What they do, in plain English
Quick answer: A senior placement agency, also called a referral agency or senior living advisor, helps you find assisted living, memory care or a board and care home that fits your parent's needs and budget. Most are free to families. The home pays the agency a referral fee when your parent moves in.
A good agency does the legwork you'd do yourself if you had a month off work. It knows the local homes, checks their state records, gets real prices, sets up tours and helps with move-in paperwork.
How placement agencies get paid
Most agencies sign agreements with care homes. When a family the agency referred moves in, the home pays the agency a one time fee, usually based on the first month's rent. Families don't get a bill.
That's why the service is free, and it's also why you should ask questions. An agency only gets paid by homes it has agreements with. A good one tells you that up front, puts it in writing, and still tells you about a better fit even if that home doesn't pay them.
Ask the home, too: "Is my monthly rate the same whether I come through an agency or walk in on my own?" It should be.
Are placement agencies licensed in California?
Not for assisted living and board and care. As of 2026, California does not issue a license to agencies that refer families to Residential Care Facilities for the Elderly, or RCFEs. Lawmakers have tried to change that. One bill passed the Legislature and was vetoed in 2016, and another stalled in 2024.
There are still rules. Under Health and Safety Code 1569.47, a placement agency can't place, refer or recommend someone to a care home unless that home is licensed or legally exempt. It can't place someone whose needs go beyond what the home is licensed to handle. And it has to report suspected unlicensed homes and unsafe conditions to the state. Breaking these rules is a misdemeanor.
Nursing homes are a separate world. Paid referrals to skilled nursing homes fall under a different state law that does require a license.
Bottom line: for assisted living, what matters most is that every home an agency suggests is licensed and has a solid record. We only work with state licensed homes, and we check each one's inspection history first.
Tell us what's going on. We'll text you licensed homes that fit, with real prices, and tour them with you.
Good questions to ask any placement agency
- How do you get paid, and will you put that in writing?
- Does my monthly price change because I came through you?
- Who will you share my parent's information with? Can I approve each home first?
- Have you personally been inside the homes you're suggesting?
- Did you check each home's state inspection reports? What did you find?
- Will you tour with us?
- Will I work with one person the whole time?
- Would you tell me about a good home that doesn't pay you?
Red flags
- They won't explain how they get paid.
- Your phone starts ringing with calls from places you never picked.
- They push one home hard, or rush you to sign "before the room is gone."
- They suggest a place you can't find on the state's Care Facility Search, or they brush off its citations.
- They want a fee from you up front with no clear written agreement. Some advisors do charge families, and that's fine if it's spelled out.
- They ask for power of attorney, access to your parent's money, or to hold onto personal property.
Who helps you find a nursing home?
If your parent needs skilled nursing after a hospital stay, the hospital case manager or discharge planner usually arranges it. You can compare nursing homes on Medicare Care Compare, and our skilled nursing page explains how to check a Fresno facility. For what comes after rehab, our hospital discharge guide helps you plan ahead.
How we do it at CalValley
We're a local, free service in Fresno. Licensed homes pay us a referral fee, and your price doesn't change. We only share your details with homes you approve, and one of us tours with you. Nick spent years at Community Regional, so we know how discharge days go. See our placement services, or compare local advisors vs national referral sites.
Updated September 2026 by Shaun and Nick, co-founders of CalValley Senior Living Advisors.