How to Open An Adult Family Home
- Dustin Saksek
- Aug 20
- 26 min read
Updated: Sep 15
Introduction – Opening Your Adult Family Home Facility & Business
Learning About AFHs
What is an AFH
In Washington, an Adult Family Home is a dwelling, licensed by the Washington State Department of Social and Health Services (DSHS), in which room, board, and care is provided to for up to 6 adults who are not related to the caregiver(s).
Before February of 2024, AFH Facilities were limited to 2-6 residents. With RCW 70.128.066RC passing in 2020, that limit has been changed to 8 beds for facilities that are approved after the requested review process is complete.
AFHs offer senior citizens a safe and secure environment that is maintained through 24-hour supervision and maintenance. All while ensuring that residents still retain their dignity, and a reasonable amount of freedom to with which to live their lives.
Basic services that AFH facilities provide include assistance with day-to-day activities such as cleaning, laundering, cooking, transportation, and respite care.
Opening an Adult Family Home facility, or even just choosing to work at one as a caregiver, means adhering to heavy legal regulations designed to provide residents with safety and dignity. That means meeting strict licensing requirements and providing all of the necessary care, day and night.
Who an AFH works with?
AFH facilities work with some of the most vulnerable members of society. This includes the elderly, people with mental illness, physical and developmental disabilities, and individuals with challenging behaviors. This is why 24/7, day and night care, needs to be juggled alongside regular communication with families. This level of responsibility is also why most facilities start with hired employees who are ready to work on day one.
Because of the diverse needs that different populations have, the type of care provided by different adult family homes is often specialized to meet those needs. One example of this would be a “Skilled Nursing Facility.” This type of AFH facility would specialize in providing care with an emphasis on having professional medical staff as caregivers, i.e. nurses with the education to take care of residents with more demanding needs.
Some of the specialized services and types of care that these facilities provide often include, but are not limited to:
Memory Care
Skilled Care
Hospice Care
Assisted Living
Developmental Disabilities Care
Children with Debilitating Diseases Care
Independent Living
Behavioral Health
Underestimating the responsibilities of running an adult family home, being unprepared for the reality of how much work is needed, is more than just why so many AFHs go out of business within their first 2 years; it’s a direct negative impact on the lives of residents and the families of those residents. All of this being more stress impacting your life and family when not planned for and managed well.
All to say, starting an adult family home business is a decision you should carefully consider before moving forward.
Why open an AFH
If you’re reading this, you probably already have your reasons for looking into starting an AFH. If you don’t, however, here are a few things to mull over as you decide whether or not opening an AFH is right for you.
You want to help your community in a meaningful way. No matter which specific type of AFH you ultimately decide to open, you’re going to be working with some of the most vulnerable people in our society. Beginning with seniors, other factors add to the amount of responsibility you assume when you decide to work with memory care, behavioral health, assisted living, or any other specialization you can choose from.
Supporting a community in a meaningful way means to take on a meaningful amount of responsibility. That is hard work; but it’s important work that directly improves the quality of life of the residents you work with, and the friends and family of those residents.
You are okay working where you live, and living where you work. The vast majority of adult family homes are just that, homes. That goes for many AFH administrators and caregivers just as much as it does for the resident patients who live there; you live where you work. If you need to separate your work and home life to be well, you should let this fact sink in and think about whether this is what you really want for your own life. However, if that’s not an obstacle for you, you’ll be able to live and work in a multi-generational home and community, learning from one another’s lives and stories.
You have a strong sense of your strengths AND weaknesses. Are you well organized? Are you experienced in leadership and management roles? Have you hired and managed employees before? Do you have the emotional intelligence and skills to work not only as a leader to your staff, but as a caregiver to your residents? How are your communication skills? What about experience, or willingness to learn, how to run a small business? All of these are going to be called on regularly when working in or managing an adult care facility.
Comfortable with all of that? If so, you’re on the right track, and your next steps are laid out below for you to read.
10 Steps for Starting An Adult Family Home Business & Facility
Step One – Research
Step one to opening your AFH is doing the research.
Your first item of business is to establish whether your area needs an AFH. Nothing will kill your business faster than your services simply not being in demand when you open. What does the population look like in your area? Is there a senior population that could use AFH services? If so, what are the needs of that population? Do those needs include medical, financial, and/or emotional support? What does that mean for the type of care you need to provide? How do you fit into the picture providing for those needs?
Next, consider different possible locations for your AFH. A contributing factor to the success or failure of many businesses is how accessible, and aesthetically pleasing they are. If you can buy, or build, “a room with a view” you’ll be in much better shape than you would be providing a room overlooking the neighbors’ wall. Go beyond just facility location options in one neighborhood – look at other towns or counties. Technically there is always a need for AFH services, but if the area you are considering is well served and the existing family homes are easily able to keep up with demand, look somewhere else. There are no bonus points awarded for unnecessarily toughing it out in a saturated market when you don’t have to; and other areas you have not considered may be sorely lacking. Those are areas where your business would be able to thrive much more easily.
Third, learn about your competition. Visit their websites and learn what they offer, who they focus on caring for, and what their services cost. With that, you can begin to piece together what the needs are in your areas’ market, and whether the existing AFH services meet each of those needs. If you do find an unmet need, that would be a great option for you to focus on as a service.
Fourth, find your “Unique Sales Proposition;” that unique angle you deliver on, that your future residents want, and that your competitors don’t address. Having looked at both the needs of the population you are looking to serve, and what your competitors offer, find the gap that’s been passed over. What needs have you learned about that your competitors do not talk about on their websites? Whatever that detail is that your competitors don’t provide or discuss, and that you make a point to excel in, and tell people about, will give you a unique advantage convincing people they should work with you, and not your competitors.
You can learn how many adult family homes are in any given area in Washington by visiting the Washington State Department of Social and Health Services’ website and looking for “Aging and Long-Term Support.” Or by simply visiting the following link to the WSDSH page and use the Adult Family Home Locator to search the geographic area you are interested in: https://fortress.wa.gov/dshs/adsaapps/lookup/AFHPubLookup.aspx
Step Two – Create A Business Plan
Business Plan
A well-considered business plan helps you to organize your efforts when you begin your business. These are both used to obtain business funding, and to identify the important milestones you want to work towards.
Some of the main components of a well-written business plan for your AFH include:
Your business plan should include 5 main sections:
Executive Summary: This is your high-level summary, where you outline what you do, who you serve, and your goals for the future, as broadly stated as possible. Just enough detail for anyone who reads it to get the gist of what you’re trying to do. It includes three subsections:
Product: Where you describe the services you will provide.
Customers: Who you plan to work with.
Future of the company: where you outline your goals.
Company Description: Here, you can provide a broad overview of beliefs, structure, and key roles. That includes:
Mission Statement: a formal summary of the goals and values of your organization.
Principal Members: If there are legally acknowledged co-founders and owners beyond yourself, they are listed here, beside you.
Legal Structure: Whatever company structure your AFH is formed as - you can read more on that in step 4.
Market Research: A working summary of the research you conducted in step one. This will organize and present what you learned about:
Industry: What the current industry looks like – this would include what your researched uncovered regarding your competition, what they prioritize providing, who they work with, and any circumstances you learn about impacting AFHs in general.
Detailed Description of Customers: Who do you plan to serve? Go into as much detail as possible – include interests, values, age, income levels & budget, care needs, everything you can learn that describes the people you are looking to work with and provide care services for.
Company Advantages: This is the “unique sales proposition” that you uncovered at the end of the research step. It doesn’t need to be limited to a single thing, either – any place where you find that you can offer something your audience will value, that your competitors do not provide; that goes on the list.
Regulations: What laws, codes, and regulations are you required to adhere to? List them out here.
Service Line: Everything service & process related. This includes:
Product/Service: A description of the AFH services you plan on providing; from general caregiving, to any specific needs your facility is going to accommodate and address.
Pricing Structure: What will the costs of your services be? What payment options will you accept? What methods will payment be accepted through
Product/Service Lifecycle: What does beginning, continuing, and ending care look like? Describe the flow of becoming a resident and the life cycle of working together.
Intellectual Property Rights: Is there anything trademarked to you or your business? Your Adult Family Home Facilities’ name? A process or care method you have outlined unique to your facility?
Research and Development: How do you plan to work to improve on your services as time goes on? Will there be a feedback mechanism on your website or through communication with residents and families to learn what they feel could be done better? Will there be comment cards sent out to families? How do you intend to continue to develop your care and services?
Marketing and Sales: final section, where you outline your plans to grow to sustainability, and if intended, beyond.
Growth Strategy: What do you plan to do to grow your business? Are you planning to save up your businesses’ income to reinvest into marketing? Are there specific time periods you want to advertise to bring in more business? What strategies are you looking at to earn people’s trust and business?
Communicate with Residents and Families: How do you plan to communicate with residents and their families? Will this only include in person talks with each? How about policy or practice updates? Will you send these in writing through physical mail, through email? Will you provide contact information on your website? Will social media be used in any way?
How to Sell: Who is responsible to selling to people? Will you handle this yourself as the business owner, or do you plan to eventually bring on a dedicated salesperson to handle the role? What does the sales process look like? Does it begin online and end with a face-to-face conversation at your facility? Do facility tours play a role in this, and if so, at what point? Chart out this process here.
Pro Forma
An AFH pro forma is your financial forecasting tool. This is where you set out the financial goals and plans which will guide you towards accomplishing the goals that you have set for your business. It is used in combination with your business plan, to plan, and to earn the trust and support of financial support from lenders and/or investors.
Your pro forma financial statement uses hypotheticals and assumptions about future performance, such as expecting to have 3 residents by X date, who pay Y amount for your services, financing Z plans for marketing which will earn your next 3 residents.
Step Three - Financing Your Business
Once you have a plan established, and you’ve decided you want to move forward, it’s time to obtain funding.
Start by estimating what your initial costs will be. That includes the start-up costs, and the costs of daily operation. Use this information to create a budget, and use that budget to forecast the total cost of running your AFH for the next full year.
Compare this estimated AFH budget to the amount of capital you already have available. The difference between these two is how much funding you will need; Be sure to include the cost of licenses, building repairs, equipment, and staff salaries.
A few options for funding your new AFH include:
Bootstrapping: The DIY approach to financing an AFH. This means providing all of the necessary capital for your business through your own income and personal business to continue its’ growth.
Friends & Family: If possible, financing through the support of friends and family can jump start you into operation. However, when mixing business with family and friends, always make sure you have a written agreement and repayment plan established.
Traditional Commercial Loan: Acquired directly through a bank, this type of loan usually comes with a lower interest rate, and access to higher amounts of capital than other options. However, you must have a high credit score, and will be required to provide some form of collateral.
Small Business Loan: Available from most banks – many of these will be supported by a bank partnering with the U.S. Small Business Administration (SBA). You may still be eligible for this type of loan even if you only have borderline credit. Importantly, SBA guidelines are designed to protect both the lender, and you, the small business owner. The one drawback to this option is that it can take some time to approved in addition to the normal collateral you are required to put up.
Step Four – Choose Your AFHs’ Business Structure
The business structure that you choose influences everything from day-to-day operations, to taxes and how much of your personal assets are at risk. You should choose a business structure that gives you the right balance of legal protections and benefits for your business.
This choice will impact:
How much you pay in taxes
Your own personally liability in the event that you are sued
Your ability to raise money, and
The paperwork that you need to file
Choose carefully, because changing your business structure may be possible, but depending on your location there may be restrictions preventing you from doing so.
Whatever your personal goals and situation may be, a good conversation with a business counselor, accountant, or attorney can help shed light on what the best business structure is for you.
Sole proprietorship
Limited Liability Company (LLC)
Partnership
C Corp
S Corp
Benefit Corporation
Close corporation
Nonprofit corporation
Cooperative
If you're a first-time business owner, we recommend a Sole Proprietorship or an LLC. These will be the easiest for you to set up
Have a conversation with a trusted accountant, attorney or business counselor to determine whether one of these, or a combination of these, is the best choice for you.
Step Five - Registering Your Washington Business
With your business structure chosen, it’s time for you to form your business. You can use any of the options listed in step 4, above, but for this example we’ll assume you’ve chosen to create an LLC. When forming your LLC, you will need to:
Name your business
Choose a Registered Agent
File your LLC with the state
Create an LLC Operating Agreement
Get an EIN
Step Six – Set Up Business Banking, Accounting, and Credit Cards
Be sure to open a business banking account separate from your personal account.
Separating your personal and business banking information is essential for your asset protection, professional appearance, easier cashflow management, being able to take advantage of opportunities you would otherwise be shut out from, and more.
In detail, those benefits include:
Professionalism: Instead of clients writing a check directly to you, they can write it to your business – when dealing with caring for someone’s wellbeing, having your act together (and looking the part) goes a long way in either maintaining, or breaking, trust.
Protection: A separate banking account can provide you with limited personal liability protection because your personal and business funds are separate. If someone steals your personal credit card information, your business account is still safe, and vice versa. Additionally, if you ever are in the situation of having your business be sued, that separation of what is your personal property and what is the business’s property can make all the difference in protecting you as an individual.
Preparedness: Business banking accounts normally come with the option to give your company a line of credit. If you need new facility equipment, or an emergency crops up, you can handle it on the spot easily.
Purchasing Power: Startup costs can be expensive, being able to offset some of those initial costs to credit so you can get the ball moving bringing revenue in can be crucial if your belt is tight.
The paperwork needed to open your AFH bank account, no matter who it’s with, will be:
Your Employment Identification Number (EIN). If you’re a sole proprietorship, however, this is replaced with your Social Security Number.
Your business’s formation documents
Your business license
Ownership agreements
Step Seven - Obtain your AFH Permits and Licenses
More than just adhering to state laws, regulations, building and fire codes, AFH facilities must also register their business with the city in which the home is located.
The home must also be approved by a local building official, ensuring that the home meets all relevant safety codes.
In WA, adult family homes are licensed by the Department of Social and Health Services after all regulations are met, and trainings complete.
Step Eight – Hiring Employees
The success of your AFH business is determined by the quality of the staff you work with. Be sure to hire professional who share your values, working together to care for residents with respect.
Step Nine – Build Your Business Website
Necessary for all small business owners today. A website lends credibility to your business, provides a platform to showcase your work and services, furthers your reach, works as a central communication hub, acts as a 24/7 storefront. While you could invest in a big custom website build, starting out, a simple default design and structure from a bulk / template designer could hold you over temporarily.
Step Ten – Promoting Your Business
You need residents to stay in business. You can only get residents if those people already know who you are. So, we need to get your AFH in front of people.
We won’t go as in depth here on marketing because each possible avenue could have a dissertation written on how to approach it. Instead, here’s a breakdown of different options you can look into learning about and using to advertise your AFH.
Traditional Media:
Signage (flyers, billboards)
Radio Ads
TV Ads
Newspaper
Direct Mail
Event Marketing (conferences, event sponsorships, etc)
Cold Calling
Networking Events
Direct Sales
Digital Media:
Email Marketing
SEO (search engine optimization)
Affiliate Marketing
Social Media Marketing
PPC (pay per click)
Content Marketing
These are all valid options, but trying to effectively work too many at once without a specialist on staff, or retainer, can easily become overwhelming.
Because of that, we recommend picking out options that overlap with one another when you start out – such as signage, event marketing, and networking events – where the signage you make for events can also be used as creative assets for flyers, brochures, and more.
Building, or Buying, Your Adult Family Home
Options for Getting A Location
You have three options for getting your AFH location. Those are:
Buying an existing location
Renovating A House into an Adult Family Home
Building a new facility, ground up.
Buying existing business (CHOW)
The most direct route into running an adult family home is to buy one. This is known as a “Change of Ownership,” (CHOW). Buying an AFH is simpler than you may think, as most are registered as an LLC or a corporation, making them entity providers. This means they that they are their own business entity, which here allows it to have changes in ownership.
A Chang e of Ownership at an AFH is required to happen whenever a change of control happens which involves a new license application needing to be submitted. It is only after that new license application is submitted and approved, that the change of ownership is legally allowed to take place.
That is to say, for a CHOW to take place, a new license application for the facility needs to be submitted, and approved, before the change in ownership can legally take place.
As of July 30th, 2025 the requirements for moving forward with an AFH CHOW include:
An AFH License application
Applicants meet qualifications and licensing requirements
The status of the home you are interested in buying must be free common issues such as:
Limits on the what type of residents the AFH is able to accept due to any structural issues, or otherwise, or any details which limits who can provide care. If these exist, they must be posted in the AFH for any considering services to be aware of before becoming a resident.
Outstanding enforcement
Exemptions to a specific WAC requirement
Specialty contracts such as Meaningful Day Activities, Expanded Community Services (ECS) and Specialized Behavior Support (SBS) are not transferable with any CHOW. The new owner must meet all qualifications, separate from the previous owner, and have a fully executed specialty contract before offering any specialty services. Payments for these specialized services cannot be issued without an appropriate specialty contract in place.
Limits and enforcements issued within the past three years can be viewed through the Washington SDSH AFH Locator.
Information regarding specialty contracts can also be found through the SDSH, on their Residential Long-Term Care Facilities Specialty Contracts page.
Renovating A House into an Adult Family Home
The same as building an AFH, converting your house into an AFH begins with applying for an adult family home building permit. These will be unique to each city. If you’re renovating in Everett, you need an Adult Family Home Building Permit specifically for Everett, WA.
You can’t just jump into taking an empty permit sheet and filling it out, however. You need to have a plan developed to take to your city.
That means providing completed:
Site plans
Building plans
Special Inspections Forms
Geotechnical Report
Engineering Calculations
And more…
The first step of getting those documents prepared, is to find an architect you can trust.
Working with an architect, they’ll prepare your site plan, building plans, and more. That’s in addition to being able to connect you with construction teams, and specialists like engineers.
Building a New Facility
This is largely the same as the renovation process explained above, with one big step that you need to take first; Deciding where you want to build your AFH. If you read through our ten steps above, this is included in “Step One – Research.”
Recapping on that:
Don’t look be married to the idea of needing to be in one location or another. Look to where the population you want to work with is located, and where that same population is underserved. If you can find a location where the websites of competing AFH’s don’t discuss something that your audience cares about, that would be a great opportunity for you to step in and make a point to speak to that care or concern you know your future residents care about. That may meaning looking a town or a county over, but if it improves the viability of your business it’s a change you’ll be grateful you made.
Once you have a location picked out, it’s time to move on the same as though you were doing a renovation. You find a reliable architect, and move forward working with them to develop the documents your city requires for your AFH permitting application.
AFH Building Codes & Inspections
Before any residents can move in, the facility needs to pass AFH building inspections. Largely, this is something that an architect familiar with AFH building construction will account for when designing your building or remodel.
It covers necessary safety precautions to be included in the design of the facility to legally be allowed to operate.
This includes things like details regarding how stairs can be placed and designed, the number of exists, how big the doors to exits need to be and how wide they open, specifics about handrails and grab bars, etc.
You can read through the current State Department of Social and Health Services AFH Building Inspection Checklist yourself, here: AFH Building Inspections | DSHS
If wading through the legal requirements of architectural specifics isn’t where you want to spend your time, though, we’ve put together a more digestible summary complete with diagrams to help explain what the inspections look for.
Here's a preview of what that document looks like:
You can download that document here:
Costs of Building an Adult Family Home Facility
It would be dishonest to simply say to expect to pay X amount, or even to give a range of costs, for building a new AFH. The same goes for renovating an existing building to function as an AFH.
That’s because no matter how custom, or how stock and standard the plans are for your AFH, each location is unique, with a unique set of variables interacting that contribute to cost. Each one of those can easily sway the project cost wildly.
The most obvious variable is whether it’s a high-end AFH facility or not. The cost of a luxury AFH will be dramatically higher than a low-income AFH, before accounting for how other factors play in.
Some of those other factors will include how many rooms will there be, what is the size and purpose of those rooms? How many bedrooms? What kind of amenities are being included in the design and construction? Are live-in care giver quarters being constructed, etc- the list keeps going.
This is before the standard items for all construction projects, like mechanical systems, plumbing, and electrical systems. Those all need to be designed, approved, and constructed according to the space limitations, the usage intended, and local codes and laws. Every one of these factors contribute and vary in cost – making this a question that without looking at your specific situation, is impossible to answer honestly beyond “it’s complicated.”
It is not a satisfying answer, but it is an honest one.
If you are at the point where you’re shopping for a construction team and need to get that complicated answer, Then you’re ready to speak with an architect to get the construction process started. If within Oregon, Idaho, or Washington State, we’d be happy to talk shop and get you on the right track – whether you choose to work with us or not.
You can schedule that talk with us by following this link to our contact page.
Managing Your AFH Employees & Team
This will change from facility to facility based on the needs of the residents you work with, and the processes you develop for your AFH. But some responsibilities are universal, regardless of facility specialization or business specific practices. With that in mind, the following lists won’t be comprehensive, but will give you items to be mindful of as you move forward.
Administrative Management
Running an Adult Family Home is more than providing quality care and keeping your numbers balanced. AFH administration is a job unto itself. While in working through the licensure you’ll be required to take an AFH Admin course already, here are three suggestions that can help lighten the load of operating an AFH:
AFH Paperwork
Adult family home Paperwork is one of the most time-consuming aspects of keeping a facility running. Managing this through digital tools can help improve accuracy, cut back on clutter, better organize your work and working environment, and save time. AFH software is out there, and can make your life easier by improving management of:
Care Plans: Digital tools to create, update, and maintain care plans can be managed and accessed in real-time from any device – and even be set up to automatically update where appropriate.
Tracking Medication Administration: Electronic Health Record (HER) systems can document medication dosages, track refills, and log medication reactions or side effects
Store and Organize Incident Reports: Digital systems are much easier to enter data into, update, sort, and access. This all makes them much more efficient for tracking incident patterns, making them easier to identify and address proactively.
Maintaining Staff Records: Training logs, background check information, certifications & licensure, work schedules and more are much easier to maintain digitally. An easy application would be to set automatic annual notifications for staff to complete their required continuing education work.
Resident Billing & Invoicing
Resident billing and invoicing can be one of the most tedious administrative tasks in an AFH. This is especially true when juggling multiple payment sources such as insurance, private pay, and Medicaid. Using a dedicated software to track payments, manage accounts receivable, and sending invoices, can easily prevent hours of tedium. Do this through:
Automating Invoicing: For residents who pay monthly, set up recurring invoices. This insures invoices are sent out on time without any manual input.
Payment Tracking: Set up notifications for payments received, or invoices that are late. You can also set up follow up messages to contact responsible parties if/when payments are late.
Integrate with Medicaid Systems: Many AFH billing platforms are able to integrate directly with Medicaid. This makes it much easier to submit claims, and track any reimbursements.
Templating Administrative Documents
Templating administrative documents can easily save you a few hours per week. Updating care plans, onboarding caregivers, or submitting reports to regulatory bodies, these tasks build up, and streamlining them will always save you more time than not.
That can include:
Incident Report Forms: Create a standardized template and format for logging incidents. This will make it easier to collect, organize, and find, information.
Care Plan Templates: Pre-fill fields that don’t change between residents, like facility information. Then further template to specific residents by pre-filling out fields that don’t change for each resident, such as birth date, name, contact information, etc.
Staff Onboarding Forms: Template reusable forms for onboarding new caregivers. This includes job descriptions, training schedules, and confidentiality agreements.
Audit and Compliance Checklists: Keep a checklist of the current AFH Inspection Preparation Checklist to work through routinely. You can find a copy of the DSHS’s Initial Inspection Preparation Checklist by clicking this link.
Staff Management Obstacles and Tips
Care giver turnover
AFH care giver turnover is unfortunately, very high. Nationally, the 2024 turnover reached 79.2%. That’s nearly 4 in every 5 care givers. Knowing this, you can look into the concerns caregivers have, why they’re leaving, and what you can do to address those problems found in the larger adult family home industry, before they become problems in your AFH facility.
First is the AFH staffing shortage. For every AFH caregiver out there, low staff makes for high stress. Making sure you have enough hands on-deck to provide the necessary care, without any individual having to spread themselves too thin carrying the whole load themselves.
It can be a thankless job. When work becomes a series of rapid-fire tasks caring for others while under stress until the day is done, nerves wear. Without a deliberate effort, it doesn’t take much for this to lead to burnout, caregiver dissatisfaction, an unappreciative workplace, and possibly a toxic workplace. Each stressor snowballing with and into greater stressors in a negative feedback loop.
Cut that feedback loop off by creating policies and practices that address stress, and foster good communication and community:
Foster Open Communication: Hold regular staff meetings where caregivers are encouraged to voice their concerns or frustrations, provide feedback, and suggest improvements. Give them an open field to have a voice not only to express frustration, but to collaborate and work together to improve the work environment for everyone.
Address workplace conflict fairly, and quickly: Create clear policies on how to handle disputes while ensuring all staff members are treated fairly.
Recognize and appreciate staff contributions: Celebrate achievements and milestones, provide employee-of-the-month awards, and take the time to genuinely show appreciation for the hard work your staff provides.
Competitive pay can be hard to find for many care-givers, this is often enough to push them to leave the field altogether. The work is stressful enough before staff shortage issues, inconsistent scheduling, or inflexible scheduling, become obstacles. Budgeting to pay and retain quality, committed AFH caregivers should be given serious consideration.
Required Skills for Operating an Adult Family Home
Whether working purely in an administration role, or as a caregiver yourself, these are important skills to foster to ensure you’re prepared to take on the work ahead providing a high quality of life to the residents you work with.
Empathy
Compassion and empathy are at the heart of caregiving, and by extension managing caregivers in a healthy way which facilitates them being able to provide quality care. You’ll be needed to tune into resident’s emotions to recognize distress, and be able to offer needed comfort and reassurance.
Many older adults face memory loss, pain, and emotional struggles. Because of this it is essential that caregivers work with intentional kindness and understanding.
Communication Skills
Communicating with AFH residents, their families, and medical professionals means being able to adapt to different communication styles and needs, while remaining professional. This includes during difficult situations.
This is more than just the words spoken:
Verbal communication: Explaining instructions clearly residents and families.
Written communication: maintaining accurate records of a resident’s condition and needs.
Nonverbal communication: Observing and understanding body language and facial expressions.
Keen Observation Skills
Without a sharp eye for detail, the subtle changes in a residents’ condition may go unnoticed. Seniors do not always show symptoms, or discomfort, so caregivers need to be able to pick up on visual and behavioral cues.
Details to watch for include:
Changes in appetite
Memory lapses, or confusion
Difficulty moving or walking
Withdrawal, or mood swings
Unexpected or unexplained weight loss
Unexpected or unexplained bruises
Time Management and Organization Skills
As a caregiver you’ll be juggling medication reminders, mobility assistance, medication reminders, and more. Having good time management means ensuring every task is completed without feeling overwhelmed or rushed.
For tasks that occur on a regular timeframe, add them to your work calendar as a repeating task. That way you’ll be sent automatic reminders when it’s time to for those jobs.
One free options for scheduling regular, repeating events, is Google Calendar. The calendar function in Office 365 and Outlook can also do this for you.
Care Standards
To ensure that residents, our loved ones, are provided the safety and quality of living they deserve, DSHS has specific adult family home care standards that all AFHs are required by law to meet. Broadly, this includes nutritious meals, medication management, and assistance with activities of daily living (ADL).
All residents require a written care plan that is uniquely tailored to their needs, and regularly reviewed to make sure that their continued, and changing needs, are met being met. AFHs must also provided a safe, comfortable living environment.
Most of this will be taught and required knowledge when you go through your licensure class, but it will be your responsibility to implement it.
AFH Caregiver Licensing Requirements
Home Care Aide License
The necessary licensing to legally be allowed to work as a Home Care Aide in Washington State requires specific trainings and qualifications be met.
Obtaining that license requires:
Passing a background check
An inspection of the home
A review of a proposed care plan
75 hours of training in adult family home care; This is made up of
3 hours of introductory information on safety practices
70 hours of training working through:
Core basic training: This covers the basic skills and information that is needed to provide hands on care.
Population specific training: This training covers topics unique to the care needs of the population served.
Passing the Prometric Knowledge and Skills Certification Exam (specific to the Home Care Aide Certification)
Exemptions are available to the 75 hour training and certified HCA requirements. Those eligible for those exemptions include:
RNs, LPNs, NACs, nurse technicians, or advanced registered nurse practitioners.
Any person with special education training and endorsement granted by the superintendent of Public Instruction (OSPI).
Any Long-Term Care Worker who worked in Washington State between January 1, 2011-January 6, 2012, and completed all of the basic training requirements which were in effect at that time.
Note that this is different from the requirements for being an Adult Family Home Administrator.
Adult Family Home Administrator training is made up of 54 hours of training specific to the licensing and management of AFH facilities.
Here, you’ll need to find one of the DSHS approved Adult Family Home Administrator Training courses.
You can easily find a list of approved classes through the Washington SDSH. Just click on this link to visit their Trainings > Find a Class page.
Scroll down to the “other training” section, and select AFH Administrator Training. Then you can filter by county, and see what colleges have training classes available near you.
Note that many of these programs have an online option, so don’t pass over a program that looks good to you just because it’s further away. For example, Whatcom College offers an all online AFH Admin Course over Zoom
Staying on top of legal regulations
If you’re not adhering to the law, you’re not staying in business long. While day-to-day practices remain fairly stable, changes are made over time.
This extends to resident rights, quality of life, record maintenance, electronic monitoring and more. The DSHS has a list of documents which each outline the current regulations for these, and other categories of regulations that need to be maintained. You can review their resources on this, here.
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