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������������������ ������ ������������������ ������ ������������������ ���������� ATMOSPHERE �� ���� ���� ���� ���� ���� �� Is the residence location and decor attractive and pleasing? ���� ���� ���� ���� ���� �� Does the administrator/staff call residents by name and interact warmly with them as you tour the residence? ���� ���� ���� ���� ���� �� Do residents socialize with each other/involved in activities? ���� ���� ���� ���� ���� �� Do residents appear to be properly groomed, dressed & healthy? ���� ���� ���� ���� ���� �� Are you able to talk with residents about their likes and dislikes? ���� ���� ���� ���� ���� �� Are staff appropriately dressed, personable, friendly and outgoing? ���� ���� ���� ���� ���� �� Are staff members attentive to residents’ needs in a timely manner? ���� ���� ���� ���� ���� �� Do staff members seem knowledgeable and competent? ���� ���� ���� ���� ���� �� Is the staff-to-resident ratio sufficient to meet residents’ needs? FACILITY FEATURE ���� ���� ���� ���� ���� �� Is the floor plan easy to follow? ���� ���� ���� ���� ���� �� Are doorways, hallways and rooms accommodating to wheelchairs and walkers? Are handrails available? ���� ���� ���� ���� ���� �� Is the residence clean, free of odors, appropriately heated or cooled and well lit? ���� ���� ���� ���� ���� �� Does the residence have sprinklers, smoke detectors and clearly marked, unobstructed exits? ���� ���� ���� ���� ���� �� Does the residence have a written emergency plan available? (Medical, fire, hurricane) �� ���� ���� ���� ���� ���� �� Is there 24-hour security? ���� ���� ���� ���� ���� �� Is there 24-hour on-site management? ���� ���� ���� ���� ���� �� Are rooms available for private occasions/parties? ���� ���� ���� ���� ���� �� Are guest accommodations available? Gratis or extra charge? HEALTHCARE & PERSONAL CARE ���� ���� ���� ���� ���� �� Is self-administration of medication allowed? ���� ���� ���� ���� ���� �� Does a physician or nurse visit regularly to provide checkups? �� ���� ���� ���� ���� ���� �� Is there a written plan for the care of each resident? ���� ���� ���� ���� ���� �� Does the residence have a process for assessing a potential resident’s need for services and are they addressed periodically? ���� ���� ���� ���� ���� �� Does this process include the resident, their family and facility staff along with the resident’s physician? �� ���� ���� ���� ���� ���� �� Does the residence have a means of security for wanderers? FOOD SERVICE (Ask for a menu) ���� ���� ���� ���� ���� �� Does the residence provide three nutritionally balanced meals a day, seven days a week? Are snacks available? ���� ���� ���� ���� ���� �� May a resident request special foods? Prescribed diets? ���� ���� ���� ���� ���� �� Are common dining areas available? May they sit anywhere? ���� ���� ���� ���� ���� �� May residents eat meals in their units? ���� ���� ���� ���� ���� �� Are there set times for meals? Available anytime? ���� ���� ���� ���� ���� �� Are meals available for friends or guests? Gratis or extra charge? ���� ���� ���� ���� ���� �� Are there meal choices? 22 www.PolkElderCare.com


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