The Basics of an Adult Care Home

Adult care homes are licensed, single family residences in Multnomah County that offer 24-hour care for up to five adult residents in a homelike setting. In other parts of Oregon and the US, they are called adult foster homes. A licensed operator or a resident manager must live in the home and be the primary caregiver to the residents.

Operators provide individualized care while supporting and honoring a resident’s independence, preferences and choices. Both the operator and the adult care home must be licensed before residents can move into the home.

The Adult Care Home Program (ACHP) provides licenses and oversight to operators in Multnomah County for different populations:

  • Older adults and people with physical disabilities (APD)
  • Mental health and addictions (MHA)
  • Intellectual and developmental disabilities (I/DD)

This differs from the approach of other states.

  • Be aware that I/DD care homes are closing because the number of I/DD residents has decreased in Multnomah County. ACHP no longer encourages new operators to apply for licenses to open I/DD adult care homes.

Who is Eligible to Become an Adult Care Home Operator?

Operators must:

  • Pass a background check.
  • Be at least 21 years old.
  • Pass an English test that demonstrates 8th grade level English skills.
  • Be physically and mentally fit.
  • Have at least the equivalent of one year of verifiable full-time experience providing hands-on care to adults in the population they intend to serve.
  • Meet the requirements outlined below.

Adult care home operators are small business owners. They must budget for monthly expenses, such as food, supplies, utilities and staffing expenses. They also are required to have enough money available to cover unexpected costs. Becoming an operator is a major financial commitment!

Operators must have enough financial resources to cover the cost of running their business for at least two months. 

Use the Proposed Operating Budget (812.42 KB) form to plan ahead. Learn more about how much an operator can get paid.

Operators must own or lease a home that meets strict structural and safety requirements. Before you buy, lease or rent a house, review the Multnomah County Administrative Rules effective 7/1/2017 (1.65 MB) to ensure your home will meet the facility requirements. See pages 93 106.

If you fulfill these basic requirements, review the eight steps to become an adult care home operator.

Eight Steps to Become an Adult Care Home Operator

Adult care homes are highly regulated. Both the operator applicant and the adult care home site must be eligible for an adult care home license. The licensing process takes approximately six months to complete.

1. Attend Free Information Session on How to Become an Adult Care Home Operator

Get your questions answered before you invest time and money into becoming an adult care home operator! This free virtual session will cover the basics of adult care homes and introduce you to the licensing process.

The ACHP strongly recommends attending the information session before purchasing a house or signing a lease.

Register Now

2. In-person Consultation With a Licenser

Meet one-on-one for an in-person consultation with a licenser at the ACHP office to get questions answered about your specific situation. Learn about common challenges with the application, ask questions you may have about the application criteria and process. The licenser will ask you questions to help you determine your own suitability and prepare for the application. 

A determination will not be made during the consultation. Approval or denial of an application can’t be made until a completed application is reviewed. The ACHP cannot provide legal advice.

Register Now for a Consultation

To prepare for your consultation, please review the information on this webpage and: 

Come to the consultation prepared to discuss in detail, and ask questions about, these application topics:

  • Employment verification
  • Financial plan for your business
  • Selection and/or preparation of the property
  • How you are prepared for the responsibilities of operating an adult care home

The Adult Care Home Program office is located at 600 NE 8th St. Suite 100, Gresham, OR 97030. Check in with the front desk at least five minutes before your consultation appointment.

3. Submit Background Check

Submit a background check. New applicants must bring a current photo ID with their background check to the ACHP office.

How to Submit a Background Check and Payment

4. Complete ACHP Orientation

The ACHP Orientation is held once a month from 9 a.m. – 3 p.m. Cost is $55. Email advsd.adult.carehomeprogram@multco.us or call 503-988-3000 to register. 

Upcoming dates in 2024: 

  • Thursday, September 5
  • Tuesday, October 1
  • Tuesday, November 5
  • Tuesday, December 3

5. Basic Training Courses and Tests

All applicants must take:

  • English Test
  • Fire Safety
  • Pre-Service Infection Prevention & Control for Community Based Care
  • Food Handler Training
  • CPR and First Aid
  • Mandatory Abuse Reporter Training
  • Providing Inclusive Care

Some courses and tests are required for specific applicants, based on the license they are pursuing.

APD applicants must take:

  • Ensuring Quality Care course
  • APD Qualifying Test
  • Home and Community-Based Services Training
  • Pre-Service Dementia Training

MHA applicants must take:

  • Ensuring Quality Care course
  • APD Qualifying Test

I/DD applicants must take:

  • Developmental Disabilities Qualifying Test
    • Study the DD Basic Training Manual

Find more information and register for these courses and tests at Basic Training & Qualifying Tests.

6. City of Portland Home Inspection

If the adult care home is located within Portland, a city inspection is required. Complete the forms Inspection Request for Adult Care Home Within City of Portland and Landlord Statement of Understanding, if applicable. These forms are included with the application.

City of Portland Inspection Instructions

7. Submit Application

Review application information and required supporting documents carefully before submitting your application. A complete application must include the supporting documents. All supporting documents must be attached to the application when you submit it.

After 60 days if your application is incomplete, it will be denied and your fee will not be refunded.

Once a complete application is received, the ACHP has 60 days to determine whether to approve or deny it.

If the application meets the licensing requirements, the ACHP will schedule the home inspection.

To request an application, submit an application or withdraw an application, email advsd.adult.cahrehomeprogram@multco.us or call 503-988-3000. Pay the fee over the phone or in person at the ACHP office.

8. ACHP Home Inspection

The final step of the application process in an inspection of the adult care home. Before you buy, lease or rent a house, review the Multnomah County Administrative Rules (1.65 MB) to ensure your home will meet the facility requirements. See pages 93 106.