Click box for each item you want to purchase.

$15

Individual Activity Record
This tool is a lifesaver! This is a clear and effective guide to specific, individualized documentation of individual (one on one) activity services according to the care plan. It provides a quick reference to the resident’s assessed interests, individualized approaches, and established care plan goals. The Activity Director is guided to document specific activity provided and the resident’s response to each intervention, clearly showing follow through of care planned approaches.

$25

Activity Preference Checklist
A very useful tool for Activity Directors in Assisted Living, Independent Living, or Nursing Home environments. This will assist in interviewing and assessing residents for recreation interests and life choices important for maintaining meaningful engagement in life. It helps to guide the Recreation services staff in individualized program planning and services.

$25

Initial Activity Assessment
This assessment complies with OBRA regulations. Effectively guides Recreation staff in accurate MDS documentation and regulatory compliance. This is the form for complete documentation of resident’s recreation interests, pleasures, functional and social status information needed for developing a comprehensive, individualized plan with the resident.

$25

Recreation Services Assessment
This is a guided narrative form for complete professional assessment of the LTC resident including capabilities and limitations in ADLs and the social, cognitive, physical domains. Additionally, leisure history, attitudes toward leisure, routines, pleasures, and interests sections are included. The final section guides an individualized Recreation plan, including identification of strengths, needs and plan for implementation. This assessment complies with OBRA regulations for LTC and Standards of Practice

$25

Social History and Initial Psychosocial Assessment
This form complies with LTC Regulations. It combines documentation of the Social History and Initial Psychosocial Assessment into one two-sided form. Includes all information required to complete MDS documentation, assess Behavioral Symptoms and identify potential psychosocial issues for individualized care planning. Also includes a separate one page form for Annual and/or Significant Change assessment.

$15

Recreation Orientation Checklist
This orientation checklist provides a trainer guide to information needed to thoroughly prepare Recreation staff for their complex and challenging jobs including compliance with federal regulations and effective interdisciplinary involvement.

$15

Social Service Orientation Checklist
This orientation checklist provides a trainer guide to information needed to thoroughly prepare Social Services staff for their complex and challenging jobs including compliance with federal regulations and effective interdisciplinary involvement.

$15

Resident Council Meeting Minutes/Report
Two forms are included to assure you have Resident Council activities and issues appropriately documented. This report help to guide you in the necessary follow-up and keeps your Resident Council activities organized and ready for review by administration and surveyors.

$25

Recreation Services/ Quality of Life QI Checklist
This is a valuable tool for utilization in your quality improvement program. It is a thorough guide for review of your Recreation and Social Services Department functions, observations and outcomes. This detailed checklist includes items for Activities program review, Quality of life observations, and documentation review for Activities and Social Services. This tool offers the guide you need to know where you stand and how to evolve your program and services to further meet your residents’ needs and assure compliance.

$25

Recreation Participation Record
The value of this unique Recreation Participation Record is the ability to offer complete individualized documentation of daily leisure participation of each resident, including group, individual, and independent leisure engagement for the entire care plan period (up to 90 days). Also, a section at the top for documenting resident interests, goals, and approaches assures communication of the individual care plan goals and approaches to the Activity staff so that implementation of the care plan is clearly documented. Each form can be individualized to the specific resident by listing those activities included in the care plan and documented as interests in the Assessment. This form assures clear support for assessing section N2 “Time Spent in Activities” on the MDS. This is definitely the best participation record form available for compliance with OBRA regulations and meeting Standard of Practice for Therapeutic Recreation.

$25

Participation Record
This is a well designed monthly resident participation record that is sent to you in Word document format so that you can insert the activities individualized to your facility and your residents. There is plenty of room for including group activities, individual service and independent leisure pursuits of the resident so that all the resident’s “time spent in activities” for the month is clearly documented on one form.

$10

Recreation Program Description Form
This form guides the organized Activity / Recreation Director in writing efficient and effective Program Descriptions for groups planned. This is essential for planning and communication of planned programs to group leaders to assure effective, consistent implementation of groups.

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