| Click here for a printable version of this checklist |
| Atmosphere | Yes | No | N/A |
| As you arrive at the residence, do you like its location and outward appearance? | | | |
| As you enter the lobby and tour the residence, is the decor attractive and home-like? | | | |
| Does the administrator/staff call residents by name and interact warmly as you tour? | | | |
| Do residents socialize with each other and appear happy and comfortable? | | | |
| Are you able to talk with residents about how they like the residence and staff? | | | |
| Do the residents seem to be appropriate housemates for you or your loved one? | | | |
| Are staff appropriately dressed, personable and outgoing? | | | |
| Do the staff members treat each other in a professional manner? | | | |
| Are the staff members that you pass during your tour friendly to you? | | | |
| Are visits with the resident welcome at any time? | | | |
| Physical Features | Yes | No | N/A |
| Is the community well-designed for resident's needs? | | | |
| Is the floor plan easy to follow? | | | |
| Are doorways, hallways and rooms accommodating to wheelchairs and walkers? | | | |
| Are elevators available for those unable to use stairways? | | | |
| Are hand rails available to aid in walking? | | | |
| Are floors of a non-skid material and carpets firm to ease walking? | | | |
| Is the residence clean, free of odors and appropriately heated/cooled? | | | |
| Does the residence meet local and/or state licensing requirements? | | | |
| Does the residence have sprinklers and clearly marked exits? | | | |
| Does the residence have a means of security if a resident wanders? | | | |
| Medication & Health Care | Yes | No | N/A |
| Does the residence have specific policies regarding storage of medication, assistance with medications, training and supervision of staff and record keeping? | | | |
| Is self-administration of medication allowed? | | | |
| Is there a staff person to coordinate home care visits from a nurse, physical therapist, occupational therapist, etc. if needed? | | | |
| Is staff available to assist residents who experience memory, orientation, of judgment losses? | | | |
| Does a physician or nurse visit the resident regularly to provide medical checkups? | | | |
| Does the residence have a clearly stated procedure for responding to a medical emergency? | | | |
| To what extent are medical services available, and how are these services provided? | | | |
| Individual Unit Features | Yes | No | N/A |
| Do dining room menus vary from day to day and meal to meal? | | | |
| Are different sized and types of units available? | | | |
| Are units for single and double occupancy available? | | | |
| Is a 24-hour emergency response system accessible from the unit? | | | |
| Are bathrooms private with handicapped accommodations - wheelchairs and walkers? | | | |
| Do all units have a telephone and cable TV and how is billing handled? | | | |
| Is a kitchen area/unit provided with a refrigerator, sink and cooking element? | | | |
| May residents keep food in their units? | | | |
| May residents smoke in their units? In public spaces? | | | |
| Needs Assessments, Contracts, Costs & Finances | Yes | No | N/A |
| Is a contractual agreement available that discloses healthcare and supportive services, all fees, as well as admission and discharge provisions? | | | |
| Does the residence have a process for assessing a potential resident's need for services and are those needs addressed periodically? | | | |
| When may a contract be terminated and what are refund policies? | | | |
| Are there any government, private or corporate programs available to help cover the cost of services to the resident? | | | |
| Is a contractual agreement available to include accommodations, personal care, health care and supportive services? | | | |
| Are additional services available if the resident's needs change? | | | |
| Is there a procedure to pay for additional services when temporary services are needed? | | | |
| Are there different costs for various levels or categories of services? | | | |
| Do billing, payment and credit policies seem fair and reasonable? | | | |
| May a resident handle their own finances with staff assistance if able or should a family member or outside party be designated to do so? | | | |
| Is staff available to meet scheduled and unscheduled needs? | | | |
| When may a contract be terminated? What are the policies for refunds and transfers? | | | |
| Is there an appeals process for dissatisfied residents? | | | |
| Services | Yes | No | N/A |
| Can the residence provide a list of services available? | | | |
| Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? ADLs include: Dressing; Eating; Mobility; Hygiene and grooming; Bathing, toileting and incontinence; Using the telephone; Shopping; and Laundry | | | |
| Does the residence provide housekeeping services in residents' units? | | | |
| Do they provide transportation to doctors' offices and other activities desired by residents? | | | |
| Can residents arrange for transportation on fairly short notice? | | | |
| Are pharmacy, barber/beautician and/or physical therapy services offered on-site? | | | |
| Social & Recreational Activities | Yes | No | N/A |
| Is there evidence of an organized activities program, such as a posted daily schedule, events in progress, reading materials, visitors, etc.? | | | |
| Do residents participate in activities outside of the residence in the neighboring community? | | | |
| Do volunteers, including family members, come into the residence to help with programs? | | | |
| Does the residence create a sense of community by requiring residents to participate in certain activities or perform simple chores for the group as a whole? | | | |
| Are residents' pets allowed in the residence? Who is responsible for their care? | | | |
| Food Service | Yes | No | N/A |
| Does the residence provide three nutritionally balanced meals a day, seven days a week? | | | |
| Are snacks available? | | | |
| May a resident request special foods? | | | |
| Are common dining areas available? | | | |
| May residents eat meals in their units? | | | |
| May meals be provided at a time a resident would like or are there set times for meals? | | | |
| Click here for a printable version of this checklist |