Washington

WA · State guide

An adult family home is a residential home that provides personal care, special care, room and board to 2–6 unrelated adults, or up to 8 with DSHS approval under RCW 70.128.066. An assisted living facility, licensed under chapter 18.20 RCW (formerly titled 'Boarding homes'), provides housing, basic services and general responsibility for the safety and well-being of seven or more residents, and may also provide domiciliary care. Since January 1, 2026, federal home- and community-based settings rules require ALFs to give residents on Medicaid a residency agreement with tenant-like protections. DSHS has also started rulemaking (WSR 26-04-001) to change AFH and ALF rules for CMS Access Rule critical-incident reporting.

License categories

Adult Family Home
Assisted Living Facility (formerly 'boarding home')
Enhanced Services Facility

Key laws

RCW 70.128; WAC 388-76

Adult Family Homes / Adult Family Home Minimum Licensing Requirements
Official text →

RCW 18.20

Assisted Living Facilities (formerly: Boarding homes)
Official text →

WAC 388-78A

Assisted Living Facility Licensing Rules
Official text →

Key requirements

An AFH applicant needs a high school diploma or equivalent, a 1,000-hour caregiving experience attestation, home care aide certification (unless exempt), and the community-college AFH Administrator Training
AFH providers and resident managers need 70 hours of basic training before licensure, 12 hours of continuing education a year, first aid/CPR, and specialty training if serving residents with dementia, mental illness or developmental disabilities
An AFH must carry liability insurance (WAC 388-76-10191 to -10192)
Background checks, TB testing and a building inspection are required before an AFH is licensed