Adult Day Care Center Checklist

Directions: This checklist is intended for use when selecting an adult day care center. Complete this for each facility you visit to keep track of and compare different facilities.

Name of Facility:

Date of Visit:

Address:

Phone Number:

Director Name:

Hours of Operation:
Basic Information Yes No Comments
Is center licensed by a state regulatory agency?
How long has the center been open?

# of years:

 
Is a valid license posted?
Does center have half-day program?
Does center have full-day program?
Are there any age requirements?
Does the center accept individuals with Alzheimer's or dementia, limited mobility, and/or incontinence?
Are special services (e.g., Alzheimer's, dementia, rehabilitation) offered?
Can the center provide care for your relative given how incapacitated he or she is?
Costs Yes No Comments
What is the fee for the hours and services you need?
Are there discounts available for those with lower incomes?
What services are included in that fee?
What are the additional services available and at what costs?
Is any of the cost covered by Medicare, Medicaid, private insurance or other financial aid?
Is a deposit required? How much?
Services Provided Needed Available
Art and crafts
Assistance with bathing, dressing, grooming or toileting
Dietary counseling
Exercise
Laundry
Meals at center
Medical assessment
Medical treatment
Medicine management
Music therapy
Occupational therapy
Physical therapy
Recreation
Social services
Speech therapy
Transportation to the center
Transportation (other)
Activities Yes No Comments
Are activity schedules varied and include resident's interests?
Do residents provide input or help plan activities?
Is reading assistance available?
Are there protected/enclosed areas for residents with dementia?
Who develops and supervises recreational activities? What is their background?
Standards of Care Yes No Comments
Can the participant bring a caregiver with him/her to the center?
Is there a separate place for sick persons to sit or sleep isolated from the other participants?
What is the procedure if a medical problem occurs?
How does staff handle difficult behavior?
What is the bathroom procedure? Do participants have to wait if they need assistance?
How is health monitored? How often?
Participants Yes No Comments
Are residents interacting with each other?
What do residents like best? Least?
What is daily life like at the center?
Environment Yes No Comments
Is the center clean, pleasant and free of odor?
Is the temperature comfortable for residents?
Is center well lit?
Are there quiet and/or private areas for conferences or private conversations?
Are noise levels in common areas comfortable?
Is smoking not allowed or is it restricted to certain sections of the center?
Are furnishings comfortable, sturdy and attractive?
Are the building and grounds well cared for and attractive?
Staff Yes No Comments
Does the staff wear name tags?
Does the relationship between staff and participants appear to be polite, warm and respectful?
Is the staff friendly, considerate and helpful to you?
If participants or staff are not a native English speaker, can they communicate effectively with each other?
What is the staff-participant ratio?
What kind of qualifications or experience does the staff have?
Menus and Food Yes No Comments
Does the food look and smell good?
Do residents have a choice of food items at each meal?
Are favorite foods offered?
Can staff help residents eat and drink at mealtimes if needed?
Safety and Security Yes No Comments
Does the center meet local, state and federal fire codes?
Are emergency exits clearly marked, accessible, unobstructed 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?
Is the center wheelchair accessible?
What safety measures are in place to protect residents from wandering?
Are there written policies about what is considered an emergency, when 911 is called and who decides to call?
What happens if the participant's transportation home at the end of the day is delayed in picking up the participant?
Transportation Yes No Comments
Does the center offer transportation for appointments?
Are there costs involved in using their transportation?
Is transportation wheelchair accessible?
Is transportation available for non-medical appointments?
General rating on a scale of 1 (poor) to 5 (excellent):

 

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