare or Medi-Cal	Department of Social Services, Community Care Licensing Division; annual unannounced inspections since 2019 (Health and Safety Code 1569.33)
How fast a complaint is visited	Onsite within 10 working days, or within 24 hours for a threat of imminent danger of death or serious bodily harm; investigation completed within 60 days, which can be extended (Health and Safety Code 1420)	Onsite inspection within 10 days of the complaint (Health and Safety Code 1569.35)
Residents' bill of rights	Health and Safety Code 1599.1, plus federal rights in 42 CFR 483.10, 483.12, 483.15 and 483.24, which state law applies to every skilled nursing facility regardless of how the resident pays	31 listed rights in Health and Safety Code 1569.269, including care by staff "sufficient in numbers, qualifications, and competency" to meet residents' needs
Residents' rights lawsuit	Yes: up to $500 per violation, plus costs and attorney's fees (Health and Safety Code 1430(b))	Section 1430(b) is written for skilled nursing and intermediate care facilities; the assisted living rights are "in addition to any other rights provided by law" (Health and Safety Code 1569.269(e))
State penalties	Citations classed AA, A or B; for a class AA citation, $30,000 to $120,000 (Health and Safety Code 1424 and 1424.5)	$500 immediately for a violation that injured a resident; $10,000 for physical abuse or serious bodily injury; $15,000 for a death (Health and Safety Code 1569.49)
Facility's own abuse report	To the Department of Public Health immediately, or within 24 hours (Health and Safety Code 1418.91)	Staff, as mandated reporters, report to the ombudsman and law enforcement, and those reports reach the Department of Social Services (Welfare and Institutions Code 15630)
Copies of records	Within 15 days of a written request (Health and Safety Code 123110)	Residents may review their records and buy copies, provided within two business days (Health and Safety Code 1569.269(a)(21))

Why does the license type matter for a claim?

It matters in three ways: the standard of care, the remedies, and the evidence.

The standard of care. Under the Elder Abuse Act, neglect is a caregiver's failure to use the care a reasonable person in the same position would use, including failing to provide medical care or to protect a resident from health and safety hazards (Welfare and Institutions Code 15610.57). What is reasonable depends on what the facility is licensed and paid to do. A nursing home that takes Medicare or Medi-Cal must, for example, keep the environment "as free of accident hazards as is possible" and give each resident adequate supervision and assistance devices to prevent accidents (42 CFR 483.25(d)). An assisted living facility owes care and supervision, must be aware of each resident's general whereabouts, and must monitor residents' activities for their health, safety and well-being (Health and Safety Code 1569.312). Those duties overlap, but they are not the same, and a claim is built on the ones that apply.

The remedies. The Elder Abuse Act reaches both kinds of facilities, because the jury instruction for neglect asks whether the defendant had a substantial caretaking or custodial relationship with the elder, not what license it holds (CACI 3103). The residents' rights lawsuit is different: Health and Safety Code 1430(b) gives a current or former resident of a skilled nursing or intermediate care facility, or their representative or successor in interest, the right to sue the licensee for violating the resident's rights, and makes the licensee liable for its employees' acts. Our guide to the residents' rights claim against a nursing home explains how those statutory damages work.

The evidence. A licensing investigation produces records a family can ask for. Assisted living inspection reports, lists of deficiencies and plans of correction are open to public inspection (Health and Safety Code 1569.33(g)). Staffing rules matter too: a decision the Judicial Council cites under CACI 3103 says a violation of staffing regulations "may provide a basis for finding neglect." Which staffing rules apply depends, again, on the license.

What happens after a complaint to each agency?

At the Department of Public Health, the department assigns an inspector and tells the complainant the inspector's name within two working days. The complainant is told of the proposed course of action and may ask to accompany the inspector, unless that would violate another patient's privacy. When the investigation ends, the department notifies the complainant and the facility in writing, and a complainant who disagrees with the result can ask for an informal conference within five business days (Health and Safety Code 1420).

At the Department of Social Services, a complaint can be made by phone at 844-538-8766, by email to [email protected], or through the online complaint portal, and it can be made anonymously. Unless you ask otherwise, your name is not disclosed to the facility (Health and Safety Code 1569.35). The department says its local office makes an unannounced visit within 10 days and decides each allegation under a "preponderance of the evidence" standard, finding it substantiated, unsubstantiated or unfounded. The complainant is notified in writing within 10 business days after the investigation is complete (Health and Safety Code 1569.35(d)).

Neither agency decides a family's claim for money. A citation is a licensing finding. It can be strong evidence of what went wrong, but a civil claim is separate and has its own deadlines, explained in our guide on how long a family has to bring an elder abuse claim.

What about memory care, hospital units and other labels?

Memory care is a marketing term, not a license type named in these statutes. When an assisted living facility advertises or promotes special care for people with dementia, it remains licensed by the Department of Social Services, and it must describe its dementia program, staffing, training and physical environment in its plan of operation, and give that information to the public on request (Health and Safety Code 1569.627). Our guide on a resident with dementia who wandered from memory care covers those duties.

A skilled nursing unit inside a hospital is part of a general acute care hospital, but its distinct-part skilled nursing beds count as a long-term health care facility under state law (Health and Safety Code 1418(c)), so the nursing home rules apply to that unit.

What changes the answer?

The campus holds more than one license. If one campus holds both an assisted living license and a skilled nursing license, each part answers to its own agency, so the question is which license covered the place where the harm happened (Health and Safety Code 1250 and 1569.10).

The resident is younger than 60 or 65. People under 60 with compatible needs may live in assisted living (Health and Safety Code 1569.2), and the Elder Abuse Act protects adults 18 to 64 as dependent adults when they have physical or mental limitations or are inpatients in a 24-hour health facility (Welfare and Institutions Code 15610.23).

An arbitration agreement was signed at admission. An agreement to waive the residents' rights lawsuit is void (Health and Safety Code 1430(b)(1)(C)), and an assisted living admission contract cannot require a resident to waive rights given by law (Health and Safety Code 1569.269(c)). Whether other claims go to arbitration is a separate question, covered in our guide to nursing home arbitration agreements.

The facility is run by a public entity. A written claim to that entity is due within six months for an injury claim (Government Code 911.2).

Records were changed or lost. Since January 1, 2026, a court may use a lower standard of proof against a covered care facility that destroyed, altered or concealed evidence (Welfare and Institutions Code 15657.02); see what changed in 2026 when a care facility destroys records.

What could this look like? An example

For example, imagine a father who lives in an assisted living community in Petaluma. He falls in his room, breaks his hip, and after a hospital stay is discharged to a skilled nursing facility in Santa Rosa for rehabilitation. Three weeks later his daughter finds a wound on his heel that no one mentioned.

His two stays fall under two regulators. Her questions about the fall in assisted living go to the Department of Social Services' Santa Rosa regional office, and she can ask for the facility's public inspection reports. Her concern about the wound in the nursing home goes to the Department of Public Health's Santa Rosa office, which must visit within 10 working days. She calls the Sonoma County ombudsman about both. If a lawyer reviews the two episodes, the fall is measured against the assisted living duties of care and supervision, and the wound against the nursing home rules on preventing pressure ulcers, with a possible residents' rights claim under section 1430(b) for the nursing home stay only. This example is made up to show how the rules fit together; it says nothing about any real case.

What mistakes do families make about who regulates a facility?

Relying on the facility's marketing name instead of the license type on file with the state.
Filing a complaint with the wrong agency and waiting weeks for a referral.
Assuming the residents' rights lawsuit in section 1430(b) covers assisted living.
Not asking for the public inspection reports, which can show earlier problems.
Treating a citation as the end of the matter, when the civil claim has its own deadlines.

What should we do this week?

Find the license type and number on the admission agreement or the facility's license.
Look the facility up with the right agency and note the local office.
Call the county ombudsman and describe what you have seen.
File a written complaint with the agency that licenses the facility, and keep a copy.
Ask for the resident's records in writing under the rule that applies to that facility.
Write down dates, names and what was said in every conversation. For the first-week checklist in a nursing home, see what to do this week if you suspect nursing home neglect.

Frequently asked questions

Is "assisted living" a license type in California?

Not by that name. Most assisted living communities for older adults are licensed as residential care facilities for the elderly, and no one may operate one without a current license or special permit (Health and Safety Code 1569.10).

Does it matter whether Medicare or Medi-Cal pays?

For nursing homes, state law applies the federal resident rights in 42 CFR 483.10, 483.12, 483.15 and 483.24 to every skilled nursing and intermediate care facility, whatever the resident's payment source (Health and Safety Code 1599.1(i)). Other federal requirements apply to facilities certified for those programs.

Can I complain without giving my name?

Yes. The Department of Social Services accepts anonymous complaints about assisted living, and keeps a complainant's name from the facility unless the complainant asks otherwise (Health and Safety Code 1569.35).

Who regulates in-home caregivers?

Home care organizations are licensed by the Department of Social Services, and abuse at home is reported to Adult Protective Services. See who is responsible for abuse by an in-home caregiver.

Can a falls or bedsore case involve both agencies?

Yes, when the resident moved between facilities, and each stay is judged under its own rules. Our guide on falls in assisted living covers one setting. The other is covered in bedsores and nursing home neglect.

Where are these offices for Sonoma and Marin County?

Both state offices that cover Sonoma and Marin County are in Santa Rosa, and the county ombudsman programs are in Petaluma and San Rafael. Our Sonoma County page lists other county agencies.

If a loved one was harmed in a nursing home or assisted living facility, contact Young Law Group today at (707) 343-0556 or through our contact page for a free consultation.

Nursing home or assisted living: who regulates it, and why does that matter for a claim?