Assessment

Let's take a tour around your home and consider some easy steps to increase your SAFETY, MOBILITY and INDEPENDENCE!

Entrance & General

Steps and walkways in good repair with no crumbling edges or broken boards

Secure railing that is easy to grasp with both hands

Lights that illuminate a wide area of the entrance, yard and walkway

Peephole or windows in the front door low enough for all residents to use

Deadbolt lock does not require a key to open from the inside (unless wandering is an issue)

Doorways wide enough to pass through using walker, wheelchair or carrying a load

Front steps and walkways around the home are free of clutter, snow, leaves or other debris

One working carbon monoxide detector on each floor

Create an emergency escape plan and pre-arrange for a family member or caregiver to help you escape if needed

Windows and screens easy to open and close

Thermostat easy to read and reach

Keep ashtrays, smoking materials, candles, hot plates and other potential fire sources away from curtains, furniture, beds and bedding. Remember: NEVER smoke while using oxygen

Living Room

All walking surfaces are free of clutter, electrical cord, boxes, furniture, appliances and other objects that could pose a tripping hazard—especially in the event of an emergency or fire

Carpets, rugs and mats lie flat or secured to keep them from slipping

No electric or phone cords running under rugs and carpeting or across open areas

No frayed electrical cords. Electric outlets and switches are not overloaded (not warm to the touch)

Easy access to a telephone from every room (consider a Personal Emergency Response Device as well). Also, make sure all emergency phone numbers are posted on or near all phones

Adequate lighting and accessible light switches that can be turned on without walking across a dark room

Sofas and chairs high and firm enough for easy sitting and rising. Plus, no casters or wheels on the furniture

All chimneys have been professionally inspected and cleaned within the last year. Also, all chimney openings are clear of leaves and other debris that could clog them

All portable space heaters and wood-burning heating equipment are at least three feet from walls, furniture, curtains, rugs, newspapers and other flammable or combustible materials

Kitchen & Dining Area

Clear walkways, free of clutter

Floor not waxed or slippery; use non-skid wax

Doorways wide enough to pass through with walker, wheelchair or when carrying a load

Appliances in good working condition with “on” indicators working and controls clearly marked

Towels, curtains and other cloth items that may catch fire located at a safe distance from flames and heat sources

Ventilation systems and range exhaust working properly

Electrical appliances and extension cords are located a safe distance away from the range and water sources

Fire extinguisher in good working order and accessible in case of an emergency

Stable step stool with a handrail for reaching high items, although it is best to locate frequently used items between eye and knee level

Bedroom

Floor free of clutter. Remove clothes, shoes, towels and magazines

Make sure there is a clear path from the bed to the bathroom

Bed no lower than the back of the user’s knees

Chair with armrests and firm seat to reduce falls while dressing

No casters or wheels on furniture

Easy access to a telephone from every room (consider a Personal Emergency Response Device as well). Also, make sure all emergency phone numbers are posted on or near all phones

No throw rugs

Night light

A flashlight within reach of the bed in case of a power outage

Ensure that electrically-heated blankets are not folded, covered by other objects, or tucked-in when not in use and that the cord is not pinched or crushed by the bed

Smoke alarms are placed inside and just outside bedrooms. Test batteries in the smoke detectors twice a year when adjusting clocks for daylight savings time

Bathroom

Floor free of clutter. Remove clothes, shoes, towels and magazines

No glass shower doors. Safety hazard in the event of a fall

Strong grab bars in the shower or bath

Non-skid floor surface in tub or shower

Shower bench or seat with handheld shower wand

Set your hot water heater to no more than 120 degrees Fahrenheit to help prevent burns

Be sure the bathroom floor is slip-resistant or is covered with slip-resistant materials. No throw rugs.

Strong grab bars near the toilet

Raised toilet seat present, if needed

All hair dryers, shavers, curling irons and other small electrical appliances are away from sinks, tubs and other water sources

Electrical receptacles in the bathroom are protected by ground-fault circuit interrupters (GFCIs)

Night light

All medications should be stored in child-resistant enclosures and clearly marked to prevent children from accessing the medication

Basements, Garages & Workshops

Staircases have light switches at top and bottom, and handrails running the full length

Extension cords not overloaded (wattage of items plugged in does not exceed capacity of cord)

Work areas where tools are used are well lit

Flammable liquids stored outside

Work areas clear of tripping hazards

Safety locks on all power tools

Product Suggestions

Advanced Home Care provides a full line of home care products and services that provide SAFETY , INDEPENDENCE and COMFORT!

Below you will find suggested products for areas of your home where you may experience challenges. Mark items of interest for a reminder on your report at the end of this assessment.

Entrance & General

Folding Suitcase Ramp (available in 5ft or 7ft)

Folding Suitcase Ramp.jpg

Would you like to mark this item?

Metro Car Handle

Metro Car Handle.jpg

Would you like to mark this item?

Hurrycane

Hurrycane.png

Would you like to mark this item?

EZ Fold-N-Go Walker

EZ Fold-N-Go Walker.jpg

Would you like to mark this item?

Standard Rollator (Rolling Walker with Seat)

Rollator (Standard).jpg

Would you like to mark this item?

Nitro Rollator

Nitro Rollator.jpg

Would you like to mark this item?

Duet Rollator/ Companion Chair Combination

Duet.jpg

Would you like to mark this item?

Rebel Wheelchair

Rebel Wheelchair.jpg

Would you like to mark this item?

Living Room

Golden Technologies Lift Chairs
(We offer the largest selection of lift chairs anywhere available with options such as Heat, Massage, Foot Extension and Fabric Guard and an extensive fabric catalogue!)

Lift Chair.jpg

Would you like to mark this item?

Assist-A-Tray (Standing Aid with Table)

Assist-A-Tray.jpg

Would you like to mark this item?

Bedroom

Security Pole

Security Pole.jpg

Would you like to mark this item?

Bedcane

Bedcane.jpg

Would you like to mark this item?

EZ Adjust Bedrail

EZ Adjust Bed Rail.jpg

Would you like to mark this item?

Home Bed Assist Rail

Home Bed Assist Handle.jpg

Would you like to mark this item?

Bedside Commode

Bedside Commode.jpg

Would you like to mark this item?

Transfer Board

Transfer Board.jpg

Would you like to mark this item?

Sock Donner

Sock Donner.png

Would you like to mark this item?

Bathroom

Handheld Shower

Handheld Shower.jpg

Would you like to mark this item?

Bath Mat (non-slip)

Bath Mat.jpg

Would you like to mark this item?

Tub Seat/ Shower Chair

Tub Seat_Shower Chair.jpg

Would you like to mark this item?

Transfer Bench

Transfer Bench.jpg

Would you like to mark this item?

Bi-Level Grab Bar

Bi-level Grab Bar.png

Would you like to mark this item?

Suction Grab Bar

Suction Grab Bar.jpg

Would you like to mark this item?

Knurled Grab Bar

Knurled Grab Bar.jpg

Would you like to mark this item?

Curve Grab Bar

Curve Grab Bar.jpg

Would you like to mark this item?

Security Pole with Curve Grab Bar

Security Pole & Curve Grab Bar.jpg

Would you like to mark this item?

Raised Toilet Seat

Raised Toilet Seat.jpg

Would you like to mark this item?

Toilet Safety Frame

Toilet Safety Frame.jpg

Would you like to mark this item?

Thank You!

Thank you for using our Home Safety Assessment! We hope this tour was beneficial to you! At the end of this assessment you will have the opportunity to send your results, in the form of a PDF, via email to our staff at Retail@advhomecare.org . Our specialists can then contact you, upon receipt of your results' report, to go over any questions or concerns you may have regarding the assessment as well as offer more information (such as pricing and inventory availability) about the products you marked on the previous page. Need to contact us? Give us a call at 800.868.8822, visit us online at www.advhomecare.org or in-store! Our retail locations are open Monday- Friday 9am-5pm. A full listing of our locations can be found below. ***Remember to select the retail location nearest you so that your results can be directed appropriately.

GEORGIA

3780 Eisenhower Pkwy Suite 5, Macon, GA 31206

800 Whitlock Ave. NW Suite 126, Marietta, GA 30064

5901 Goshen Springs Rd. Suite G, Norcross, GA 30071

NORTH CAROLINA

1806 N Sandhills Blvd., Aberdeen, NC 28315

120 Sweeten Creek Road, Asheville, NC 28803

1225 Huffman Mill Road, Suite 104, Burlington, NC 27215

1231 NE Maynard Road, Cary, NC 27513

2520 Whitehall Park Drive, Suite 950, Charlotte, NC 28273

105 W. Highway 54, Suite 267, Durham, NC 27713

2391 Court Drive, Suite 105, Gastonia, NC 28054

1018 N. Elm Street, Greensboro, NC 27401

1005 W.H. Smith Blvd., Greenville, NC 27834

375 Main Ave. NE, Hickory, NC 28601

2110 Westchester Drive, High Point, NC 27262

461 Harper Ave SW, Lenoir, NC 28645

8380 Hwy 87, Reidsville, NC 27320

1406B W. Innes Street, Salisbury, NC 28144

567 W. Main Street, Sylva, NC 28779

1100 S. Stratford Road, Winston-Salem, NC 27103

744 Church Street N, Concord, NC 28025

4001 Piedmont Parkway, High Point, NC 27265

1620 Wright St , Wilmington, NC 28401

SOUTH CAROLINA

2067 Celanese Rd, Rock Hill, SC 29732

TENNESSEE

951 Highway 126, Bristol, TN 37620

105 Jack White Drive, Kingsport, TN 37664

VIRGINIA

48 West Main St, Christiansburg, VA 24073

7669 Limestone Drive Suite 120, Gainesville, VA 20155

72 St. John Pl, Salem, VA 24153

165 Wise Plaza Road, Wise, VA 24293

480 South Commerce Ave, Suite D, Front Royal, VA 22630

525 Amherst St, Suite 100, Winchester, VA 22601

762 South Main St, Woodstock, VA 22664

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.