independent living checklist

Assisted Living Checklist Independent Living Checklist

Property Name:

Date:

Address:

Contact Information:

Room Size:

Price:

Comments:

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Acts 4:12

Independent Living Checklist


Acts 4:12Forms

Don't forget to request a copy of the following items from each

community you visit. These items will help you in your decision

making process.

The forms include, but are not limited to:

• Copy of the lease/contract

• Activity Calendar

• Sample Dinner Menu

• A copy of Resident Bill of Rights

• A copy of the floor plans

• A list of a all included Services and Amenities

• A copy of the most recent survey (If applicable)



Acts 4:12First ImpressionWere you greeted upon arrival?

Was the community clean?

Was the community odor free?

Was the staff friendly?

Was the staff interacting w/residents?

Were the residents engaged in activities?

Do the residents appear happy?

Does the community have elevators?

Does the community have grab bars?

Was the temperature comfortable?

Living SpaceWill Apt./room size accommodate you?

Do they have availability?

Do they offer private rooms/apartments?

Can the resident control their temperature?

Will space allow for a walker or wheelchair?

Can you have a private phone?

Is there internet access in the room?

□Yes □No□Yes □No□Yes □No□Yes □No□Yes □No□Yes □No□Yes □No

□Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No



Acts 4:12Policy QuestionsCan residents manage their own medication?

Is the staff available 24/7?

Is there On-Site Home Health Care?

Does a Physician come to the facility?

Are there accommodations for a special diet?

Is there scheduled transportation?

Can the transportation vehicle accommodate a wheelchair?

Are Outings included in the monthly cost?

□Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No □Yes □No



Acts 4:12

BEFORE YOU SIGN: Ask These Top 10 Questions

1. Is there a community fee? If so, how much and what does it pay for?

2. What is the pet policy?

3. How many meals a day are included in my rent?

4. If I have an emergency in the middle of the night who will be notified?

5. What utilities are included in the monthly rent?

6. What is the length of the lease I will have to sign?

7. Is there a rate lock? How long is the rate I sign for locked in?



Acts 4:12

8. What is the average age of the residents living there now?

9. If I ever need greater care can it be provided here, or

will I have to move? What are the penalties if I have to move prior to the

end of my contract?

10. Is there a fee for guests to join for meals or stay the evening? If so,

how much is the fee?

ADDITIONAL COMMENTS:

independent living checklist

Healthcare