The Adult Family Home Option

Our Mission

The Adult Family Home Council exists to improve the lives & well-being of vulnerable adults through the support of Adult Family Home Providers.

When looking for the right care option for themselves or a loved one, thousands of people across Washington State have chosen adult family homes.

Adult Family Homes are an option providing a community based residential setting with 24-hour care and services. There are nearly 3,600 adult family homes across the state. Each home is independently licensed and operated. An adult family home can serve between 2 and 6 residents and qualified adult family homes can apply to serve up to 8 residents.  All adult family homes provide essential services including assistance with activities of daily living, meals, laundry and more. The level of care each home provides will vary. Some adult family homes are operated by nurses, or they hire nurses or other appropriate licensed staff to support a resident’s need. Others may specialize in the care of residents with dementia or Alzheimer’s disease. Some homes specialize in the care of people living with developmental or intellectual disabilities. 

All adult family homes are required to have a current assessment of the resident and a plan of care reflecting not only their needs, but their preferences on how they would like to receive those services. 

The diversity of adult family homes across our state is reflected by the large range of services and residents they serve. These facilities are regulated by the state and visited at least every 15 months to ensure compliance with appropriate care standards.  All AFH owners and their staff undergo significant training before being able to work directly with residents. Further, they must keep up with training and best practices in care by completing a minimum of 12 hours of continuing education per year.

The small nature of an adult family home creates a unique opportunity for truly individualized and compassionate care.

  • In an adult family home, the staff to resident ratio is at least 1:6.
  • In most adult family homes the owner or caregivers live on site with the residents.
  • Adult family homes have a greater capacity to tailor the environment and approach to best meet your individual needs
  • Through the pandemic, adult family homes have the lowest percentage of outbreaks of any residntail long term care option.

As care needs are considered, it is important to find the right match between caregiver and care receiver. The small, intimate, residential, home-like feel of an adult family home may be the right option for you or your loved one. Since each AFH is unique, we encourage families to take the time to do the appropriate research, to evaluate the care needs today, and anticipate what changes they can to ensure an appropriate match. 

When meeting with potential homes we encourage a conversation about not only the care needs, but the social, cultural, and spiritual needs.


Some questions to consider are:

  • How long has the AFH been operating?
  • How many staff are typically on shift?
  • Is there awake staff at night?
  • Are there staff that speak my primary language?
  • Is the location accessible for family visits?
  • What activities are arranged?
  • Is it a good fit with the other residents?
  • Are there steps or a second level of the home?
  • Are transportation services available?
  • Will the food served meet my needs?

Each person will have their own specific questions to ask, but these are samples of the types of things one may want to consider. 

Because adult family homes are smaller and often operated by the owner, there is often more flexibility in being able to provide services that meet each individual needs.  Obviously, it is not a decision that should be made lightly.

Adult Family Homes offer affordable long-term care rates.  Fees are based on the level of care needed and type of room desired.  Feel free to compare what different care settings and homes charge.

Ask what is included in the base fee and what the additional charges are per month. Many Adult Family Homes accept private pay, Medicaid, Veteran’s Aid & Attendance, and long-term care insurance. Then ask yourself where you would want to live.

Find Adult Family Care In WA

Click a category below to see what adult family care options are available in Washington State.

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