Information for AFH Prospective Providers

This page outlines the legal, educational, and structural requirements for opening an adult family home. It provides prospective providers with access to mandatory training guidelines, building codes, inspection checklists, and licensing rules necessary to safely operate a facility.

Announcements

AFH online license application note: There are certain symbols that can create errors or prevent submission in the completed application. Do not use the following symbols &, =, +, or #. Instead, use the following terms: (and) (equals) (plus) (number sign), spelling out the words, with parentheses on either side. See the updated Instructions for the license application for details. We are researching a permanent fix to this issue and will advise you of any changes.

Effective Jan. 1, 2024, the Department-provided Orientation class is no longer required. View the AFH Initial Inspection process informational slideshow

Liability insurance is required in all adult family homes by WACs 388-76-10191 through 388-76-10192. We are hearing that some homes are having difficulty obtaining and maintaining liability insurance upon licensure. Some insurance companies have implemented training and experience requirements above and beyond what is required by DSHS for licensure in order to obtain liability insurance. Please be sure to research your liability insurance options before licensure in order to be prepared to meet their requirements in order to obtain insurance.

If you have any questions regarding the adult family home application process, please contact the Business Analysis and Applications Unit at baau@dshs.wa.gov. If you have general questions about opening an AFH, please reach out to Resource Support and Development at resourcedevelopment@dshs.wa.gov.

What is it like to be an adult family home provider?
What are the training requirements for adult family homes?
Do I need the Home Care Aide certification?

Yes, you will have to be Home Care Aide Certified UNLESS you meet one of the following exemptions:

  • RNs, LPNs, and certified nursing assistants (NA- C/CNA) or persons in an approved CNA training program;
  • Medicare-certified home health aides;
  • Person with special education training and an endorsement granted by the Superintendent of Public Instruction; or
  • Employed as a LTC worker sometime between 1/1/2011 and 1/6/2012 AND who completed the training requirements in effect at the time. Must have proof of that employment meeting the requirements of DOH WAC 246-980-070.

If you do not meet one of those exemptions, you must complete the 75-hour orientation, safety, and basic training requirements, take the home care aide certification examination, and receive certification from the Department of Health before applying for an adult family home license. Find an approved training program here.

What qualifications do I need to become an adult family home provider?
  • High school diploma or high school equivalency certificate per RCW 288.50.536
  • Long-term care worker
    • Documentation to show you are Exempt OR
    • Non-exempt 75 hours plus Home Care Aid Certification
  • Experience
    • 1,000 hours Caregiving Experience Attestation (CEA) form – DSHS 10-417
  • Adult Family Home Administrator Training Class  
  • Prospective Provider Orientation class 
  • CPR
  • First Aid (Not required for licensed nurses)
  • Food Safety

The following trainings are required only for homes admitting residents with the listed diagnosis or assessed need:

What do I need to know about getting my home ready for inspection?

If your home is on a septic system, the system will need to be inspected by your local health authority or approved septic system inspection entity and you will need to provide documentation of the following:

  • The septic system has been inspected and approved
  • How many people (not bedrooms) the system can accommodate
  • The local health authority or inspection entity is aware that the system will be used in an AFH

This information does not need to be submitted with the application, but it will need to be provided to the licensor prior to licensure recommendation. There can be significant costs associated with septic system improvements, so it is highly recommended that this process be completed prior to submitting the application.

Now that I have met all the qualifications...
Setting up your adult family home records

Administration records: You must have a system to maintain your administrative records. Your system must include the following documents:

Resident records: You must have a system to maintain confidential resident records so you can provide the needed care to the residents. Your system must be organized so there is a place for the following documents:

  • Personal Belongings Inventory Log DSHS 02-516 
  • Resident Assessment/Preliminary Service plan
  • Negotiated Care Plan
  • Medical Professional Orders
  • Legal Documents
  • Financial Record Keeping
  • Resident Information Sheet
  • Nurse Delegation documents:
  • Medication Logs - MARS
What are the laws and regulations for running an adult family home?
Other resources for opening a small business
I'm buying an AFH through CHOW (Change of Ownership)
  • Requires an AFH license application.
  • Applicants must meet qualification and licensing requirements.
  • Check the history and current status of the home you are interested in buying. Some AFHs have issues such as:
    • Limits on the type of residents the AFH can accept due to structural or other issues, or limits on who can provide care.  These must be posted in the AFH.
    • Outstanding enforcement.
    • Exemptions to a specific WAC requirement.
  • Check the AFH Locator to view limits and enforcements issued within the previous three years and check with the home's current owner about any ongoing limits or exemptions and any outstanding enforcement on the current license.
  • Specialty contracts such as Meaningful Day Activities, Expanded Community Services (ECS) and Specialized Behavior Support (SBS) are not transferable when there is a change in ownership (CHOW). The new owner must meet the qualifications and have a fully executed specialty contract prior to providing specialty services. Payment for specialized services cannot be issued without the appropriate specialty contract in place. Information regarding specialty contracts can be found here: Residential Long-Term Care Facilities Specialty Contracts.
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AFH License Application Process Informational Slideshow | Instructions