Assisted Living Residence Checklist

Directions: This checklist is intended for use when selecting an assisted living residence. Complete this for each facility you visit to keep track of and compare different facilities.

Name of Facility:

Date of Visit:


Phone Number:

Director Name:

Basic Information Yes No Comments
Total number of units

# of units:


Is the residence licensed?
Is a valid license posted?
Is the director or administrator's license current (if required by state)?
Is there a waiting period for admission?
Is a room available?
Is facility located close enough to friends and family?
Is the facility nearby shopping, medical services and/or entertainment?
Financial and Legal Contract Yes No Comments
What is the base monthly fee?

What services are included in that fee?
Is any of the cost eligible for coverage under Medicare, Medicaid, another financial aid program or private insurance?
Is a deposit required?
At what point, can you provide a copy of the residency agreement or contract now?
What are the additional services available and at what costs?
What is the procedure for when fees are changed? Who is notified?
If resident is hospitalized or placed in other care, how long will his or her room held? At what fee or charge?
What are the reasons for termination of the residency agreement? How much notice is given and to whom?
Does the facility assist families and residents with the move-out or discharge process?
Is there a suggestion, complaint, internal appeal and/or grievance process? Are issues handled in a timely manner?
Is the resident required to hold a renters insurance policy?
Who is responsible for repairs or replacement after spills or accidents that destroy either the facility or resident's property?
Medical Care Yes No Comments
Are residents encouraged to be as independent as possible?
What happens if the health care needs of a resident change?
Can hospice care be provided? Will the facility help to coordinate with the physician and family?
Does facility have the ability to determine the cause of confusion a resident may develop (medications versus diagnosis of dementia or Alzheimer's)?
Does the facility have the ability to deal with a resident's behavior that may change and become abusive?
What is the policy on dispersing medications? Are there any limitations on how the staff will handle your loved one's medications?
Can a resident take his/her medications on own?
Does the facility use a particular pharmacy? If so, is the pharmacy participating in the resident's Medicare Part D prescription plan?
Does the pharmacy provide a yearly review and consultation services?
Are physical, occupational or speech therapists available or arranged?
May residents still see their own doctors?
Will the staff set up appointments for residents?
Does the staff respond quickly when residents push the call buttons?
Does the facility have an arrangement with a nearby hospital for emergencies?
Does the facility call family or a personal doctor when emergencies arise? Under what circumstances?
Plan of Care Yes No Comments
How and by whom are residents' needs assessed and monitored?
Are there special programs available (memory loss, dementia, limited mobility)?
Does the facility prepare a written plan for how it will care for the resident?
Are Certified Nursing Assistants involved in care planning meetings?
Are care plan meetings are held with residents and family at convenient times if possible?
What involvement does a confused resident have?
Does the plan cover all aspect of a resident's life? (physical, mental, social and medical)
Residents Yes No Comments
Are residents interacting with each other? Do they look content and engaged?
What is the average age of the residents?



What do residents like best? Least?
What is daily life like at the facility?
Is there a resident and/or family council? How often does it meet?
Are residents' rights posted? Does the facility follow a resident's bill of rights?
Do residents have the right to come and go as they please?
Is mail delivered promptly and unopened?
Can residents have subscriptions to magazines and/or newspapers?
Environment Yes No Comments
Are there any overwhelming unpleasant odors?
Is the facility clean and well-kept?
Is the temperature comfortable for residents?
Is facility well lit?
Are there plenty of community areas for residents to use?
Are there quiet and/or private areas for visiting with friends and family?
Are noise levels in common areas comfortable?
Is smoking not allowed or is it restricted to certain sections of the facility?
Are furnishings comfortable, sturdy and attractive?
Are the building and grounds well cared for and attractive?
Is there a bank, beauty parlor or barber?
Are there laundry services? Is there an extra cost?
Staff Yes No Comments
Is the staff visible?
Does the staff wear name tags?
Does the relationship between staff and residents appear to be polite, warm and respectful?
If residents or staff are not native English speakers, can they communicate effectively with each other?
Can a private duty companion be hired? What is the procedure?
Is training and continuing education programs available to all staff? Are there on-going programs?
Does the staff receive abuse prevention training?
Are background checks completed for all staff?
Is there at least one full-time registered nurse (RN) on duty around the clock? If not, how does facility support resident in obtaining nursing care?
Residents' Room Yes No Comments
Is the living space big enough?
Are the rooms private?
Do any rooms have kitchens or kitchenettes?
Are rooms furnished? If so, can residents have personal belongings and/or furniture in their rooms?
Is it well lit?
How often is the room cleaned?
Is there a window in each resident's room?
Do residents have access to a personal telephone, Internet and television?
Is there a cable TV connection in each room?
Are linens and towels provided?
Do policies and procedures exist to protect residents' personal possessions?
What is the policy for visitors? Staying overnight? Are there guest rooms?
Is there additional storage space available?
Are there call systems in each room?
Is there a private bathroom? If so, how often is it cleaned?
Is there a call system in the bathroom?
Menus and Food Yes No Comments
How often do the menus rotate? Are residents' suggestions taken into account?
Do residents have a choice of food items at each meal?
Does the food look and smell good?
Are special dietary needs accommodated? How?
Are nutritious snacks available upon request?
Can staff help residents eat and drink at mealtimes if needed?
Is the meal schedule flexible? At what times are meals served?
Does a nutritionist or dietician review meals and special diets?
Can a meal tray be delivered to a resident's room? At what cost?
Activities Yes No Comments
Are residents encouraged, not pushed, to participate in activities?
Are activity schedules varied and include resident's interests? Do residents provide input?
Is there someone who develops and supervises recreational activities? What is his/her background?
Does the facility have pleasant outdoor areas for resident use? Is there a place for residents to garden?
Are there protected/enclosed areas for residents with dementia?
Are residents involved in the community outside the facility? If so, how? How is staff involved?
Are there recreation facilities on site (such as a game room)? Can residents use supplies outside of scheduled programs?
Can residents exercise? What are the exercise facilities like?
Does the facility have an active volunteer program? Are volunteers from the community? Are they screened?
Are pets allowed? If not, does the facility have pets? Or can family pets come with visitors? If yes, what are the restrictions?
How does the facility accommodate religious or spiritual needs?
Safety and Security Yes No Comments
Does the facility offer security? Is there a security checkpoint at the entrance?
Does the facility meet local, state and federal fire codes?
Are emergency exits clearly marked, accessible and easily opened from the inside?
Are there fire safety systems? (For example, smoke detectors, fire extinguishers and sprinklers are in each room.)
Is there an emergency evacuation plan? Is it posted?
Does the facility hold regular fire drills?
Are the facility's doors locked? When? How does a resident or family member get into the home when the doors are locked? Are exit doors alarmed?
Are residents with dementia or Alzheimer's prevented from wandering from the facility? How?
Are there safety locks on windows?
Are there handrails in the hallways and grab bars in the bathrooms?
Are stairway doors kept closed to prevent potential spread of fire?
Is the facility wheelchair accessible? (Example: hallways are wide enough, there are wheelchair ramps)
Is there an emergency generator or alternate power source?
Are there written policies about emergencies, when 911 is called and who decides to call?
Transportation Yes No Comments
How does the facility handle transportation for appointments?
What are the costs involved in using their transportation?
Is transportation wheelchair accessible?
Is transportation available for non-medical appointments?
Is there parking available? Can residents have their own automobiles?
Is there public transportation nearby?
General rating on a scale of 1 (poor) to 5 (excellent):



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