SERVICES OFFERED

This assisted living home is being developed to provide room and board, assistance with the activities of daily living and
24-hour protective oversight for no more than three (3) elderly persons who are in need of supportive care and personal
assistance. My services include the following:

   a safe and caring environment

   24-hour monitoring of residents to ensure their safety and well-being

   three nutritious meals daily, plus snacks

   assistance with the activities of daily living (ADL’s), such as walking, eating, dressing, bathing, toileting, and transfer
   between bed and chair

   assistance with instrumental activities of daily living (IADL’s) such as doing laundry, cleaning of living areas, food
   preparation, managing money and conducting business affairs, using public transportation, writing letters, obtaining
   appointments, using the telephone, and engaging in recreational or leisure activities

   provide personal assistance with one or more of the following personal services:
           obtaining supportive services as provided in the resident’s assisted living plan;
           obtaining instrumental activities of daily living as provided for in the resident’s assisted living plan;
           being aware of the resident’s general whereabouts while the resident is traveling independently in the
           monitoring the resident’s activities while on the home premises to provide for the resident’s and others’
            safety and well-being.

supervision of self-administration of medication, if needed

planned home recreation activities and assistance with participating in community social programs

transportation provided or arranged for appointments, church services, and community events

referral to medical and social services as needed

comfortable furnishings and storage space for clothing and personal possessions

towels and bed linens furnished weekly, and

weekly housekeeping services to include vacuuming, dusting of furniture, changing bed linens, and
   washing/drying/folding resident’s personal laundry, if needed.

This page is a sample document and may be used as a guideline for your final product. In preparing your own
document, please use a similar format. Add or delete information and services as they apply to your individual home.

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