Environmental Assessment

Home Safety Evaluation

Silver Home Care • In-Person Assessment

Decode Code

Assessment Instructions

  • Complete during in-person visit — actually look at each area
  • Ask permission before opening cabinets or private spaces
  • Note immediate hazards — address before leaving if possible
  • Focus on the path of travel: bedroom → bathroom → kitchen → exit

De-identified code - letters mixed into date

1 Home Exterior & Entry

2 General Interior

3 Bathroom High Risk Area

Most falls happen here. Look carefully.

4 Bedroom

5 Kitchen

6 Medications & Medical Equipment

7 Clinical Observations During Visit

What did you observe about the client during the visit?

8 Summary & Recommendations

Silver Home Care • Environmental Assessment • Confidential