Assisted Living Facility Evaluation Checklist Template printable pdf download

Assisted Living Facility Evaluation Checklist Template

Assisted Living Facility Evaluation Checklist

Instructions: Print a blank checklist for each facility you are considering. Complete it as you

move through the selection process.

Facility Name: ________________________________________________________________

Address: _____________________________________________________________________

Telephone Number:___________________________________________________________

Your Call

Yes

Are all rooms private?

Do any units have kitchens or kitchenettes?

Do you offer special care units, such as for Alzheimer’s patients?

Is a contract available that details all fees, services, and admission and

discharge policies?

Are additional services available on the same campus if a resident’s needs

change?

Can residents choose their own doctors, therapists, and pharmacies?

Is there a written care plan for each patient?

What role does the resident have in developing the care plan?

What different sizes and types of units are available?

How many living units are in the facility?

How does the facility bill for services?

What happens if a resident runs out of money?

Under what conditions would a resident have to leave the facility?

Assisted Living Facility Evaluation Checklist Template