How to start an adult family home in Washington
The whole path, in the order it actually happens, with the real costs and the two things that decide your timeline. My family did this. This is the guide I wish we had been handed at the start.
The short version
- Two things set your timeline: 1,000 hours of documented caregiving experience, and the 54-hour Administrator course. Everything else is scheduling and paperwork.
- The course costs $729 to $885. Same certificate at every school, so choose on schedule.
- Check zoning and building code before you buy a house. This is the most expensive mistake available to you.
- Your license is the starting line, not the finish. The day you are licensed, your costs begin and your revenue does not.
- A bed is worth roughly $5,000 to $8,000 a month. Which means an empty one is the same number, leaving, every month.
- Being findable is the last step and the one people skip. Licensed homes nobody can find stay empty a long time.
Step 1 · Decide if the business actually fits your life
Before any of the paperwork, be honest about what this is. An adult family home is a licensed care setting inside a residential house, usually serving up to six residents. Someone has to be awake and responsible around the clock. Residents live in your building, and often you live there too.
The money can be genuinely good. Private pay rooms in Washington commonly run $5,000 to $8,000 a month, so a full six-bed home is a real business. But the work is care work, not property management, and the people who succeed at it are the ones who wanted the care part.
Step 2 · Start banking your 1,000 caregiving hours
The state requires 1,000 hours of caregiving experience, documented on the Caregiving Experience Attestation form. Start this first, because it is the only requirement you cannot buy, schedule or rush.
If you are already working in care, you may be closer than you think, but you need it documented. If you are coming from another industry entirely, this is the step that turns your plan from months into a year or more. Plan around it honestly rather than hoping around it.
Step 3 · Get your caregiver credentials
You will need the 75-hour long-term care worker orientation, safety and basic training, plus Home Care Aide certification, unless you are exempt. Licensed nurses are the most common exemption. You will also need current CPR and first aid, and food safety training.
Step 4 · Take the 54-hour Administrator course
Required for applicants and entity representatives. DSHS sets the curriculum, so the content is identical everywhere, and the price is not: it runs from $729 at Highline to $885 at Spokane. The certificate does not expire, so taking it early while you finish your hours is a sensible move.
We compared the four main schools on price, format and schedule in our 54-hour training comparison, including which one runs evening classes if you still have a day job.
Step 5 · Find a house that can pass inspection
This is where real money starts moving, and where the expensive mistakes live.
Call the local permitting office with the address before you buy or sign anything. Adult family homes need a local building code inspection from the jurisdiction the house sits in, and requirements differ from city to city. A house you have already committed to that cannot pass, or that needs five figures of work to pass, is the single worst outcome in this whole process. One phone call prevents it.
You will also need floor plans for each level, the state's Initial Inspection Preparation Checklist worked through in advance, and a septic inspection if the property is on septic.
Step 6 · Apply, and get inspected
- Create a Secure Access Washington (SAW) account.
- Complete the AFH online license application.
- Submit the Disclosure of Services form describing the care you will provide.
- Complete your background check.
- Submit your Caregiving Experience Attestation.
- Pass the state licensing inspection.
- Complete TB testing within three days of the home being licensed.
- Obtain liability insurance.
The full requirement list, including the conditional specialty trainings, is in our license requirements guide. Application questions go to the DSHS Business Analysis and Applications Unit at [email protected].
Step 7 · Decide who you will actually serve
Two decisions shape your revenue more than anything else.
- Private pay, Medicaid, or both. Private pay rooms pay more. Medicaid residents come with steadier referral flow through case managers. Most homes do both, and the mix is a real strategic choice rather than an afterthought.
- Specialty populations. Taking dementia, mental health or developmental disability residents requires the matching specialty manager training, and it opens up a large share of the referrals actually being made in your county. Nurse delegation training does the same for residents with medical needs.
Step 8 · Fill the beds, which nobody prepares you for
The part that surprised us
We assumed that being licensed meant residents would come. They do not. The day your license is issued you appear on the DSHS public list and essentially nowhere else. Meanwhile the mortgage, the insurance and the staffing all start.
Our home sat with empty beds while I could not work out why nobody called. The answer was simple and slightly embarrassing: when a family searched for care in Lynnwood, we did not exist. Not on Google, not on a map, not on a website. I built one, and in the first week it was live a daughter searching after her father's hospital discharge found it, toured, and moved him in. That one resident has been about $5,000 a month ever since.
Do these in your first week licensed, in this order:
- Claim your Google Business Profile. Free. This is how you appear on Maps for "adult family home near me".
- List your open beds. Medicaid openings list free on marketplaces, private pay is inexpensive. See our Room & Care guide.
- Get listed free on Dear Care Home, our Washington directory. No cost, and we never sell anyone's information.
- Get a website with your home's name on it. When a discharge planner recommends you, the family Googles that name the same night. If nothing comes up, you were never really in the running.
- Understand what referrals cost before you agree to any. A placement agency's standard commission is roughly your entire first month of care. Read agencies versus listing your own beds first.
Step 9 · Decide about the Council
The Adult Family Home Council represents Washington adult family homes, including in collective bargaining with the state over Medicaid rates. It costs $624 a year. Whether it is worth it depends mostly on whether you take Medicaid residents. We wrote an honest breakdown in is Council membership worth it.
Planning to open in the next few months?
The homes that fill fastest are the ones families can find the week they open, not six months later. If you would like your website and Google presence ready before your first resident, tell me about your home and I will take it from there.
Common questions
How do I start an adult family home in Washington?
Bank 1,000 documented caregiving hours, complete the 75-hour long-term care worker training and Home Care Aide certification unless exempt, take the 54-hour Administrator course, secure a house that can pass local building code, then apply through Secure Access Washington, pass your background check and state inspection, complete TB testing and get liability insurance.
How much does it cost to start an adult family home?
The trainings themselves are the predictable part: roughly $729 to $885 for the Administrator course plus your caregiver certifications. The variable and much larger costs are the house, any work needed to pass building code, insurance, staffing, and the months of running costs before your beds fill.
How long does it take?
Mostly determined by your 1,000 caregiving hours. If you already have them documented and have taken the course, the remaining application, inspections and background check are the work. If you are starting from zero caregiving experience, plan in the range of a year.
How many residents can I have?
Adult family homes serve a small number of residents in a regular residential house, most commonly up to six. Your licensed bed count is set during licensing and depends on the home.
How much can an adult family home make?
Private pay rooms in Washington commonly run $5,000 to $8,000 a month per resident, so a full home is a substantial business. The number that decides your profitability is occupancy, because an empty bed costs you that same amount every month it stays empty.
Do I need to be a nurse?
No. Licensed nurses are exempt from certain requirements, but you do not need to be one to be licensed.
Serving adult family homes across Washington
We work with licensed adult family homes throughout Snohomish, King, Pierce, Thurston, Spokane, Whatcom, Skagit, Kitsap and Clark counties, including Everett, Lynnwood, Edmonds, Marysville, Mill Creek, Seattle, Bellevue, Kent, Renton, Federal Way, Auburn, SeaTac, Shoreline, Kirkland, Tacoma, Lakewood, Puyallup, Olympia, Lacey, Spokane, Spokane Valley, Bellingham, Blaine, Vancouver and Mount Vernon.