How do I find an ALW facility near me?

Open the DHCS Assisted Living Waiver participating-sites list (linked at the bottom of this page). Filter or scroll to your county. Each facility on the list has agreed to accept ALW payment, but the list does not show current capacity. The next step is to call each facility directly and ask whether they currently have an ALW bed available, what level of care they accept (including secured-perimeter memory care if needed), and what their internal waitlist looks like.

Where is the official list of ALW participating facilities?

The California Department of Health Care Services maintains the canonical list at dhcs.ca.gov on the Assisted Living Waiver page. The list is typically published as a PDF organized by county. We do not republish the list here because DHCS updates it periodically and the authoritative version should always be the one served by DHCS itself. We last checked it on 2026-05-25.

Which California counties have the most ALW facilities?

Los Angeles, Orange, San Diego, San Francisco, and the broader Bay Area have the deepest concentrations of ALW-participating RCFEs. Sacramento and Alameda County have meaningful presence. Inland Empire (Riverside, San Bernardino) varies. Rural counties and most of the Central Valley have far fewer participating facilities, and some counties may have none at all.

What if no ALW facility exists in my county?

Three practical paths. First, bridge with IHSS Protective Supervision at home while you wait, IHSS is available in every California county and family members can be paid providers. Second, consider whether a relocation to a participating county is realistic; for some families the cost and disruption is worth the access. Third, if your parent’s care needs justify nursing-facility level of care, transition to a Medi-Cal SNF, which is available statewide. An elder-law attorney can help model the options.

Can I tour an ALW facility before I have a slot?

Yes, and you should. Facilities welcome inquiries from prospective ALW residents because participation is voluntary and they need to know whether you are a good fit for them as much as the reverse. Bring the Title 22 inspection record (available from CDSS) to the tour and ask about specific deficiencies if any. Ask which of their staff is dementia-trained if memory care is the need. Ask how their actual ALW waitlist works internally.

How to find assisted living that accepts Medi-Cal in California?

Medi-Cal payment for assisted living in California only flows through the Assisted Living Waiver (ALW). The DHCS participating-facility list is therefore the answer to both questions, find an ALW facility, and you have found assisted living that accepts Medi-Cal. Outside the ALW network, no California assisted-living facility accepts Medi-Cal. See the does-Medi-Cal-pay-for-assisted-living coverage page for the full payment picture.

ALW participating facilities: how to find one near you

ALW participating facilities in California: how to find one near you.

The California Department of Health Care Services publishes the official list of Assisted Living Waiver participating Residential Care Facilities for the Elderly by county. Availability is uneven: Los Angeles, Orange County, San Diego, and the Bay Area have the most facilities and the longest waitlists; rural counties may have none. The list shows participation but not current capacity, capacity must be checked directly with each facility.

The California ALW participating-facility list is published by DHCS

The Assisted Living Waiver is a California Medi-Cal program, and the California Department of Health Care Services (DHCS) maintains the canonical list of participating Residential Care Facilities for the Elderly (RCFEs). The list is updated periodically and the authoritative source is always the DHCS PDF. This page does not republish that list. It exists to help you read it.

How to read the DHCS list

The DHCS list is organized by county. For each facility, expect to find the legal name, the licensed RCFE number, the city, and a contact. What the list does not show:

Current capacity or whether a bed is available
The facility’s internal waitlist depth
Whether the facility accepts secured-perimeter memory-care residents
The level of care a specific facility will admit
Title 22 inspection-record cleanliness (that’s a separate CDSS lookup)
Room-and-board rates (these vary by facility and by unit)

Treat the DHCS list as the universe of eligible facilities, not the universe of available facilities. The phone calls are where the real shortlisting happens.

Per-county quick reference

Participating-facility counts and licensed capacity below come from the DHCS Assisted Living Waiver participating-sites list. Fifteen of California’s fifty-eight counties have any participating facility at all. Capacity is licensed capacity, not open beds: a county can look well covered here and still have nothing available this month.

The ratio matters as much as the count. A county with many small residential homes is a different search from a county with a few large communities, and the facility count alone does not tell you which one you are walking into.

Los Angeles County — 404 participating facilities, about 17,688 licensed beds. The largest network in the state by a wide margin.
Orange County — 215 facilities, about 5,155 beds. Weighted toward the coastal cities.
Riverside County — 132 facilities, about 3,571 beds. The third-largest network, and larger than San Diego.
Fresno County — 96 facilities, about 1,695 beds. More facilities than San Diego and fewer than half the beds, because the network is built from small homes.
San Diego County — 89 facilities, about 2,624 beds. Some dementia-specialized RCFEs.
Sacramento County — 81 facilities, about 2,032 beds. Lower room-and-board pricing than the coastal metros.
San Bernardino County — 69 facilities, about 2,359 beds, clustered in the valley corridor rather than the High Desert.
Kern County — 47 facilities, about 672 beds. At roughly fourteen beds per facility, the smallest average in the state.
Alameda County — 22 facilities, about 1,132 beds, concentrated in the East Bay.
San Francisco County — 3 facilities, about 180 beds. Most San Francisco families end up looking down the Peninsula.
Contra Costa (35 facilities), San Joaquin (13), Sonoma (7), San Mateo (6) and Santa Clara (5) also have participating facilities. We have not built a county guide for these yet; use the DHCS list directly and the seven questions below.
The other forty-three counties have no participating facility on the DHCS list. For Modoc, Alpine, Mariposa, Trinity and similar rural counties, plan alternative funding: IHSS at home, Medi-Cal nursing-facility care if the level of care justifies it, or relocation to a participating county.

What participation does not guarantee

A facility appearing on the DHCS list means the facility has agreed to accept ALW reimbursement for residents who arrive with an approved waiver slot. It does not mean the facility currently has an open bed for an ALW resident, has trained staff for higher-acuity needs, has a secured perimeter for memory care, or is in good standing with CDSS on its most recent inspection. Verify each of those separately.

Seven questions to ask a participating facility before you tour

Do you currently have an open ALW bed, or how long is your internal waitlist?
What level of care do you admit? Do you accept residents needing two-person transfers, full feeding assistance, or behavior management for dementia?
Are you CDSS-approved for secured-perimeter memory care, if that is the need?
What does room and board cost monthly at your facility, given that ALW does not cover that portion?
What additional fees apply outside ALW reimbursement (level-of-care surcharges, one-time community fees, medication-administration fees)?
How long have you been ALW-participating, and what is your current ALW resident census?
Can I see your most recent Title 22 inspection report and your written explanation of any cited deficiencies?

If your county has no participating facility

Three options:

Bridge with IHSS, In-Home Supportive Services is available in every California county and pays for personal care, supervision, and (with Protective Supervision approval) dementia care at home. Family members can be paid providers. See the IHSS eligibility page.
Consider a California relocation, for some families, moving to a participating county is the most practical path. The cost and disruption are real; weigh against the cost of indefinite private-pay assisted living.
Evaluate Medi-Cal SNF care, if your parent’s care needs are at or near skilled-nursing level, Medi-Cal-funded nursing-facility care is available statewide. See the long-term skilled nursing page.

DHCS participating-sites list last checked on 2026-05-25. The DHCS list is the source of truth; verify against the live PDF before acting.

Related guides and next steps

This guide explains program rules and county-specific contacts, not legal advice. California Care Compass does not place referrals on county or planning pages.