ALF Compliance Checklist: What You Need Before Opening Your Assisted Living Facility

At ALF Consultants, we support new assisted living facilities across the U.S. Whether you’re just getting started or preparing for your inspection, this compliance checklist will help ensure you meet your state’s requirements and open with confidence.

✅ 1. Licensing & Regulatory Paperwork

Every state has specific licensing rules for assisted living facilities. While requirements vary, you’ll typically need:

• Completed State License Application

• Local Zoning Approval or Use Permit

• Fire Safety Inspection Report

• Health Department Inspection (if required)

• Owner and Staff Background Checks (Level II or equivalent)

✅ 2. Staffing Requirements

Your team is the heart of your ALF — and most states have minimum staffing and training requirements before you open:

• Administrator Certification or Training

• Staff Background Checks

• Mandatory Training (e.g., resident rights, infection control, emergency procedures)

• CPR & First Aid Certification on Site at All Times

✅ 3. Facility Readiness

Your building must be safe, functional, and ready to support residents:

• Resident Rooms: Must meet space, privacy, and safety standards (grab bars, emergency alerts, etc.)

• Emergency Plan: Some states require a written emergency preparedness plan for natural disasters, power outages, etc.

• Food Preparation Areas: Must meet health codes for sanitation and safety

• Secure Medication Storage: You need a locked area for medications with documentation systems in place

✅ 4. Policies & Procedures Manual

A complete, state-compliant manual shows regulators you’re ready. Your manual should include:

• Resident admission and discharge policies

• Incident reporting procedures

• Medication management protocols

• Grievance process for residents

• Staff training plans and schedules

• Infection control guidelines

• Emergency and disaster response procedures

✅ 5. Final State Inspection (or Survey)

Before you can welcome residents, your state’s licensing agency will likely conduct a pre-opening inspection. Be prepared for:

• A facility walk-through

• Staff interviews and file reviews

• Review of written policies and emergency plans

• Verification of compliance with physical and operational standards