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Hello everyone. I will soon be Activity director of an Adult daycare. I am looking for a sample care plan. I have looked at few sites,and can't seem to find anything. Can anyone help??



Thank you

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There is a Care Plan form in this download




This is an MS Excel Workbook that provides an initial assessment/interview, that once completed, would then produce several forms that are needed to document the on going Care for the resident in a Nursing or Assisted Living Facility.

So this being said .... I dont have any experience in Adult Day Care, but I will outline a care plan for a Nursing facility and try to parallel the procedure to fit the day care facility, but I can only assume certain aspects of the day care not having been involved with any.

First off a Nursing Facility is federally funded and the state requires that the Activity Dept. document all of the planning involved in caring and meeting the needs of each resident. You would conduct an initial interview (assessment) with each guest / resident (and family if needed) in an attempt to determine each residents interests, hobbies, their mental and physical functioning level, etc. Once you have this information, you would be required to maintain documentation (in the form of a Care Plan, Initial Assessment and Quarterly Assessments, Individual Activity Participation,) This documentation would give state regulators and inspectors your professional view of the resident and how you and your program will be implementing your Care Plan to meet the needs of the resident.

I can only assume that the day care facility would work much in the same way if

they are federally funded, but if not than documentation of the same nature should be kept to satisfy your facility and the family, that you are indeed meeting the needs of your guests and their loved ones.


So lets say you have 30 guest attending your daycare on a daily / weekly schedule. During your interview you have determined that you have 20 high function, good physically and mentally residents and 10 low function guest / residents, than your Activity Planning for the facility should reflect these percentages, you should offer 66% high function activities and 33% low,

Go to Charles Dixons site:




and look at his collection of activities, he has hundreds all categorized by function level and number of participants, this will help you plan your Activity Calendar... of course you will also have previous favorites from the Directors before you, parties to celebrate the holidays, outings and community activities that fit your particular community and facility.

In a Nursing / Assisted Living Facility you would conduct a meeting with all the departments to create Care Plan for each resident,... Nursing, Activitys, Dietary, Admins would all bring their expertise to the table and Care Plan and document an effective plan for each resident,


In Day Care you may not have such a situation, but you would do your own Care Plan, using what you info you have gathered on each guest, you would create an activity plan that you think would be suitable for your guests, of course document each step for your bosses, admins and the family, the more you plan the better the experience for everyone.


Most new Activity Directors panic at the thought of writing a care plan, which is the wrong approach... you should just use common sense and compassion, What would Jesus do? is the way I teach and implement Care Planning... Your new resident is scared, she has been removed from her home and placed in a Nursing Home, that in her day was called a Mental Institution... she is withdrawn and unsure.. how can I help her? how can I get to know her, be her friend? how can I get her to believe that I am here for her, to help her meet people, have fun, that I am on her side to fight for what she needs to protect her from her uncertainties. Your love and compassion will guide you from here...common sense.

How do I document this...well a standard care plan would have the individual residents info, and an area for the Problems: the Goals: and the Approaches:


So how do I convey that she is scared and I am going to do everything I can to make her happy, safe, loved and welcome... ummm


In the problems area, which may or may not be a problem per say you would enter



::: resident is new to the facility and the surroundings.



:::Resident will be out of room and involved in activities X 90days

NOTE: this is an obtainable goal, dont document specific goals that may be hard to achieve... state regulators will only assume you are not doing your job...



::: interview the resident and family for residents interests, provide resident with Activity Calendar, invite resident and family to activities. Introduce resident to other residents of similar interests. Monitor residents participation in activities

NOTE: again dont document things that you cant prove that you actually did, if you are not going to create an individual Participation record for the resident at each activity, then dont say you are going to Monitor the resident... state will want to see the proof... and if it doesnt exist, then you get an X in that square.


I hope this helps with your new position, the Activity Director is one of the most powerful forces in Nursing / Assissted Living and Adult Day Care facility, on the business side, the owners, shareholders, the administrators, bosses all need to make money and run a efficient machine, they need to have every bed occupied and or a large attendance at their facility in order to be successful, your job as the ruler of all things fun and exciting is to make sure that your faciltity is the place to be! Your calendar should be full of things to do, your newsletters should reflect the exciting Activity that goes on in your facility, the programs, the outings, the up and coming events, the parties, the participation of the community, the acknolegment of those who join in, that volunteer, that help your facility provide the quality of life that our elderly so very much deserve. You should send your newsletters and calendars to all guests and their families, to the local businesses, the churches, the schools, the city goverments.... in doing so you will be the most valuable employee in your facility and the brightest star and a best friend to some folks who really need you...


thanks, Pennie :-)

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  • 2 weeks later...

hi my name is rachel.

I would like be a certify A.D. Do you know any program that i'll be able to do? While at home.

I have some at work. I'll fax it for you tommorow.


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Hello. I need some help. I have not worked in a nursing home since 1998 and now I am back working in LTC. I have mainly been working at Medical Adult Day Programs and the documentation is different. Does anyone have a sample care plan or progress note I can use as a guide? I want to make certain that I am using the correct terminology for the documentation

Thanks! :-)

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Guest Guest

I have a few sample care plans I wrote you are welcome to look at and/or use. I may have, somewhere- a sample activity progress note. But... I would need to fax it to you. Let me know. email me at hla415@yahoo.com

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  • 5 weeks later...


The Progress Notes I always liked best are blank lined sheets. They say Activity Progress Notes at the top and are lined. I would just place the date on left with a note on what the progress note is for the below that make my notes and sign off on it. I like it because I can write as little or as much as I need. The next time just start again on same sheet under you're sign. I don't have near the bulk in my section of res. chart if I used a seperate sheet everytime. Just a note however, be sure to sign you're name below the last entry(each time) and draw a line to the end of the line so that noone else can make an entry between you're notes and you're name.

CP's usually have 3 parts: Res. Problem/Needs, Goals and approaches. These can have up to 4 entries on them if they are 2 sided.


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  • 3 months later...



My boss is leaving in a couple of weeks to have a baby, she will be gone 2 months and I am taking over in her slot, we are moving a restorative aid to do my job, she is wonderful and will do a great job, In my position as a activity assistant I have not had to do progress notes, and care plans, I have the progress notes under control, but am lost with the care plans,

I will add that I now do the initial assessment, I run most of our programs and have created many new programs, that is what I love to do, so is there a book about care plans out there that you all love and that is easy to understand,? (I know my residents well, I have worked in this facality for 3 years,) it is the lanquage of the care plans that I have a hard time with, if you all could give me some examples, and I get enought I can customized them to my residents making sure that they fit my resident, i would so apprectiate it, I have already checked our current care plans.

any help you can give me would be appreciated.

Betty Ann

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Guest Tinki

This is a good book

Activity Care Plans for Long Term Care Facilities

by Pam Sander you can buy it at www.ppandp.com - If you have any question just let me know k8822@hotmail.com


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You should first make sure what is required, by asking your administrator the polices and procedures, you should have one for your department

Long term care, assisted living and adult day care documentation varies, it also varies state to state.

You do not want to over document, creating repetitive forms and wasting your time

The Care Planning Team should really be involved in this

We came up with a quarterly note form that is inter-disciplinary, so we aren't re- writing the same things in different sections of a residents or patients chart.


Keep in mind whatever you write had to be followed through on

so if you state a resident will participate 3-5 times per week, make sure that happens or else you will have to re write his/her care plan.

Do not use pre-written care plans

Identify the problem first, then the goals then the interventions

In My state, attendance is no longer required in long term care

We only document room visits as per my own policy to make sure everyone is being seen regularly.

We also don't write careplans for every problem, we latch on to the teams careplans to make it more inter-disciplinary

Check with your MDS coordinator in long term care facilities to help you with this.


Also check out Documentation in a Snap for Activity professionals by Ann G Uniack ISBN # 1-881671-13-5

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  • 2 months later...

Hi Denese,

I have always done my own care plans :lol: I wouldn't want to do nursing care plans and I don't want them messing with mine. At care plan meetings we go over each disciplines section and we do give each other good insight. An overall good care plan has to be a team approach.

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I make my own. They are usually general in nature and I then add specifics to each person.

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Guest Constance

I do my own because the nursing department does not always have a full understanding of what the function of activities is. We are often told things by the residents that they do not tell the staff. Also, as a discipline, I feel that it is important that we do our own care plans.

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I also do my own care plans. I am finally getting the hang of it and I actually kinda enjoy it. Activities is a very important part of a resident's life here and I want to make sure I write an individualized care plan for each resident. We also get together as an IDP and review them together to get input from the other disciplines, which is very helpful!

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  • 2 weeks later...


I make sure I write my own care plans!! Unless nursing has went thru the activity classes and actively assists with activities they have no right to do them. How do they know how the residents do in activities??? Also think who is responsible for the activity care plan in states eyes???

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  • 3 years later...

These materials on "I" Centered Care Plans were shared through our collaboration with other state QIOs. There is a template, a few sample "I" Centered Care Plans, and a power point presentation.


Please review and share here changes in care plan writing at your facility or other materials on "I" Centered Care Plans.

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