Winston-Salem Senior AdvisorWho licenses assisted living in Winston-Salem, NC?
The Adult Care Licensure Section of the N.C. Division of Health Service Regulation (DHSR), part of the state Department of Health and Human Services, licenses every assisted living residence in Winston-Salem and the four surrounding counties under N.C.G.S. Chapter 131D.
The City of Winston-Salem and Forsyth County control zoning, building permits and fire inspections, but neither can license a care home. What the county does contribute is people: each department of social services employs adult home specialists who visit the homes in its county, follow up on many complaints and report to the state. That is why some documents in a home's file are labelled as county investigations rather than state surveys. When you want to know whether a building is actually allowed to provide care, the DHSR license number is the thing to check.
What separates an adult care home from a family care home?
Size and rulebook: an adult care home serves seven or more residents and follows 10A NCAC 13F, while a family care home serves two to six residents and follows 10A NCAC 13G; families would call either one assisted living.
The state's October 2026 rosters list 47 adult care homes (2,977 beds) and 13 family care homes (63 beds) across Forsyth, Davidson, Davie, Stokes and Yadkin counties; Forsyth County accounts for 30 of the adult care homes and 9 of the family care homes.
The two rulebooks run almost in parallel on residents' rights, medication handling, care planning and personal care, and they differ mainly on building standards and how staffing is organized, since a five-bed house in Lexington cannot run like a 140-bed building off Reynolda Road. Neither license has tiers or levels, so a small family home and a large campus with a dementia wing hold the same kind of license as their peers.
How long does an adult care home license last in North Carolina?
A calendar year: the adult care home and family care home licenses on DHSR's current lists for the five counties all expire on December 31, and the state renews them after reviewing each home's compliance record.
Every license names one licensee, the legal operator, at one street address. When a home changes hands, the buyer has to obtain a new license, so the license number on a facility page changes with ownership. Our directory shows the licensee's legal name beside the name on the sign because inspections, fines and plans of correction are all issued to the licensee. If the two names do not match, that is normal; if the licensee changed recently, ask what else changed with it.
Who is in charge of a licensed adult care home day to day?
An administrator whose name appears on DHSR's roster, backed by supervisors and personal care aides whose required hours rise with the number of residents under 10A NCAC 13F .0605 and .0606, and the rules forbid ever leaving residents in the building without staff.
Anyone hired to give hands-on care must clear a criminal history check under N.C.G.S. 131D-40 and a search of the Health Care Personnel Registry, and staff who hand out medications must be trained and checked before they start. On a visit, ask for the administrator by name, then ask who is in charge at 2 a.m. on a Sunday. The answer to the second question says more about daily life in the building than the first.
How often are assisted living homes around Winston-Salem inspected?
DHSR's adult care surveyors make a full annual survey of each home, return for follow-up visits when deficiencies are cited, and investigate complaints in between; DHSR's construction section checks the physical building on its own schedule.
All of it is public. The state posts each home's statements of deficiencies, plans of correction and follow-up results on its Facility Inspections, Ratings and Penalties search, together with the star rating and any fine from the past 36 months. Every facility page in our directory lists those documents by date, so you can see whether the last annual survey came back clean before you pick up the phone. Our guide to reading the rating and the survey explains what to look for.
What it is, and what it is not
| A North Carolina adult care home license is | A North Carolina adult care home license is not | |
|---|---|---|
| Issued by | The Division of Health Service Regulation, NCDHHS | A federal CMS certification |
| Allows | Room, board, supervision, personal care and medication help | Daily skilled nursing care |
| Dementia | Able to include approved special care unit beds | A separate memory care license |
| Rated by | DHSR, zero to four stars | CMS's five-star nursing home system |
Based on N.C.G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS documents, NC Medicaid, CMS, the VA, CareScout and the local agencies named above; see our editorial standards for how each is checked.
