A three-page fillable PDF for recording activity participation one month at a time. Instead of a checkmark for attendance, staff enter a one-letter code that shows how the resident took part.

 

- A: Active. Took part by doing.

- P: Passive. Present and attentive, but did not join in.

- D: Declined. Was invited and chose not to attend.

- 1: One to one. A visit or activity with staff or a volunteer.

- I: Independent. Chose and carried out own leisure activity.

- U: Unavailable. Ill, at an appointment, out of the building, or with visitors.

 

- Page 1: Code key with plain definitions, four steps for using the logs, and a "Reading the pattern" guide

- Page 2: Individual Participation Log for one resident. 10 activity types plus 7 write-in rows, days 1 to 31, month totals, notes, and sign-off

- Page 3: Group Participation Log for one program or unit. 22 resident rows, days 1 to 31, and month totals for each resident

 

Music, Movement, Games, Creative Arts, Everyday Life, Social, Sensory, Spiritual, Learning, and Outings and Events. Seven empty rows let you type in your own.

 

- 1 PDF file, 3 pages, US Letter size (8.5 x 11 inches), landscape

- Type into it on a computer, or print it and fill it in by hand

- Fillable fields work in the free Adobe Acrobat Reader

- Each day box holds one character

- Save a fresh copy for each resident or group each month

 

GOOD FOR

- Activity directors and activity assistants

- Skilled nursing, assisted living, and memory care communities

- Adult day centers

- Care plan reviews and quarterly notes

 

PLEASE NOTE

Follow your community's documentation policy. This log supports required documentation and does not replace it.

 

This is a digital download. No physical item will be shipped.

 

Created by a senior care professional with about 30 years of experience as an activity director and program director.