Family guide
What is an adult family home?
An adult family home is a licensed residential house where a small number of adults — no more than six in Washington State — live and receive personal care. This guide explains what they provide, who they suit, and how to check one before you choose it.
The short answer
An adult family home is a regular house in a residential neighbourhood that is licensed by the state to provide room, board, laundry, supervision, and personal care to a small group of unrelated adults. In Washington State the licence allows up to six residents at a time, and the term “Adult Family Home” is the state's own legal name for this care setting. Other states license the same idea under different names — Oregon calls them Adult Foster Homes, Georgia uses Personal Care Homes, and California uses Residential Care Facilities for the Elderly.
The defining features are scale and setting: a household rather than a facility, with the same few caregivers, shared meals, and a level of daily attention that is difficult to reproduce in a building with a hundred residents.
What an adult family home provides
- A private or shared bedroom in an ordinary residential house
- Meals, snacks, and help with eating when it is needed
- Help with bathing, dressing, grooming, toileting, and mobility
- Medication assistance or administration, depending on the home's licence and staff
- Supervision and companionship throughout the day and night
- Laundry, housekeeping, and help arranging appointments or transport
Many homes also specialise. Washington recognises specialty training and designations for Dementia care, Mental health support, Developmental disabilities, and some homes coordinate with visiting nurses or hospice teams for residents with more complex needs. A home's specialties, and the care types it reports, appear on its listing in this directory.
Who an adult family home suits
Adult family homes tend to fit people who need daily hands-on help but not continuous skilled nursing, who do better in a quiet household than in a large building, or who are leaving hospital or rehabilitation and cannot safely return home alone. They also suit younger adults with developmental disabilities or mental health needs who need long-term support in a normal domestic setting.
They are usually not the right setting for someone who needs continuous nursing supervision, ventilator care, or intensive behavioural treatment. If you are unsure, ask the home whether it has cared for someone with the same needs, and ask the person's doctor or discharge planner what level of care they recommend.
How it compares with other care settings
| Setting | Typical size | Level of care |
|---|---|---|
| Adult family home | Up to 6 residents in a house | Personal care, meals, medication help, supervision; outside nursing or hospice brought in as needed |
| Assisted living | Dozens to hundreds of apartments | Personal care with shift staffing, plus dining, activities, and on-site amenities |
| Nursing home | Dozens to hundreds of beds | Continuous skilled nursing and rehabilitation under nursing supervision |
What it costs and how it is paid for
Rates are set by each individual home, not by this directory or by the state. What a home charges depends on where it is, whether the room is private or shared, and how much help the resident needs each day. Providers who choose to publish pricing show it on their listing as a monthly range; many prefer to quote after an assessment.
Payment usually comes from private funds, long-term care insurance, veterans' benefits, or Medicaid where a home participates and has a Medicaid space open. Because participation changes, confirm payment arrangements with the home directly before you rely on them.
How to check a home before you choose it
1. Check the licence before anything else
Look the home up in the DSHS Adult Family Home Locator. Confirm the licence is active, read the inspection history, and note any enforcement actions. A home that is reluctant to give you its licence number is a warning sign.
2. Visit in person, ideally more than once
Visit at a mealtime and again at a different hour. Notice whether residents are up and engaged, whether the house smells and looks clean, and whether the caregiver knows each resident by name and habit.
3. Ask who is actually in the house
Ask how many residents live there now, who provides care overnight, who covers days off, and how often the same caregivers work. Consistency matters more in a six-person home than in a large facility.
4. Match the home to the care that is needed
Ask whether the home is currently caring for anyone with similar needs — dementia, transfers, insulin, oxygen, hospice — and what would happen if those needs increased. Ask directly what would cause a resident to be asked to move.
5. Get the money in writing
Ask for the monthly rate, what is included, what is billed on top, how much notice you get before a rate increase, and the refund and discharge terms. Read the residency agreement before signing anything.
Washington's licence records are public. You can search any home in the DSHS Adult Family Home Locator, and read the state's adult family home overview for the licensing rules themselves.
Common questions
- How many people live in an adult family home?
- Washington licenses adult family homes for up to six residents at a time. Some homes are licensed for fewer. Because the household is small, residents usually share the same living room, dining table, and staff throughout the day.
- Who licenses adult family homes in Washington?
- The Washington State Department of Social and Health Services (DSHS), Aging and Long-Term Support Administration, licenses and inspects adult family homes. DSHS publishes each home's licence status, inspection history, and any enforcement actions in its public Adult Family Home Locator.
- What is the difference between an adult family home and assisted living?
- An assisted living facility is typically a larger building with dozens of apartments, shared dining rooms, and shift-based staffing. An adult family home is an ordinary house in a residential neighbourhood with no more than six residents. Families often choose an adult family home for the smaller scale and consistent caregivers, and assisted living for the wider range of on-site amenities.
- What is the difference between an adult family home and a nursing home?
- A nursing home provides skilled nursing care around the clock under direct nursing supervision. An adult family home provides personal care, meals, medication assistance, and supervision, and may bring in outside nursing, hospice, or therapy services. People whose medical needs require continuous skilled nursing are usually served by a nursing home instead.
- Do adult family homes accept Medicaid?
- Some do and some do not, and a home may accept Medicaid for existing residents but not for new admissions. Payment is set by each home, not by this directory. Ask the home directly which payment sources it currently accepts and whether that applies to a new resident.
- What do adult family homes cost?
- Rates are set by each individual home and vary with location, room type, and the level of care a resident needs. Providers who publish pricing on their listing show it as a monthly range. Always confirm the current rate, what it includes, and what is billed separately directly with the home.
Find adult family homes near you
Listings on this directory are managed by the providers themselves, and you contact the home directly using the phone number, email, or website it publishes. We do not match, refer, or place families.