Assisted Living Checklist

Assisted Living Checklist (1)

General assessment:
· Do you like the location and the outward appearance of the residence? yes [] no

· Is the decor attractive and homelike? [] yes [] no

· Did you and your potential resident receive a warm welcome? [] yes [] no

· Does the staff call residents by name and interact warmly with them? [] yes [] no

· Do residents socialize with each other and appear to be happy and comfortable?
[] yes [] no

· Is staff appropriately dressed, personable and outgoing? [] yes [] no

· Are visits to the resident welcome at any time? [] yes [] no

· Is the community well designed for resident's needs? [] yes [] no

· Is the floor plan easy to follow? [] yes [] no

· Are doorways, hallways and rooms accommodating to wheelchairs and walkers? [] yes []
no

· Are handrails available to aid in walking? [] yes [] no

· Does the residence have good natural and artificial lighting? [] yes [] no

Needs assessments, contracts, costs and finances:
    · Is there a written care plan for each resident? [] yes [] no

    ·    Is there a procedure for assessing a potential residents need for services and are those
        needs reassessed periodically? [] yes [] no

Assisted Living Checklist (2)

Medication/health care:

Is there a residence policy regarding storage of medication, assistance with medications, training and supervision of staff and record keeping? [] yes [] no

Is self-administration of medication allowed? [] yes [] no

Does a physician or nurse visit the resident regularly to provide medical checkups? [] yes [] no

Services:
Is staff available to provide 24-hour assistance with activities of daily living if needed? Dressing? [] yes [] no Eating? [] yes [] no Mobility? [] yes [] no Hygiene and

grooming? [] yes [] no
telephone? [] yes [] no
Housekeeping in unit? [] yes [] no
Transportation to doctor, hairdresser, activities, etc.? [] yes [] no

Features of individual units:

· Are units for single and double occupancy available? [] yes [] no

Using the [] yes [] no

· Do residents have their own lockable doors? [] yes [] no

· Is a 24-hour emergency response system assessable from the unit? [] yes [] no

· Are bathrooms private with handicapped accommodations? [] yes [] no

· Is a 24-hour emergency response system accessible from the unit? ? [] yes [] no

· Are the bathrooms private with handicapped accommodations for wheelchairs and
walkers? [] yes [] no

· Are residents able to bring their own furnishings for their unit? [] yes [] no

· Is a kitchen area/unit provided with a refrigerator, sink and cooking element? yes [] no

· May residents smoke in their units? [] yes [] no

Social and Recreational Activities:

Assisted Living Checklist (3)

Food Service:

· Does the residence provide three nutritionally balanced meals/day everyday?
[] yes [] no

· May a resident request special foods? [] yes [] no

· Are common dining areas available? [] yes [] no

· May residents eat meals in their units? ( )yes ( )no

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