Assisted living on Medi-Cal in California: 1,070 waiver homes, by county

As of September 23, 2026, 1,070 licensed residential care homes in California participate in the Assisted Living Waiver (ALW), the Medi-Cal program that pays for assisted-living services. Homes are on file in 15 counties; 749 are small board-and-care homes licensed for six or fewer residents. Every count on this page comes from DHCS ALW enrollment records matched to the CDSS licensing roster.

DHCS ALW enrollment records · CDSS licensing roster · September 23, 2026

What is the Assisted Living Waiver?

The Assisted Living Waiver is a Medi-Cal program administered by the California Department of Health Care Services (DHCS). For eligible Medi-Cal members who would otherwise qualify for nursing-facility care, it pays for care and services in a participating assisted-living or board-and-care home; residents generally pay room and board separately. The home lists on this site reflect DHCS enrollment records as of September 23, 2026.

Which California counties have Assisted Living Waiver homes?

DHCS enrollment records as of September 23, 2026 show licensed ALW-participating homes in 15 California counties. Los Angeles County has the most on file with 334, followed by Orange (201), Riverside (120), Fresno (89). The table below lists every county with at least one participating home; each county name links to the full, free list of its homes.

CountyALW homes on fileAll licensed homes
Los Angeles County334Los Angeles County directory
Orange County201Orange County directory
Riverside County120Riverside County directory
Fresno County89Fresno County directory
San Diego County88San Diego County directory
Sacramento County69Sacramento County directory
San Bernardino County62San Bernardino County directory
Kern County32Kern County directory
Contra Costa County28Contra Costa County directory
Alameda County19Alameda County directory
San Joaquin County11San Joaquin County directory
Sonoma County7Sonoma County directory
San Mateo County4San Mateo County directory
San Francisco County3San Francisco County directory
Santa Clara County3Santa Clara County directory

DHCS ALW enrollment records · September 23, 2026

Which counties have no Assisted Living Waiver homes?

Of the 48 California counties with licensed residential care homes on the state roster, 33 have no ALW-participating home in DHCS enrollment records as of September 23, 2026 — including Ventura (257 licensed homes), Placer (237 licensed homes), Solano (166 licensed homes), Stanislaus (102 licensed homes). Families there can still compare every licensed home free of charge; the waiver simply has no enrolled home in those counties to pay.

How do you qualify for the Assisted Living Waiver?

Enrollment is not automatic with Medi-Cal. Per DHCS, applicants must be Medi-Cal members who need the level of care Medi-Cal would otherwise cover in a nursing facility, and enrollment is handled through DHCS-contracted care coordination agencies. Our plain-language guide to the Assisted Living Waiver walks through eligibility and how to apply, and DHCS publishes program details and the participating-facility list on its website.

Related: ALW homes and recorded empty beds, by county.

Browse all licensed homes in the California county directory. Homes never pay to appear here, and unknown facts are shown as “not on file” — never guessed.