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Choosing Assisted Living in California: Common Inspection Findings
Inspectors in California cited the regulation covering medication and medical care more often than any other: 5,172 deficiencies at 2,481 assisted living facilities. We reviewed 43,124 deficiencies in the state's inspection and complaint reports dated December 14, 2018 through August 31, 2026.
A deficiency is a problem an inspector cites under a licensing requirement. Building upkeep, staffing and dementia care are also among the most cited.
These findings give families specific things to ask about. Who helps residents with medication? How does the facility respond when someone's care needs change? And if inspectors found a problem, what did the facility change afterward?
Published September 16, 2026 · Official records published by the California Department of Social Services, Community Care Licensing Division · Retrieved from the SeniorLivingFacts database on September 15, 2026
Key findings
Medication and medical care were cited most often
Inspectors cited this regulation 5,172 times at 2,481 facilities.
Building upkeep comes next
Inspectors cited Maintenance and Operation 4,335 times at 2,109 facilities.
Background-check deficiencies were usually Type A
California classified 86.2% of Criminal Record Clearance deficiencies as Type A, meaning a direct and immediate risk if not corrected.
Dementia care was the fourth most cited section
Inspectors cited Care of Persons with Dementia 2,059 times at 1,298 facilities.
What inspectors cite most often
The chart below shows the 15 most frequently cited sections of California's assisted living regulations and state law. Ten sections account for 53.6% of deficiencies with a section number. Each section can cover several requirements, so read its title and description before comparing the counts.
California assigns deficiencies one of two classifications. These are the state's definitions, used throughout the charts:
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
California · December 14, 2018 - August 31, 2026
The 15 most frequently cited sections
View counts and classifications for all 15 sections
Deficiencies in reports dated December 14, 2018 through August 31, 2026. These 15 sections account for 66.8% of the 42,861 deficiencies with a section number. A facility can appear under more than one section.
| Section | Deficiencies | Type A | Type A share | Facilities cited |
|---|---|---|---|---|
| Incidental Medical and Dental Care Title 22, section 87465 | 5,172 | 3,233 | 62.5% | 2,481 |
| Maintenance and Operation Title 22, section 87303 | 4,335 | 1,399 | 32.3% | 2,109 |
| Personnel Requirements - General Title 22, section 87411 | 2,101 | 678 | 32.3% | 1,330 |
| Care of Persons with Dementia Title 22, section 87705 | 2,059 | 1,149 | 55.8% | 1,298 |
| Storage Space Title 22, section 87309 | 1,825 | 1,486 | 81.4% | 1,306 |
| Personal Rights of Residents in All Residential Care Facilities for the Elderly Title 22, section 87468.1 | 1,684 | 713 | 42.3% | 1,062 |
| Emergency Plans Health and Safety Code, section 1569.695 | 1,497 | 166 | 11.1% | 1,080 |
| Criminal Record Clearance Title 22, section 87355 | 1,483 | 1,278 | 86.2% | 1,090 |
| Personnel Records Title 22, section 87412 | 1,462 | 200 | 13.7% | 1,014 |
| General Food Service Requirements Title 22, section 87555 | 1,338 | 400 | 29.9% | 883 |
| Reporting Requirements Title 22, section 87211 | 1,326 | 141 | 10.6% | 921 |
| Resident Records Title 22, section 87506 | 1,113 | 91 | 8.2% | 832 |
| Personal Accommodations and Services Title 22, section 87307 | 1,106 | 270 | 24.4% | 837 |
| Reappraisals Title 22, section 87463 | 1,066 | 105 | 9.8% | 846 |
| Postural Supports Title 22, section 87608 | 1,043 | 343 | 32.9% | 790 |
Medication and medical care
The official title of section 87465 is Incidental Medical and Dental Care. It covers medication support along with other medical and dental care requirements. The 5,172 total includes every deficiency cited under that section. The individual report explains what happened.
California classified 62.5% of these deficiencies as Type A. Inspectors also cited this section at more facilities than any other, 2,481.
Ask who helps residents with medication, what training they have, and how medication is stored. Find out who takes over when the usual staff member is absent.
Which deficiencies were most often Type A
Across all 43,124 deficiencies in the study, 39.0% were Type A. Background checks and storage stand well above that: California classified 86.2% of Criminal Record Clearance deficiencies and 81.4% of Storage Space deficiencies as Type A. It shows that when inspectors cite background checks or storage, the state usually treats it as a direct and immediate risk if not corrected.
Among the 15 most frequently cited sections, these had the highest and lowest percentages classified Type A.
Highest percentage classified Type A
Among the 15 most frequently cited sections.
Lowest percentage classified Type A
Type B deficiencies also require correction.
These percentages are for all deficiencies combined. They don't tell you how many facilities had a problem, or how California classified a particular facility's deficiency. That facility's report shows its classification.
On a visit, ask how the facility checks staff background clearances and controls access to medicines, cleaning products and other potentially hazardous items.
Questions to ask about dementia care
Inspectors cited 2,059 deficiencies under Care of Persons with Dementia, section 87705, at 1,298 facilities. It was the fourth most frequently cited section, and 55.8% of its deficiencies were Type A.
California reorganized its dementia care regulations effective January 1, 2025, moving requirements into several sections. This total counts deficiencies cited under section 87705 in the reports we reviewed. It is not a count of every deficiency involving a resident with dementia. The state explains the changes in its dementia care guidance.
If the person moving in has dementia, ask what training staff receive, how supervision works during the day and overnight, and how staff respond when someone's needs change. Ask the facility to explain how it would support that person's daily routines and care needs.
Reading a facility's inspection record
Start with the report dates, the deficiencies inspectors cited and their Type A or Type B classifications. Read the descriptions of what happened. A total alone leaves out the details you need to discuss with the facility.
A deficiency records a problem identified at the time of a report. This study does not show whether it was corrected. Ask what changed afterward and whether the facility can show documentation of the correction. Bring questions that match the person's needs, including medication support, dementia care or help with daily activities.
If we have no recorded deficiency for a facility in the records covered here, that does not mean the facility has a clean record, or tell you what care is like there today.
Find a California facility and read its inspection reports
How we did this
We counted 43,124 deficiencies in California's published inspection and complaint reports dated December 14, 2018 through August 31, 2026, using the copies stored in the SeniorLivingFacts database. The study covers Residential Care Facilities for the Elderly, California's licensing category for assisted living. It does not cover nursing homes.
We grouped deficiencies by the numbered section of the regulations or state law cited in each record. Different subsections of the same section are counted together. Of the total, 263 deficiencies have no section number and are excluded from the section rankings. Titles identify the sections cited in the reports. The short explanations alongside them are ours.
Detailed methods and limitations
Reports and facilities covered
The 43,124 deficiencies come from 20,441 reports covering 5,410 facilities. The earliest report with a deficiency is dated December 14, 2018. We included reports dated through August 31, 2026. The latest report contributing a deficiency is dated August 28, 2026.
How the percentages were calculated
Section rankings and their shares of the total use the 42,861 deficiencies with a section number, grouped into 477 distinct sections. The ten most frequently cited sections account for 22,956 of those deficiencies (53.6%). Each section's Type A percentage uses all deficiencies cited under that section. The overall Type A percentage includes the 263 deficiencies without a section number.
Regulations and state law
California Code of Regulations, Title 22 accounts for 37,786 deficiencies with a section number (88.2%). California Health and Safety Code accounts for 5,075 deficiencies with a section number (11.8%). The table identifies which body of law each section belongs to. A section can contain several requirements, and this study groups deficiencies by section rather than assigning them to new topics. Requirements and section titles can change over time, including the dementia care changes effective in 2025.
Dates and exclusions
Records were retrieved from the SeniorLivingFacts database on September 15, 2026. That is the database extraction date, not the date the state published each report. We used August 31, 2026, the end of the preceding month, as the report-date cutoff. The database includes some reports dated after extraction. We excluded the 2 deficiencies that fall after the cutoff from every deficiency count and percentage in this article.
What the records cannot tell us
This study does not measure whether a deficiency was corrected or describe a facility's condition today. It does not rank individual facilities, cities or counties, measure overall care quality, or explain why one section is cited more often than another. Inspection frequency and reporting practices vary, so deficiency counts cannot tell us how common a problem is across all facilities.
These are administrative records, not a random sample. We did not calculate a sampling margin of error or perform a significance test. All study figures use the same saved set of counts, retrieved on the date above.
Sources and related pages
- California Department of Social Services, Community Care Licensing Division. Facility search and published inspection reports. Open official source
- California Code of Regulations, Title 22, Division 6, Chapter 8. Residential Care Facilities for the Elderly regulations. Open official source
- California Department of Social Services. Dementia care regulation changes effective January 1, 2025. Open official source
- SeniorLivingFacts. Data and methodology
- SeniorLivingFacts. California facility records
Cite this article
Paukstys, M. (2026, September 16). Choosing Assisted Living in California: Common Inspection Findings. SeniorLivingFacts. https://seniorlivingfacts.com/articles/choosing-assisted-living-in-california-common-inspection-findings