Single-Room Occupancy Hotels in San Francisco

Published By
Health Impact Project

The San Francisco Department of Public Health conducted an HIA to explore how three policies it was considering could improve health for residents in single-room occupancy hotels, which serve as the biggest source of inexpensive housing for the city’s most vulnerable populations, such as seniors, adults with disabilities, and children. They typically offer an 8-by-10 room with shared bathrooms and kitchens. The department was considering requiring or incentivizing operators of these hotels to be certified, increasing data reporting requirements for certain characteristics such as number of rooms or showers, and incorporating data analysis and analytics into city oversight. 

The HIA found that single-room occupancy hotel operators have adequate knowledge of health, housing, and fire codes and that training focused only on city codes would not significantly improve compliance or tenant health. Instead, the HIA recommended that certification and training be focused on increasing tenants’ understanding of the well-established connections between housing and health, and the services offered by city agencies. Possible training topics include preparing a case for Adult Protective Services, communicating with individuals with mental health challenges, and communicating and engaging with city agencies. The HIA recommended that the city use an existing data platform to publish housing inspection data to make people more aware of housing conditions and property maintenance at these hotels. To expand coordination and share best practices among housing inspection departments, the HIA recommended that the city create an interagency committee, with a subcommittee dedicated to establishing and tracking inspection performance measures.

The Centers for Disease Control and Prevention provided funding for this work through the Health Impact Assessment to Foster Healthy Community Design grant.


This HIA was focused on strategies to improve the management of single-room occupancy (SRO) hotels and reduce health and housing code violations to make them safer. The HIA recommended a mandatory training for SRO operators that focused on successfully working with hotel tenants, increasing knowledge of health outcomes, and understanding the role of city agencies and management best practices. The HIA also recommended that educational materials that take into account tenants’ social, cultural, and linguistic needs be created for SRO operators. In addition, the HIA recommended that public housing inspection data, including data on SRO facilities, be standardized and published automatically in order to improve the visibility of housing inspection programs, housing conditions, and the level of property maintenance. These recommendations were informed by three advisory groups: San Francisco Department of Public Health staff, SRO nonprofit owners, and city agencies. In September 2016, the San Francisco Health Commission endorsed all of the HIA recommendations and requested that the Department of Public Health report back in a year on efforts to implement them.


This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.

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