Assisted Living, Regulations, California, Title 22
Aug 4, 2023

California Code of Regulations Title 22

Picture of Nicole Shelton
by Nicole Shelton

What is California Code of Regulations Title 22?

The California Code of Regulations (CCR) Title 22 is the primary regulatory framework for assisted living operators in California. The California Assisted Living Association (CALA) has a helpful site including a more focused set of Title 22 rules as they apply to Assisted Living operators here.

Title 22 is a set of rules and regulations established by the California Department of Social Services (CDSS) that governs community care facilities, including assisted living facilities. It also defines the two primary licensing types for assisted living communities in California: Residential Care Facilities for the Elderly (RCFE) and Adult Residential Care Facilities (ARF).

Title 22 encompasses a wide range of regulations, from licensing requirements and staffing ratios to safety standards and resident rights. Its primary objective is to protect the health, safety, and well-being of residents in care facilities.

Many AL communities use software like ECP to help comply with Title 22 regulations.

Key Areas Covered by Title 22

  1. Licensing and Certification: Title 22 outlines the requirements for obtaining and maintaining a license to operate an assisted living facility. This includes eligibility criteria, application procedures, and compliance with specific standards to ensure the facility meets all necessary safety and operational guidelines.

  2. Staffing and Training: Title 22 specifies the minimum staffing ratios for assisted living facilities to ensure that residents receive adequate care and supervision. Additionally, Title 22 contains requirements that operators must provide ongoing training to staff members to maintain high-quality care and adapt to the changing needs of residents.

  3. Resident Rights and Protections: Title 22 emphasizes the protection of residents' rights, ensuring their dignity and autonomy are upheld. It outlines the procedures for addressing grievances, protecting personal property, and maintaining confidentiality of resident information.

  4. Health and Safety Standards: Assisted living operators must adhere to stringent health and safety guidelines set forth in Title 22. This includes sanitation, infection control, medication management, nutrition, and the maintenance of a safe physical environment.

  5. Resident Assessment and Care Planning: Title 22 requires operators to conduct comprehensive assessments of residents' health and care needs upon admission and periodically thereafter. These assessments inform individualized care plans that cater to each resident's unique needs.

Implications for Assisted Living Operators

Compliance with Title 22 is not optional for assisted living operators; it is mandatory.  New operators opening communities will need to comply with Title 22 to get licensed and begin moving in residents. For existing operators, failure to adhere to these regulations can result in severe penalties, fines, or even the revocation of the facility's license. Understanding the implications of Title 22 is vital for operators to ensure the success of their assisted living facility while providing exceptional care to their residents.

What's next?

Assisted living operators should carefully review Title 22 and be sure to familiarize themselves with that and other regulations. Regulatory compliance is a huge part of what makes an assisted living community successful - nobody wants to move mom or dad into a community with lots of citations!

If you're a new or existing RCFE or ARF operator, and you're looking for software to help you comply with Title 22 and other regulations, please don't hesitate to reach out to ECP at or to request a demo here.

Note - The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only. ECP makes no warranties as to the accuracy of this content and does not commit to updating it as regulations change. Readers of this website should contact their attorney to obtain advice with respect to any particular legal or compliance matter. 


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