Use this list to prioritize work tasks. Leave a copy of this list with the family so they can make further improvements.
EXTERIOR ENTRANCES AND EXITS
- Note condition of walk and drive surface; existence of curb cuts
- Note handrail condition, right and left sides
- Note light level for driveway, walk, porch
- Check door threshold height
- Note ability to use knob. lock key, mailbox, peephole, and package shelf
- Do door and window locks work?
INTERIOR DOORS, STAIRS, HALLS
- Note height of door threshold. Knob and hinge types; clear width door opening; determine direction that door swings
- Note presence of floor level changes
- Note hall width, adequate for walker/wheelchair
- Determine stair flight run: straight or curved
- Note stair rails.. condition, right and left side
- Examine light level, clutter hazards
- Note floor surface texture and contrast
BATHROOM
- Are basins and tub faucets, shower control and drain plugs manageable?
- Are hot water pipes covered?
- Is mirror height appropriate, sit and stand?
- Note ability reach shelf above, below basin covered?
- Note ability to step in and out of the bath and shower
- Can resident use bath bench in tub or shower?
- Note toilet height; ability to reach paper; flush; come from sit to stand posture
- Is space available for caregiver to assist?
KITCHEN
- Note overall light level, task lighting
- Note sink and counter heights
- Note wall and floor storage shelf heights
- Are underside hot water pipes covered?
- Is there under counter knee space?
- Is there a nearby surface to rest hot foods on when removed from oven?
- Note stove control location (rear or front)
LIVING, DINING, BEDROOM
- Chair, sofa, bed heights allow sitting or standing?
- Do rugs have non-slip pad or rug tape?
- Chair available with arm rests?
- Able to turn on light, radio, TV, place a phone call from bed, chair, and sofa?
LAUNDRY
- Able to hand-wash and hang clothes to dry?
- Able to access automatic washer/dryer?
TELEPHONE AND DOOR
- Phone jack location near bed, sofa. chair?
- Able to get phone, dial, hear caller?
- Able to identify visitors, hear doorbell?
- Able to reach and empty mailbox?
- Wears neck/wrist device to obtain emergency help?
STORAGE SPACE
- Able to reach closet rods and hooks, open bureau drawers?
- Is there a light inside the closet?
WINDOWS
- Opening mechanism at 42 inches from floor?
- Lock accessible. easy to operate? Sill height above floor level?
ELECTRIC OUTLETS AND CONTROLS
- Sufficient outlets?
- Outlet height, wall locations Low vision/sound warnings available?
- Extension cord hazard?
HEAT, LIGHT VENTILATION, SECURITY CARBON MONOXIDE, WATER TEMP CONTROL
- Are there smoke detectors and a fire extinguisher?
- Thermometer displays easily readable?
- Accessible environmental controls?
- Pressure balance valve available?
- Note rooms where poor light level exists
- Able to open windows; slide patio doors?
- Able to open drapes or curtains?
