Free Nursing Home Accessibility Standards Assessment Form Template
Nursing Home Accessibility
Standards Assessment Form
This form is to be completed annually to assess compliance with accessibility standards across our facilities. Ensure thorough inspection and accurate reporting in each section, and submit the completed form to the designated compliance officer.
Facility Information
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Date of Assessment |
Facility Location |
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Assessor's Name |
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Entrances and Exits
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Yes |
No |
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|---|---|---|
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Are all main entrances wheelchair accessible? |
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Are doorways at least 32 inches wide for accessible passage? |
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Are entrance and exit signs clearly marked and visible? |
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Are ramps available where there are steps? |
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Parking and Exterior Pathways
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Yes |
No |
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|---|---|---|
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Is there designated accessible parking that is adequately sized and marked? |
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Are parking areas well-lit and free of obstructions? |
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Are exterior pathways to the building smooth and well-maintained? |
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Do exterior pathways have a minimum width of 36 inches? |
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Interior Navigation
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Yes |
No |
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|---|---|---|
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Are hallways and corridors free of obstacles and at least 36 inches wide? |
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Are floors slip-resistant and free of hazards? |
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Are elevators available for multi-level access? |
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Are elevator buttons accessible at a height reachable from a wheelchair? |
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Restrooms
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Yes |
No |
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|---|---|---|
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Are accessible restrooms available on each floor? |
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Do restrooms have grab bars installed by the toilets and in shower areas? |
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Is there appropriate turning space in restrooms for wheelchairs? |
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Are sinks and hand drying facilities accessible? |
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Common Areas
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Yes |
No |
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|---|---|---|
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Are dining areas, lounges, and other common areas accessible? |
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Is furniture arranged to allow easy passage and use by individuals with disabilities? |
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Are sinks and hand drying facilities accessible? |
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Emergency Systems
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Yes |
No |
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|---|---|---|
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Are visual and audio emergency alarms functional and accessible? |
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Is there clear signage for emergency exits and routes? |
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Are emergency plans available and communicated to all residents and staff? |
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