NC ASSISTED LIVING ADMINISTRATOR STATE
EXAM AND PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
NC Assisted Living Laws and Statutes (G.S. Chapter 131D, Chapter 90)
Adult Care Licensure Section (ACLS) Regulatory Framework
Administrator Certification and Qualification Requirements
Resident Rights and Quality of Life Standards
Admission, Discharge, and Service Planning Procedures
Medication Management and Medication Aide Rules
Staffing Requirements and Training Standards
Health, Safety, and Physical Plant Requirements
Abuse, Neglect, and Exploitation Reporting
Administrative Responsibilities and Regulatory Compliance
Introduction
The NC Assisted Living Administrator State Exam assesses knowledge required to operate and manage
adult care homes in compliance with North Carolina statutes and administrative rules. This examination
evaluates understanding of G.S. Chapter 90, Article 20A, 10A NCAC 13F and 13G, administrator
certification requirements, resident rights, medication management, staffing standards, and regulatory
compliance. Questions are structured in multiple-choice and scenario-based formats emphasizing real-
world application, critical decision-making, and regulatory adherence. Candidates must demonstrate
competency in facility operations, resident care standards, and the legal responsibilities of assisted living
administrators.
SECTION ONE: QUESTIONS 1–100
Question 1
Which North Carolina state agency is responsible for certifying assisted living administrators and
licensing adult care homes?
A. North Carolina Department of Labor
B. North Carolina Department of Health and Human Services, Division of Health Service Regulation
C. North Carolina Board of Nursing
D. North Carolina Department of Insurance
, B. North Carolina Department of Health and Human Services, Division of Health Service Regulation
RATIONALE: The North Carolina Department of Health and Human Services (NCDHHS), through the
Division of Health Service Regulation (DHSR) and the Adult Care Licensure Section (ACLS), is responsible
for certifying assisted living administrators and licensing adult care homes .
Question 2
Under G.S. § 90-288.14, what is the minimum age requirement to become a certified assisted living
administrator in North Carolina?
A. 18 years
B. 21 years
C. 25 years
D. No minimum age
B. 21 years
RATIONALE: North Carolina law requires assisted living administrators to be at least 21 years old.
This ensures a minimum level of maturity and legal capacity to manage resident care, finances, and
regulatory compliance .
Question 3
How many hours must an Administrator-in-Training (AIT) program consist of at minimum?
A. 60 hours
B. 80 hours
C. 120 hours
D. 160 hours
C. 120 hours
RATIONALE: The AIT program requires a minimum of 120 hours, consisting of at least 20 hours of
coursework or study and at least 100 hours of on-the-job training under an approved preceptor .
Question 4
What percentage score is required to pass the written administrator examination in North Carolina?
A. 70 percent
B. 75 percent
C. 80 percent
D. 85 percent
B. 75 percent
RATIONALE: Candidates must complete the written examination administered by the Department
with 75 percent accuracy. The examination must be completed within 12 months of completing the AIT
program .
, Question 5
What is the maximum number of residents permitted in a Family Care Home in North Carolina?
A. 3 residents
B. 6 residents
C. 12 residents
D. 20 residents
B. 6 residents
RATIONALE: Family Care Homes are licensed for 2 to 6 residents. Adult Care Homes are licensed for
7 or more residents .
Question 6
Which agency must complete a criminal background report for administrator certification applicants?
A. Federal Bureau of Investigation only
B. North Carolina State Bureau of Investigation
C. Local police department
D. North Carolina Department of Motor Vehicles
B. North Carolina State Bureau of Investigation
RATIONALE: A satisfactory criminal history report completed by the North Carolina State Bureau of
Investigation (SBI) is required. If the applicant has resided in North Carolina for less than five years, a
federal FBI report is also required .
Question 7
What is the primary responsibility of an assisted living administrator?
A. Performing all resident personal-care tasks personally
B. Managing the facility and ensuring compliance with applicable laws and regulations
C. Prescribing medications for residents
D. Replacing the resident's physician
B. Managing the facility and ensuring compliance with applicable laws and regulations
RATIONALE: The administrator is responsible for overall facility operation and compliance. The
administrator does not function as a physician or personally perform every direct-care task .
Question 8
When the administrator is absent from an adult care home, who may be designated to handle day-to-
day operations?
A. Any employee regardless of qualifications
B. A designated qualified manager
EXAM AND PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
NC Assisted Living Laws and Statutes (G.S. Chapter 131D, Chapter 90)
Adult Care Licensure Section (ACLS) Regulatory Framework
Administrator Certification and Qualification Requirements
Resident Rights and Quality of Life Standards
Admission, Discharge, and Service Planning Procedures
Medication Management and Medication Aide Rules
Staffing Requirements and Training Standards
Health, Safety, and Physical Plant Requirements
Abuse, Neglect, and Exploitation Reporting
Administrative Responsibilities and Regulatory Compliance
Introduction
The NC Assisted Living Administrator State Exam assesses knowledge required to operate and manage
adult care homes in compliance with North Carolina statutes and administrative rules. This examination
evaluates understanding of G.S. Chapter 90, Article 20A, 10A NCAC 13F and 13G, administrator
certification requirements, resident rights, medication management, staffing standards, and regulatory
compliance. Questions are structured in multiple-choice and scenario-based formats emphasizing real-
world application, critical decision-making, and regulatory adherence. Candidates must demonstrate
competency in facility operations, resident care standards, and the legal responsibilities of assisted living
administrators.
SECTION ONE: QUESTIONS 1–100
Question 1
Which North Carolina state agency is responsible for certifying assisted living administrators and
licensing adult care homes?
A. North Carolina Department of Labor
B. North Carolina Department of Health and Human Services, Division of Health Service Regulation
C. North Carolina Board of Nursing
D. North Carolina Department of Insurance
, B. North Carolina Department of Health and Human Services, Division of Health Service Regulation
RATIONALE: The North Carolina Department of Health and Human Services (NCDHHS), through the
Division of Health Service Regulation (DHSR) and the Adult Care Licensure Section (ACLS), is responsible
for certifying assisted living administrators and licensing adult care homes .
Question 2
Under G.S. § 90-288.14, what is the minimum age requirement to become a certified assisted living
administrator in North Carolina?
A. 18 years
B. 21 years
C. 25 years
D. No minimum age
B. 21 years
RATIONALE: North Carolina law requires assisted living administrators to be at least 21 years old.
This ensures a minimum level of maturity and legal capacity to manage resident care, finances, and
regulatory compliance .
Question 3
How many hours must an Administrator-in-Training (AIT) program consist of at minimum?
A. 60 hours
B. 80 hours
C. 120 hours
D. 160 hours
C. 120 hours
RATIONALE: The AIT program requires a minimum of 120 hours, consisting of at least 20 hours of
coursework or study and at least 100 hours of on-the-job training under an approved preceptor .
Question 4
What percentage score is required to pass the written administrator examination in North Carolina?
A. 70 percent
B. 75 percent
C. 80 percent
D. 85 percent
B. 75 percent
RATIONALE: Candidates must complete the written examination administered by the Department
with 75 percent accuracy. The examination must be completed within 12 months of completing the AIT
program .
, Question 5
What is the maximum number of residents permitted in a Family Care Home in North Carolina?
A. 3 residents
B. 6 residents
C. 12 residents
D. 20 residents
B. 6 residents
RATIONALE: Family Care Homes are licensed for 2 to 6 residents. Adult Care Homes are licensed for
7 or more residents .
Question 6
Which agency must complete a criminal background report for administrator certification applicants?
A. Federal Bureau of Investigation only
B. North Carolina State Bureau of Investigation
C. Local police department
D. North Carolina Department of Motor Vehicles
B. North Carolina State Bureau of Investigation
RATIONALE: A satisfactory criminal history report completed by the North Carolina State Bureau of
Investigation (SBI) is required. If the applicant has resided in North Carolina for less than five years, a
federal FBI report is also required .
Question 7
What is the primary responsibility of an assisted living administrator?
A. Performing all resident personal-care tasks personally
B. Managing the facility and ensuring compliance with applicable laws and regulations
C. Prescribing medications for residents
D. Replacing the resident's physician
B. Managing the facility and ensuring compliance with applicable laws and regulations
RATIONALE: The administrator is responsible for overall facility operation and compliance. The
administrator does not function as a physician or personally perform every direct-care task .
Question 8
When the administrator is absent from an adult care home, who may be designated to handle day-to-
day operations?
A. Any employee regardless of qualifications
B. A designated qualified manager
