{"product_id":"resident-activity-survey-printable-activity-director-resources-nursing-home-forms-senior-living-printable-assisted-living-survey","title":"Resident Activity Survey Printable | Activity Director Resources | Nursing Home Forms | Senior Living Printable | Assisted Living Survey","description":"\u003ch2 data-path-to-node=\"0\"\u003eResident Activity Survey\u003c\/h2\u003e\u003cp data-path-to-node=\"1\"\u003eA clean, large-print, 2-page printable for \u003cb data-path-to-node=\"1\" data-index-in-node=\"45\"\u003eActivity Directors, Activity Assistants, and Life Enrichment Coordinators\u003c\/b\u003e in nursing homes, assisted living, and memory care. Hand it to residents to learn what they love, what they want more of, and what's getting in the way—perfect for MDS interest documentation, care planning, and quarterly program reviews.\u003c\/p\u003e\u003chr data-path-to-node=\"2\"\u003e\u003ch3 data-path-to-node=\"3\"\u003eWhat's Included\u003c\/h3\u003e\u003cul data-path-to-node=\"4\"\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"4,0,0\"\u003e\u003cb data-path-to-node=\"4,0,0\" data-index-in-node=\"0\"\u003e1 Instant-Download PDF\u003c\/b\u003e (US Letter, 8.5x11)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"4,2,0\"\u003e\u003cb data-path-to-node=\"4,2,0\" data-index-in-node=\"0\"\u003eLarge-Print 14pt Arial Font\u003c\/b\u003e—designed specifically for older adults to read and fill out independently\u003c\/p\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\u003chr data-path-to-node=\"5\"\u003e\u003ch3 data-path-to-node=\"6\"\u003eWhat's on the Survey\u003c\/h3\u003e\u003cul data-path-to-node=\"7\"\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,0,0\"\u003e\u003cb data-path-to-node=\"7,0,0\" data-index-in-node=\"0\"\u003eOverall satisfaction\u003c\/b\u003e with current activities\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,1,0\"\u003e\u003cb data-path-to-node=\"7,1,0\" data-index-in-node=\"0\"\u003eFrequency of participation\u003c\/b\u003e\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,2,0\"\u003e\u003cb data-path-to-node=\"7,2,0\" data-index-in-node=\"0\"\u003eFavorite current activities\u003c\/b\u003e (10 common options with a check-all-that-apply layout)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,3,0\"\u003e\u003cb data-path-to-node=\"7,3,0\" data-index-in-node=\"0\"\u003eWhat residents want MORE of\u003c\/b\u003e (8 distinct categories)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,4,0\"\u003e\u003cb data-path-to-node=\"7,4,0\" data-index-in-node=\"0\"\u003eSpecific activity requests\u003c\/b\u003e (open write-in section)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,5,0\"\u003e\u003cb data-path-to-node=\"7,5,0\" data-index-in-node=\"0\"\u003eBest time of day\u003c\/b\u003e for programs\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,6,0\"\u003e\u003cb data-path-to-node=\"7,6,0\" data-index-in-node=\"0\"\u003eGroup-size preferences\u003c\/b\u003e (Large group, small group, 1:1, or in-room)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,7,0\"\u003e\u003cb data-path-to-node=\"7,7,0\" data-index-in-node=\"0\"\u003eBarriers to participation\u003c\/b\u003e (Evaluates hearing, vision, mobility, and communication needs)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,8,0\"\u003e\u003cb data-path-to-node=\"7,8,0\" data-index-in-node=\"0\"\u003eCommunication preferences\u003c\/b\u003e (How they want to be reminded about activities)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"7,9,0\"\u003e\u003cb data-path-to-node=\"7,9,0\" data-index-in-node=\"0\"\u003eOpen comments section\u003c\/b\u003e for additional feedback\u003c\/p\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\u003chr data-path-to-node=\"8\"\u003e\u003ch3 data-path-to-node=\"9\"\u003ePerfect For\u003c\/h3\u003e\u003cul data-path-to-node=\"10\"\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,0,0\"\u003e\u003cb data-path-to-node=\"10,0,0\" data-index-in-node=\"0\"\u003eActivity Directors\u003c\/b\u003e in skilled nursing facilities (SNF)\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,1,0\"\u003e\u003cb data-path-to-node=\"10,1,0\" data-index-in-node=\"0\"\u003eAssisted Living\u003c\/b\u003e and \u003cb data-path-to-node=\"10,1,0\" data-index-in-node=\"20\"\u003eMemory Care\u003c\/b\u003e communities\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,2,0\"\u003e\u003cb data-path-to-node=\"10,2,0\" data-index-in-node=\"0\"\u003eAdult Day Programs\u003c\/b\u003e\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,3,0\"\u003e\u003cb data-path-to-node=\"10,3,0\" data-index-in-node=\"0\"\u003eRecreation Therapists\u003c\/b\u003e\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,4,0\"\u003e\u003cb data-path-to-node=\"10,4,0\" data-index-in-node=\"0\"\u003eActivity Assistants\u003c\/b\u003e and new \u003cb data-path-to-node=\"10,4,0\" data-index-in-node=\"28\"\u003eLife Enrichment Coordinators\u003c\/b\u003e\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,5,0\"\u003e\u003cb data-path-to-node=\"10,5,0\" data-index-in-node=\"0\"\u003eMDS Coordinators\u003c\/b\u003e gathering authentic resident voice for care plans\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"10,6,0\"\u003e\u003cb data-path-to-node=\"10,6,0\" data-index-in-node=\"0\"\u003eQuarterly Resident Council\u003c\/b\u003e preparation\u003c\/p\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\u003chr data-path-to-node=\"11\"\u003e\u003ch3 data-path-to-node=\"12\"\u003eHow It Works\u003c\/h3\u003e\u003col start=\"1\" data-path-to-node=\"13\"\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"13,0,0\"\u003e\u003cb data-path-to-node=\"13,0,0\" data-index-in-node=\"0\"\u003ePurchase\u003c\/b\u003e → Files appear instantly in your Etsy downloads.\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"13,1,0\"\u003e\u003cb data-path-to-node=\"13,1,0\" data-index-in-node=\"0\"\u003eCustomize\u003c\/b\u003e → Print the PDF as-is, or open the Word document to add your facility name and logo.\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"13,2,0\"\u003e\u003cb data-path-to-node=\"13,2,0\" data-index-in-node=\"0\"\u003eDistribute\u003c\/b\u003e → Pass them out to residents to complete independently, or use the form as a guide during 1:1 admission interviews.\u003c\/p\u003e\u003c\/li\u003e\n\u003cli\u003e\u003cp data-path-to-node=\"13,3,0\"\u003e\u003cb data-path-to-node=\"13,3,0\" data-index-in-node=\"0\"\u003eImplement\u003c\/b\u003e → Use the data to refresh your monthly activity calendar and document compliance-ready resident preferences.\u003c\/p\u003e\u003c\/li\u003e\n\u003c\/ol\u003e\u003chr data-path-to-node=\"14\"\u003e\u003cblockquote data-path-to-node=\"15\"\u003e\u003cp data-path-to-node=\"15,0\"\u003e\u003cb data-path-to-node=\"15,0\" data-index-in-node=\"0\"\u003eImportant Note:\u003c\/b\u003e This is a \u003cb data-path-to-node=\"15,0\" data-index-in-node=\"26\"\u003eDIGITAL DOWNLOAD\u003c\/b\u003e—no physical item will be shipped. Licensed for personal and single-facility use only. Please do not resell, redistribute, or share the digital files.\u003c\/p\u003e\u003c\/blockquote\u003e","brand":"Senior Space","offers":[{"title":"Default Title","offer_id":54177394262291,"sku":null,"price":3.0,"currency_code":"USD","in_stock":true},{"title":"Simple Resident Activity Satisfaction Survey","offer_id":54193524211987,"sku":null,"price":3.0,"currency_code":"USD","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0978\/8732\/2387\/files\/Hiprt57DYf.png?v=1779051329","url":"https:\/\/www.activitydirectorspayactivitydirectors.com\/products\/resident-activity-survey-printable-activity-director-resources-nursing-home-forms-senior-living-printable-assisted-living-survey","provider":"Activity Directors Pay Activity Directors","version":"1.0","type":"link"}