SITE VISIT CHECKLIST
POSITIVE
NEGATIVE
  • Nurses and Aides are interacting with
    residents.


  • Residents appear well-groomed, clothing is
    clean, wheelchairs and walkers appear clean
    and in good repair.


  • Residents move about the unit freely in
    walkers or wheelchairs.  Some residents are
    wearing seatbelts.



  • Unit is reasonably quiet.  Staff and residents
    are speaking in conversational tones of
    voice.  Call bells may ring in the hallways but
    Nurses or Aides answer them in a reasonable
    time frame.  Name tags are clearly displayed.



  • Residents appear happy and content.  Some
    are gathered in small groups conversing or
    participating in an activity.


  • Nurses and Aides are courteous to each
    other and to you.  They speak pleasantly and
    respectfully to residents when assisting them.




  • Common areas smell pleasant or there is no
    odor at all.

  • Hallways are clean and free from clutter.  
    Articles stored in hallways (linen carts, empty
    wheelchairs, laundry receptacles) are lined
    up on one side of the hall.




  • Food delivered to residents during your visit
    appears hot, nutritious and appetizing.  
    Residents who need assistance feeding
    themselves are attended by Nurses or
    Aides.  Trays are returned to the delivery
    cart with meals mostly consumed.


  • Residents who are being bathed or toileted in
    their rooms are behind closed doors or
    privacy curtains.
  • Nurses or Aides are behind the desk;
    residents are unattended.

  • Residents' clothing is soiled, hair does not
    appear clean or is unkempt or slicked back,
    food is visible on chin or lips.  Wheelchairs
    and walkers are visibly soiled or damaged.

  • Residents are seated in hallways or at tables
    with brakes locked.  Many residents are
    wearing restraints which prevent them from
    rising from their chairs.  Residents seated in
    regular armchairs do not have walkers or
    canes available.

  • Unit is loud and busy.  Staff speak loudly in
    the halls and common areas.  Call bells are
    not answered, or Nurses and Aides enter a
    room to answer a call bell and emerge only a
    moment later having turned the call bell off.  
    Name tags are not present or are difficult to
    read.

  • Residents are sleeping in common areas or
    are arguing amongst themselves.  Residents
    call for assistance from bedrooms or common
    areas and are ignored by staff.

  • Nurses and Aides frown, speak sharply to
    one another, look away when you pass. They
    speak sharply to residents or not at all when
    they assist them.  Staff speak in foreign
    languages in front of residents or while
    assisting them.

  • Common areas smell of feces, urine or body
    odor.

  • Hallways are cluttered or congested.  
    Laundry receptacles are overflowing.  Doors
    to storage or utility rooms are propped open
    with furniture.  Articles such as linen carts
    and laundry receptacles are lining both sides
    of the hallway or are left in the middle of the
    hallway.

  • Food delivered to residents during your visit
    appears to have cooled to room temperature
    and looks unappealing and/or non-
    nutritious.  Residents are left sleeping in
    chairs or in bed with meal in front of them.  
    Trays are returned to the delivery cart only
    partially eaten or untouched.

  • Residents who are being bathed or toileted
    are visible from the hallway.  Residents are in
    common areas wearing only johnnies with
    backs exposed.