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ACH Licensing & Monitoring 

Looking for information on a specific Adult Care Home (ACH)? Check out the Division of Health Service Regulation website for information on violations and penalties, facility STAR ratings and lists of all licensed facilities.

Adult Care Homes, commonly referred to as Rest Homes, Family Care Homes, or Assisted Living, are homes which provide residential care for aged and disabled adults. These homes provide around-the-clock or live-in staff who prepare meals, supervise medications, provide assistance with bathing, grooming and other personal care needs.

Adult Care Homes not only provide care for the elderly, but also for those with mental illnesses, developmental disabilities and substance abuse problems. Family Care Homes provide care for up to six people in a family-like setting. These homes are usually found in residential areas. Homes for the Aged are larger facilities, serving seven or more people. Also, there are homes for Developmentally Disabled Adults which serve developmentally disabled individuals who participate in approved day programs. These homes are licensed and monitored by Mental Health. Questions or concerns should be directed to the Division of Facility Services - Mental Health Section. All three types of homes provide assistance with meeting the residents' daily needs and have staff on duty 24 hours a day.

Nurses are not required in Adult Care Homes, although some do have nurses and certified nursing assistants on staff. Aides provide assistance with the activities of daily living such as bathing, dressing, grooming and feeding. Adult Care Homes are different from nursing homes in the level of care they provide and the qualifications of staff.

NC Department of Facility Services is responsible for licensing these Adult Care Homes.

Buncombe County Social Work Services is responsible for providing an Adult Home Specialist to monitor the facilities provision of services to the residents as set forth by the State standards.

Adult Home Specialist:

The Adult Service unit provides Adult Home Specialists (AHS), whose purpose is to monitor, investigate complaints, and provide assistance to facilities who work with a very challenging and diverse population.

If there are any problems identified during the routine monitoring of the facility, the AHS is responsible to assure that a corrective plan is completed and signed by facility administrator and the problem is corrected.

If you have any questions you may call our Intake line at 250-5800 between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday and after hours if needed.

Adult Care Home Licensing and Monitoring Services Include:

  • Assist the State with Initial Licensure Process
  • Investigations on "Unlicensed Facilities"
  • Technical Assistance
  • Routine Monitoring
  • Complaint Investigation
  • Negative Actions

Annually the AHS is responsible for completing a comprehensive evaluation of all licensure areas, and developing an Annual Monitoring Plan to prioritize and target each area for review. The areas include:

  • Medication
  • Activities
  • Resident Funds
  • Food Service
  • Admission and Discharge
  • Physical Environment
  • Management and Personnel
  • Health Care
  • Resident Rights

How services are paid for?

No fee for this service.


For a listing of county-wide programs & services offered by Buncombe County Government, please visit our Services For Adults section.