California Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: January 28, 2024


In California, Residential Care Facilities for the Elderly offer a place to live with different levels of full-time care.

These residences must:

– Have adequate supervision

– Have a structured activity program

– Have enhanced safety including locks and alert devices

That means, in California, a residence cannot safely care for someone with dementia unless it has a formal program in place to meet the needs of dementia patients.

California’s Community Care Licensing Division, run by the Department of Social Services, governs all assisted living facilities in the state.


California Memory Care / Residential Alzheimer’s Care Costs

California spans a wide geographical area between its coastal areas, mountains, and borders. Because of its large size, there can be a vast difference in the cost of memory care for your loved one. The projected average cost of memory care in 2024 in California will be $6,391 per month. This includes room, board, general care, and a guarantee that residential care facilities will not change their prices without 60 days’ advance notice.

Just outside the Bay Area, in Northern California, Santa Rosa is the priciest city for memory care in the state. To the south, in the Central Valley’s largest city, Visalia has the least expensive memory care in the state.

 Help Finding a Residence: There are over 1,500 memory care facilities statewide. Californians have access to free assistance finding residences that meet their care needs and budget. Get Started Here

With high monthly prices statewide, it is possible to find more affordable memory care in neighboring states. For example, if you live to the east in the San Joaquin Valley, memory care in both Nevada and Arizona is less expensive. In Nevada, memory care costs about $5,377 per month and in Arizona, it is $5,773 monthly. The difference in prices can be large, so be sure to assess all your options for assisted living before agreeing to move your loved one into a memory care residence. Other major California cities and their care costs are:

2024 California Memory Care / Assisted Living Costs
Assisted Living Memory Care / Residential Alzheimer’s Care
Region / City  Daily Cost Monthly Cost Yearly Cost  Daily Cost Monthly Cost Yearly Cost
Statewide $226 $5,810 $69,725 $247 $6,391 $76,697
Los Angeles $226 $5,810 $69,725 $247 $6,391 $76,697
San Francisco $272 $8,268 $99,222 $299 $9,095 $109,136
San Diego $235 $7,155 $85,860 $258 $7,870 $94,440
Fresno $167 $5,088 $61,055 $184 $5,597 $67,159
Sacramento $225 $6,837 $82,050 $246 $7,521 $90,253


Assisted Living Laws & Regulations

Admissions Requirements & Process

In California, there are several conditions one must meet before being admitted to a residential care facility. Before admission, residents must be assessed for:

– Functional capacity

– Mental condition

– Social factors like how well they interact with other patients and staff

This assessment can be performed by staff at the residence. While there is no standard form, a Functional Capability Assessment is available here. Assessments must be updated yearly or whenever there’s a major change in your loved one’s condition. The cost of this assessment should not be an additional fee; it’s part of moving in and should be covered under the basic rate.

In addition to an in-house evaluation, admission also requires a detailed medical report. The first step in the process of moving into memory care in California is to make an appointment with your loved one’s doctor and ask for this report. The doctor can guide you on what to look for, including helping to know what level of care is required. Paying for this doctor’s evaluation is probably the responsibility of the person moving in. If your loved one is on Medicare, an annual free “wellness visit” (also called a “cognitive assessment”) that screens for dementia symptoms are covered.

Residents who need help with all activities of daily living (even people with dementia can usually perform some ADLs without assistance) cannot be admitted unless they’ve submitted a written exception request to the Department of Social Services, and been approved. A residence cannot admit someone who needs 24-hour skilled nursing care or has a mental disorder that disrupts a group unless all guidelines are met. In addition, people with the following conditions also cannot be admitted:

– Stage 3 or 4 dermal ulcers

– Gastrostomy care

– Naso-gastric tubes

– Staph infection or other serious infection

The signed admissions agreement must list all services, rates, payment provisions, and conditions that would allow for refunds. It must explain billing and payment procedures and the conditions that could cause rates to increase. Any factors that could lead to eviction must also be listed.

Because it can take months between picking a residence and moving in, you’ll want to start looking as soon as possible. Your loved one will also be able to provide more input the sooner you start your search. It is possible to move into memory care on short notice, but the longer you spend investigating options, the more likely you are to find a home that’s a good fit. This is especially true because some residences have extended wait lists for admissions.

 Too soon or too late? While families often hesitate to move a loved one to memory care, it can be beneficial to move in earlier as persons with greater cognizance have an easier time adjusting to the change.


Facility / Residence Requirements

Residents’ rooms don’t need to be a specific size, except that they must “be of sufficient size to allow for mobility of the resident and equipment.” Be sure to see exactly where your loved one will sleep before you sign an agreement, to assess whether there’s enough space. Bedrooms may have two residents at most. There must be one toilet and sink for every six residents, and a bathtub or shower for every 10.

In memory care homes for people with dementia, doors with outdoor access require special locks to prevent people from wandering outside and getting lost. Unlike in other states, California memory care homes are not required by regulations to be designed with dementia-friendly features like clear layouts and circular hallways. This is another reason to carefully inspect a residence before moving in; keep an eye on whether you think your loved one could get lost or confused by the buildings’ designs.


Staff & Training Requirements

There is no specific staffing ratio that must be met in California, though staffing “must be sufficient” for the number of residents throughout the day and night. An administrator or manager who is certified and at least 21 years old must be on the premises 24 hours per day. All other staff in residential care facilities must be at least 18 years old, with on-the-job training. Additionally:

– Initial training in the first month of hiring is 40 hours total. 20 hours must be done before they can work with patients and 12 hours must be focused on dementia care.
– Staff who work directly with residents need 20 hours of training annually, including eight hours of dementia-care training.
– First aid training is also required. Someone trained to do CPR must be working at the residence at all times.
– All training for every employee must be documented by the facility.
– Residences must train staff to recognize elder abuse.
– Residents with specialized health conditions, like diabetes, must be cared for by staff with training from a licensed professional that meets the specific need.
– Staff who handle medications must meet training requirements that vary depending on the number of residents.



The admission agreement signed when moving in must include information about evictions, including all the reasons a person can be asked to leave the residence. An eviction notice can be issued that gives someone 30 days to move out, for the following reasons:

– Nonpayment within 10 days of the due date
– Illegal behavior
– Not following the residence’s policies
– Resident’s health needs have changed and the residence can no longer safely provide care

If a resident’s behavior is considered threatening to anyone in the residence, it’s possible that the state’s Department of Social Services would approve a three-day eviction notice, rather than the usual 30 days. A judge’s order is required to remove someone who doesn’t leave voluntarily after receiving an eviction notice. Help with relocation must be made available to someone being evicted. For general information on what to do if you receive an eviction notice in memory care, click here.


Financial Assistance for Memory Care in California

Medi-Cal Assisted Living Waiver

Medicaid is a jointly funded federal and state program. In California, the program that provides long-term care and support is called Medi-Cal. For financially qualified people, Medi-Cal will help cover the cost of nursing homes for patients who require round-the-clock nursing care. Medi-Cal generally does not pay for assisted living or memory care except through a program called the Assisted Living Waiver (ALW). ALW is a Home and Community-Based Services (HCBS) program that pays for personal care in assisted living and memory care, though your loved one will still need to pay toward their room and board.

To qualify for ALW’s help with assisted living or memory care, your loved one must live in a residence licensed by the state and qualify for Medi-Cal including monthly income under $1,677 in 2024. These residences are only in the following counties:

Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.

California residents who do not currently reside in one of those counties can enter the program by moving to an assisted living/memory care home located in one of those counties.

For additional information on the program, including how to enroll, click here. Medi-Cal eligibility details are here and a Medi-Cal Spend-Down Calculator is here.


California’s Supplemental Security Income and State Supplemental Payment (SSI/SSP) Programs

A person in assisted living who needs additional help covering costs may be eligible for combined federal and state assistance through the SSI and SSP programs, often in the form of additional Medi-Cal benefits. The maximum monthly cash payments paid through these programs are $1,575 in 2024 per month for someone in assisted living. The Social Security Administration determines whether your loved one is eligible based on federal rules. For more on eligibility and how to apply, click here.


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.


VA Pensions
There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

 More information on VA Pensions’ eligibility criteria, payment rates and the application process is available here.

Veterans Homes

There are eight veterans’ homes in California, which are residential care facilities that provide long-term care for veterans. They are scattered throughout the state and located in Barstow, Chula Vista, Yountville, Lancaster, Fresno, Ventura, Redding, and Los Angeles. Given that California has almost two million veterans, more than any other state, services are impacted. For help finding the right residence for a loved one who served, contact the VA. Patients who live near Nevada, Arizona, or Oregon might also consider looking across the state border. More info.


Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.