All 54 categories

The complete CareGuard facility checklist — 189 items across 54 categories — in source order. Nine categories are section headings; the rest carry the items.

If you would rather read it grouped by theme, start at the safety review.

1. Resident Safety

• Hot water temperature checks (≤ 120°F to prevent scalding)
• Emergency exits clearly marked and accessible
• Fire extinguishers and smoke detectors operational
• Handrails and grab bars securely installed
• Adequate lighting in hallways and common areas
• Proper functioning of call buttons in resident rooms
• Wheelchair accessibility throughout the facility

2. Infection Control

• Regular cleaning schedule followed for resident rooms
• Disinfectant available in high-traffic areas
• Communicable disease screening for residents
• Staff hand hygiene compliance
• Use of personal protective equipment (PPE) by staff
• Laundry facilities maintain hygiene standards

3. Kitchen & Dining Areas

• Food storage temperatures maintained (cold: ≤ 40°F, hot: ≥ 140°F)
• Food preparation surfaces sanitized
• Expired food discarded appropriately
• Dining areas clean and free of debris
• Safe water supply (check for lead, contaminants)

4. Bathrooms

• Cleanliness of resident bathrooms
• Safe water temperature for resident use
• Non-slip mats or flooring installed in shower areas
• Functioning and accessible grab bars in showers and near toilets

5. Common Areas

• Floors free of trip hazards (wires, rugs, spills)
• Furniture in good condition (no sharp edges or broken parts)
• Adequate ventilation and air quality in common spaces
• Clear and visible evacuation maps posted

6. Resident Rooms

• Clean linens and beddings
• Proper room ventilation (temperature control: 68-72°F)
• Room free from clutter and fall hazards
• Personal belongings organized and stored safely
• Mobility aids (walkers, canes) in good condition

7. Staff Areas

• Staff rooms clean and stocked with PPE
• Training materials and compliance logs accessible
• Staff lockers and storage areas clean and organized

8. Medication Storage & Administration

• Medications stored in locked, secure cabinets
• Expired medications properly disposed of
• Accurate medication administration records
• Compliance with pharmacy storage guidelines (e.g., temperature control)

9. Outdoor Areas

• Sidewalks and paths free of debris and cracks
• Proper lighting in outdoor walkways
• Secure fencing around the property (if needed)
• Emergency vehicle access maintained
• Outdoor furniture safe and clean

10. Ongoing Monitoring

Section heading. The categories that follow sit under it.

11. Intake STD, Quant TB, Urine Tox, RPR, Nasal PCR, Genetics Neurocognitive

Section heading. The categories that follow sit under it.

12. Monthly Urine Tox, RTM, Nasal PCR

Section heading. The categories that follow sit under it.

13. Memory Care and Dementia

Section heading. The categories that follow sit under it.

14. Wandering Prevention & Security

• Secured entrances/exits to prevent wandering (e.g., locked doors with keypads)
• Alarm systems or monitoring devices at all exits
• Staff awareness of residents with high risk for wandering
• Enclosed outdoor areas safe for resident use
• Emergency exit doors equipped with alarms or security systems
• Clear signage and visual cues to help residents navigate the facility

15. Resident Safety for Cognitive Impairments

• Elopement prevention plans in place for at-risk residents
• Rooms free of sharp objects or items that could cause harm
• Monitoring systems (e.g., cameras or staff checks) in place for high-risk residents
• Non-toxic, safe cleaning supplies used in resident areas
• Secure storage of medications, cleaning supplies, and hazardous materials
• Easily accessible emergency call systems in resident rooms

16. Environmental Comfort & Design

• Bright, natural lighting to reduce confusion and anxiety
• Clearly marked rooms and common areas with large, easy-to-read signs
• Clocks, calendars, and daily schedules visible to residents
• Simple, calm decor (no excessive patterns or bright colors that may cause disorientation)
• Temperature control systems in place to maintain a comfortable environment
• Noise control measures in place to reduce agitation or confusion

17. Routine & Engagement

• Safe, enclosed outdoor spaces for physical activity
• Daily activity schedule for cognitive stimulation and social interaction
• Adequate staff-to-resident ratio to ensure individualized attention
• Activities tailored to the cognitive abilities of residents

18. Fall Prevention

• Non-slip flooring or carpets in resident rooms and common areas
• Low-rise beds with bed rails, if necessary
• Removal of clutter and potential tripping hazards from rooms and hallways
• Proper lighting in hallways and bathrooms, especially at night

19. Behavioral Support & De-escalation

• Staff trained in dementia care and behavioral management techniques
• Quiet, designated spaces for residents to calm down if agitated
• Consistent daily routine to reduce confusion and behavioral issues
• Monitoring for sudden changes in behavior that may indicate distress or illness

20. Nutrition & Hydration

• Adaptive eating utensils available for residents with motor challenges
• Regular hydration reminders and accessible water stations
• Nutritious, easy-to-eat meals designed for cognitive and physical abilities
• Assistance with feeding for residents who need it

21. Medication Management

• Strict protocols for administering medications to avoid overmedication
• Medication logs updated daily for residents with cognitive impairments
• Staff trained to identify adverse reactions to medications in memory care patients

22. Dignity & Privacy

• Respectful language and interactions with residents at all times
• Private areas for personal care (dressing, toileting) maintained
• Personal belongings and room decor that reflect the resident’s preferences and history

23. Avoiding Chemical and Physical Restraints

Section heading. The categories that follow sit under it.

24. Resident Assessment

• Comprehensive assessment of the resident’s physical, mental, and emotional health
• Identified the root cause of behaviors (e.g., pain, discomfort, boredom, confusion)
• Reviewed medical history for underlying conditions that may contribute to behavior (e.g., UTI, dehydration, infection, dementia progression)
• Input from family or caregivers on past triggers and successful behavior management techniques
• Regular reassessment of behavior to ensure interventions remain appropriate

25. Non-Pharmacological Interventions

• Established routine daily activities to provide structure and reduce agitation
• Provided opportunities for safe physical activity (e.g., walks, simple exercises)
• Engaged resident in meaningful activities (e.g., hobbies, music therapy, sensory stimulation)
• Created a calm, comforting environment (e.g., reduced noise, dimmed lights, familiar objects)
• Used distraction or redirection techniques when agitation arises
• Provided frequent hydration, nutrition, and bathroom breaks to avoid discomfort
• Ensured resident has access to personal items that may provide comfort
• Utilized seating that promotes safe mobility and comfort (e.g., recliners, ergonomic chairs)

26. Communication & De-Escalation

• Staff trained in verbal de-escalation techniques
• Calm, respectful communication with residents to reduce anxiety and frustration
• Allowed time for resident to process information and respond before taking action
• Used simple language and non-verbal cues to communicate with cognitively impaired residents
• Provided choices to the resident to increase their sense of control
• Involved family or familiar caregivers in calming the resident

27. Pain Management & Comfort

• Conducted regular pain assessments (especially for non-verbal residents)
• Provided appropriate pain relief through non-pharmacological means (e.g., massage, heat therapy)
• Adjusted resident’s seating or position regularly to prevent discomfort
• Offered comfort items (e.g., pillows, soft blankets, soothing music)

28. Environmental Modifications

• Ensured room is safe and free of hazards that might cause agitation or injury
• Provided adequate lighting and temperature control
• Used familiar objects or decor to reduce disorientation or confusion
• Allowed free movement within secure areas to reduce feelings of confinement

29. Monitoring & Observation

• Increased staff observation for residents at risk of behavioral disturbances
• Used bed or chair alarms as a passive measure for fall prevention, without restraint
• Conducted regular check-ins for high-risk residents, especially during times of agitation
• Monitored for early signs of behavioral escalation and intervened promptly

30. Collaboration & Care Planning

• Created an individualized care plan to manage behavior without restraints
• Collaborated with healthcare providers, family members, and caregivers to develop the plan
• Held regular team meetings to review progress and adjust care plan as needed
• Ensured all staff are trained and informed about the resident’s specific care plan

31. Medication Review & Management

• Reviewed medications regularly to avoid overmedication or inappropriate use of sedatives
• Considered reducing or deprescribing unnecessary psychotropic medications
• Worked with healthcare providers to manage behavior without chemical restraints
• Monitored for side effects or negative interactions with current medications

32. Behavioral Triggers

• Identified and minimized potential environmental or emotional triggers (e.g., loud noises, unfamiliar people)
• Allowed the resident to rest or retreat to a quiet space when overwhelmed
• Provided consistent, familiar staff to reduce agitation related to unfamiliarity

33. Family Involvement & Advocacy

• Encouraged family members to participate in care and behavior management
• Provided family education on the negative impacts of restraints and alternative approaches
• Maintained open communication with family regarding behavior management strategies

34. Legal & Ethical Compliance

• Confirmed all staff are trained on state and federal regulations against unnecessary restraints
• Followed facility policies regarding restraint avoidance and alternatives
• Used restraints only as a last resort in emergencies, and with proper documentation and oversight
• Informed residents and families of their rights regarding restraint-free care

35. Identifying Legal Issues in Nursing Home Facilities

Section heading. The categories that follow sit under it.

36. Employee-Related Issues

Section heading. The categories that follow sit under it.

37. Labor Law Compliance

• Employees receive overtime pay as required by law
• Compliance with minimum wage laws
• Accurate timekeeping and attendance records maintained
• Employees provided with mandated meal and rest breaks
• Workers classified correctly (employee vs. independent contractor)

38. Workplace Safety (OSHA Compliance)

• Adequate PPE provided to staff and safety protocols followed
• Reporting and recording of workplace injuries
• Staff trained in proper ergonomics and lifting techniques to avoid injury
• Infection control measures in place to protect staff

39. Discrimination & Harassment

• Zero-tolerance policy on discrimination based on race, gender, religion, age, disability, etc.
• Training provided to staff on anti-harassment and anti-discrimination policies
• Proper procedures for employees to file complaints about harassment or discrimination
• Prompt investigation and resolution of discrimination or harassment claims

40. Retaliation Protections

• Policies in place to protect employees from retaliation for filing complaints
• Reporting system for employees to confidentially file complaints about unsafe conditions or mistreatment
• Staff trained on whistleblower protections and reporting procedures

41. Training & Certification Requirements

• All employees are properly trained and licensed for their roles
• Regular re-certification or continuing education for staff in critical areas (e.g., dementia care, infection control)
• Documentation of all staff certifications and training records

42. Staffing and Supervision

• Adequate staff-to-resident ratio to avoid neglect
• Supervision and support available for less experienced staff
• Timely response to staff complaints about understaffing or burnout

43. Resident-Related Issues

Section heading. The categories that follow sit under it.

44. Resident Rights & Autonomy

• Residents are informed of their rights, including the right to refuse treatment
• No use of chemical or physical restraints without legal justification
• Residents’ privacy is respected in personal care and living spaces
• Informed consent obtained for all medical treatments and interventions

45. Abuse, Neglect, and Exploitation

• Staff trained to identify and report signs of abuse, neglect, or exploitation
• Regular monitoring for any signs of physical, emotional, or financial abuse
• Policies in place for mandatory reporting of suspected abuse to the appropriate authorities
• Prompt investigation and resolution of resident complaints related to mistreatment

46. Medication Mismanagement

• Proper documentation and administration of all resident medications
• Avoidance of overmedication or improper use of psychotropic drugs
• Regular medication reviews to prevent errors or harmful drug interactions
• Immediate reporting of any medication errors or adverse events

47. Inadequate Care & Neglect

• Proper hygiene and personal care provided to residents (e.g., bathing, dressing)
• Adequate food, water, and nutrition provided to all residents
• Fall prevention measures in place (e.g., non-slip floors, proper supervision)
• Timely medical care provided for illnesses, injuries, or worsening conditions

48. Financial Abuse & Mismanagement

• Safeguards against unauthorized access to resident funds or financial accounts
• Detailed, transparent billing statements provided to residents and families
• Avoidance of overcharging or hidden fees for services
• Policies in place to protect residents from financial exploitation

49. Communicable Disease Outbreaks

• Proper procedures in place for infection control and disease prevention
• Rapid reporting and response to potential communicable disease outbreaks
• Isolation protocols available and used when necessary

50. End-of-Life Care and Advance Directives

• Documentation of each resident’s advance directives (e.g., DNR orders, power of attorney)
• Staff trained on residents’ end-of-life wishes and legal documentation
• No unauthorized or inappropriate actions taken regarding end-of-life care

51. Facility-Wide Legal Concerns

Section heading. The categories that follow sit under it.

52. Licensure and Accreditation

• Facility fully licensed according to state and federal regulations
• Proper documentation of certifications and licensure for regulatory inspections
• Compliance with all Medicaid and Medicare requirements

53. Regulatory Compliance

• Regular internal audits to ensure compliance with state and federal regulations
• Updated policies and procedures to reflect changes in healthcare laws
• Regular inspections of facility cleanliness and safety standards

54. Emergency Preparedness

• Emergency plans in place for natural disasters or medical emergencies
• Regular training and drills for staff on emergency response protocols
• Documentation of compliance with state and federal emergency preparedness regulations

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Ask for a safety review of your facility

A CareGuard safety review walks the building against 189 items in 54 categories and reports what it finds to you, not to your site manager. The registration form takes the facility and a contact for the ownership group; scope is settled in the conversation that follows.