From the State Surveyors Guide Here is the beginning steps used by the Surveyor to determine if the facility has provided an adequate environment for Activities.
To determine if the facility has provided an ongoing program of activities designed to
accommodate the individual resident’s interests and help enhance her/his physical,
mental and psychosocial well-being, according to her/his comprehensive resident
Use this procedure for each sampled resident to determine through interview, observation
and record review whether the facility is in compliance with the regulation.
Briefly review the comprehensive assessment and interdisciplinary care plan to guide
observations to be made.
Observe during various shifts in order to determine if staff are consistently implementing
those portions of the comprehensive plan of care related to activities. Determine if staff
take into account the resident’s food preferences and restrictions for activities that
involve food, and provide ADL assistance and adaptive equipment as needed during
activities programs. For a resident with personal assistive devices such as glasses or
hearing aides, determine if these devices are in place, glasses are clean, and assistive
devices are functional.
For a resident whose care plan includes group activities, observe if staff inform the
resident of the activities program schedule and provide timely transportation, if needed,
for the resident to attend in-facility activities and help the resident access transportation
to out-of-facility and community activities.
Determine whether the facility provides activities that are compatible with the resident’s
known interests, needs, abilities and preferences. If the resident is in group activity
programs, note if the resident is making attempts to leave, or is expressing displeasure
with, or sleeping through, an activity program. If so, determine if staff attempted to
identify the reason the resident is attempting to leave, and if they addressed the resident’s
needs. Determine whether the group activity has been adapted for the resident as needed
and whether it is “person appropriate.”
NOTE: If you observe an activity that you believe would be age inappropriate for most
residents, investigate further to determine the reason the resident and staff
selected this activity. The National Alzheimer’s Association has changed from
endorsing the idea of “age-appropriate” activities to promoting “personappropriate”
activities. In general, surveyors should not expect to see the
facility providing dolls or stuffed animals for most residents, but some residents are
attached to these items and should be able to continue having them available
if they prefer.
Regarding group activities in common areas, determine if the activities are occurring in
rooms that have sufficient space, light, ventilation, equipment and supplies. Sufficient
space includes enough space for residents to participate in the activity and space for a
resident to enter and leave the room without having to move several other residents.
Determine if the room is sufficiently free of extraneous noise, such as environmental
noises from mechanical equipment and staff interruptions.
For a resident who is involved in individual activities in her/his room, observe if staff
have provided needed assistance, equipment and supplies. Observe if the room has
sufficient light and space for the resident to complete the activity.