Six Beds or Fewer: Family Care Homes in Forsyth and Davidson Counties

What a family care home is

A family care home is assisted living in a house. North Carolina licenses homes for two to six residents under 10A NCAC 13G, a rulebook that closely follows the one for larger adult care homes on residents' rights, medications and personal care. Residents get a room, meals, supervision and help with bathing, dressing and medications, often from the same two or three caregivers every day.

They are easy to miss. Many have no sign, no website and no marketing budget, which is why families who search online for assisted living in Winston-Salem rarely find them.

Where they are

Every family care home on the state's October 2026 roster for the five counties:

Source: N.C. DHSR adult care rosters, star ratings and 36-month penalty list, pulled November 6, 2026.

Winston-Salem holds most of them, with others in Lexington, Kernersville, Thomasville and Mocksville. Stokes and Yadkin counties have none on the current list.

Who does well in a small home

Family care homes suit people who find big buildings overwhelming: a parent who eats better at one table, sleeps better in a quiet house or becomes anxious in crowds. They can work well for some people with early dementia, although no family care home has a licensed dementia unit, so a resident who begins to wander will eventually need a home that does.

They suit families on a budget, too. No survey publishes separate prices for family care homes, but their rates are often below the large buildings around Winston-Salem, and they are more likely to accept State/County Special Assistance, which pays up to $1,397 a month in 2026.

The questions to ask

The small size that makes these homes feel personal also makes staffing the key question. Ask how many caregivers are on duty at night and whether they are awake. Ask what happens when one resident needs help in the bathroom while another is calling. Ask who covers when the owner or main caregiver is sick or on vacation.

Then read the survey. Because each home has only a handful of residents, a single citation can describe something that happened to your parent's future housemate. The facility pages on this site list each home's documents and link to the state's copies.

What happens if a family care home closes or changes hands

Small homes depend heavily on one owner. When that person retires, sells or falls ill, a family care home can close or change operators with little warning. A new operator needs a new license, so the license number on our facility pages changes, and the state's records start fresh under the new name.

Ask the owner how long they plan to operate and what would happen to residents if they stopped. Ask whether there is a relief caregiver who knows the residents. None of this is a reason to avoid family care homes, which give many residents a warm and stable home for years, but it belongs in the conversation.

How they compare with larger homes

A large adult care home brings an activity calendar, a dining room, often a beauty shop and sometimes a dementia unit for later. A family care home brings a household. Neither is better in general; the right one depends on the person. Visit one of each at lunchtime and watch how your parent responds. Our comparison of adult care homes and family care homes sets out the differences side by side.