Bay Area families often discover two very different care settings when exploring senior living: large assisted living communities and small board and care homes (also called residential care homes). Both are licensed RCFEs in California, but the experience can feel worlds apart.

Board and Care Homes

Typically 6–10 residents in a converted residential home. Care is highly personalized with a family-like atmosphere. Common on the Peninsula in neighborhoods like San Carlos, Belmont, and Redwood City.

Advantages: Intimate setting, consistent caregivers, lower stimulation for those with dementia, often lower cost than large memory care units

Considerations: Fewer amenities, limited activities, smaller staff backup, may feel isolating for very social seniors

Typical cost: $5,000–$8,500/month

Assisted Living Communities

Larger purpose-built communities with 50–200+ residents. Offer dining rooms, activity programs, transportation, and a wider range of services and social opportunities.

Advantages: Robust activities, social opportunities, on-site amenities, more staff coverage, easier to increase care levels

Considerations: Can feel institutional, less personalized attention, higher cost especially for memory care wings

Typical cost: $5,500–$10,000/month

How to Decide

  • Personality: Social seniors who thrive on activities often prefer communities; those who value quiet and routine may prefer board and care
  • Care needs: Higher medical complexity may require a larger community with nursing oversight
  • Dementia: Small homes work well for early-to-moderate dementia; advanced memory care may need specialized secure units
  • Family proximity: Visit frequency matters — choose a location your family can realistically visit
  • Budget: Compare total cost including care level add-ons, not just base rates

Questions for Both Settings

  • What is your staff-to-resident ratio, including overnight?
  • Can you accommodate my loved one's specific dietary and cultural needs?
  • What happens if care needs increase?
  • Can I speak with a current family?
  • Are you licensed and what does your most recent inspection show?

Our advisors tour both community types with families across the Bay Area and help match personality, care needs, and budget to the right setting.