Home Visit Assessment
Are handholds sturdy and in appropriate places?
Can the toilet seat be raised?
Does the bathtub/shower have a nonslip surface?
Is the bathroom floor slick?
Are cords frayed or damaged?
Do cords cross walking paths?
Are emergency numbers available?
Are there means of egress from home?
Are firearms present?
If yes, are they secured? (e.g., gun lock, locked case/cabinet, weapon and ammunition separated)
Are fire extinguishers present?
If yes, are they accessible and in working order?
Is the patient or caregiver able to use them?
Are controls accessible and easy to read?
Is the home an appropriate temperature year-round?
Temperature set below 120° F (49°C)?
Is it easy to tell if burner or oven gas is on?
Does the patient wear loose garments while cooking?
Is lighting present and sufficient?
Are carpets and throw rugs present?
If yes, do they need to be secured or removed?
Are pets present?
If yes, are they easy to care for?
Are they present?
If yes, are they functioning and monitored?
Does the home have stairs?
If yes, are they carpeted and is the carpeting secure?
Are stairs well lit?
Are there railings?
Is furniture sturdy, balanced, and in good repair?
Are the systems monitored and maintained?
Is water from a public source or a well?
Is the source functioning and safe?