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Congratulations on your position! I've seen a range of Activity Assessment forms out there but here are a few suggestions based on what I have found helpful.
Try and leave lots of room so that you have space to write if a resident provides a lot of detail.
Ask "What do you prefer to be called?" i.e., Mr. Smith, John, John Sr. Johnny.
Ask "What is your preferred routine? i.e., Would you rather have 1:1 and in-room activities or would you like to be invited to all events? Are you a morning person? Or a night owl?
Ask "What types of activities do you enjoy?" and create a checklist of all the activity categories:
Exercise/Sports
Music
Art
Spiritual/Religous
Games/Puzzles
Movies/TV
Reading/Writing
Cooking
Trips/Outings
Parties/Entertainment
Ask (For fun or as an icebreaker) "What is your favorite flavor of ice cream?"
Ask "Do you like to be around Pets?"
Ask questions about family history, "Do you have any children?" "What was your husband or wife's name?"
The activity assessment is a great tool to get to know your residents so it should be as detailed as you can make it. Best of luck with the opening of your new facility!