Assess a patient home
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Patient & care profile
Use an internal ID — avoid names or other identifiers.
Home safety assessment
Unknown means not yet verified. Each No or Unknown becomes a remediation item.
Smoke detectors functional
Fire extinguishers available
Fire safety plan documented
Caregiver understands emergency procedures
Electrical systems appear safe
Rugs and floor hazards addressed
Heating and cooling functional
Entrances and exits unobstructed
Running water and plumbing functional
Lighting and ventilation adequate
Phone or communications service available
Hazardous chemicals secured
Safety gates and locks appropriate
Pets and service animals accounted for
Home exit inventory
Accessibility must be verified — step count alone doesn't make an exit safe.
Medical equipment & dependencies
Runtime must come from verified device data, not estimates.
Emergency contact network
Other notes
Results will appear here.