Start With DSHS Licensing
Every legitimate AFH is listed in the DSHS provider database. Search by county or city, then filter by specialties (memory care, Medicaid, DDA). Remove any home that shows an expired license — that's a hard stop.
Use the license profile to confirm capacity, owner name, and whether the home is contracted for Medicaid.
Check Inspection Reports (They're Public)
Click the inspection tab on the DSHS listing and read the last two years of reports. Administrative issues (late paperwork) aren't a big deal. Patterns of supervision failures, medication errors, or abuse allegations are. Make notes on each home so you remember which citations mattered.
If a report references a "directed plan of correction," ask the provider how they resolved it.
What Staff Ratios Tell You
Ask every home: "How many caregivers are on during days? Evenings? Nights?" Look for at least one awake staff overnight for memory care residents. Confirm backup coverage for sick days. Homes that hesitate to answer probably run leaner than they should.
Also ask how long current caregivers have been with the home. Stability matters.
The In-Person Tour
Use all your senses. Does the house smell clean without heavy air fresheners? Are residents groomed and engaged? Do staff greet your parent directly? Peek in the fridge, look at bathrooms, and ask to see the medication storage area. A good provider is proud to show it off.
Bring a checklist of must-ask questions so nerves don't make you forget the important stuff.
Questions That Reveal the Real Picture
Ask scenario-based questions: "Tell me about a time a resident's needs increased and how you handled it." "What happens if my mom refuses a shower?" "How do you keep residents with dementia safe at night?" Real providers answer with real stories, not vague promises.
Red Flags That Should Make You Walk
Walk away if the home refuses to show inspection reports, dodges staffing questions, has locked interior doors you can't see behind, or smells strongly of urine. Also beware of homes that demand large non-refundable deposits before you've seen the contract.
Trust your gut. If something feels off, it usually is.
Frequently Asked Questions
Q: How many homes should we tour? A: At least two. Three if time allows. Comparisons clarify priorities.
Q: Should we bring our parent? A: If they're cognitively able and willing, yes. Otherwise, tour first and bring them back once you've narrowed the list.
Q: Are placement agencies worth it? A: Good ones are. They know who has openings and which homes are truly great. Ask how they get paid (most receive a commission from the home).
Q: Do we need a lawyer? A: Not usually, but have someone else read the contract to catch auto-renew clauses or fee escalators.