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Assessment Audit Tool

Name: Student Name

E-Mail: Student@email.com

Course ID#: ME1-StartDate

Assessment Audit Tool

Review 10% of your current population. Using this form add the number of residents interested in the programs. You should be specific as to individual interests, including names of favorite teams, TV Shows, type of music or radio programs.

Total Number of Residents in your facility: _____ 10% would be: _____

Hobbies

__Gardening

__ Pets

__ Family Events

__ Holiday Celebrations

__ Bird Watching

__ Boating

__ Camping

__ Hunting

__ Fishing

__ Cooking

__ Baking

__ Computer

__ Reading

__ Traveling

__ Newspaper

__ ___________________

__ ___________________

Favorite Games

__ Crosswords

__ Bingo

__ Word Search

__ Jigsaw Puzzles

__ Casino Games

__ Board Games

__ Computer Games

__ Group Games

__ Trivia

__ ___________________

__ ___________________

__ Flower Arranging

__ Letter Writing

__ Nature Interests

__ Travel

__ Poetry

__ Antiques/Collectibles

__ Museums

__ ___________________

__ ___________________

Spiritual Needs

__ Services (attends regularly)

__ Bible Study

__ Meditation

__ Family Events

__ Temple

__ Protestant Service

__ Catholic Mass

__ Clergy Visit (1-1)

__ ___________________

Sports

Name of Team

______________________

__ Baseball

__ Football

__ NASCAR

__ Basketball

__ Hockey

__ Soccer

__ Horseshoes

__ Bocce Ball

__ Horse Racing

__ Snow Sports

__ Olympics

__ ___________________

__ Self Advocacy

__ Support Groups

__ Shopping

__ Intergenerational

__ VFW/Legion

__ Instrument Played

__ Social Membership

__ ________________

__ ________________

__ Antiques/Collectibles

__ Museums

__ ___________________

__ ___________________

Card Playing

__ Poker

__ Bridge

__ Hearts/Spades

__ Solitaire

__ Rummy

__ ___________________

__ ___________________

Crafts

__ Knitting

__ Cooking

__ Crocheting

__ Sewing

__ Painting

__ Ceramics

__ Scrapbooking

__ Woodworking

__ Writing/Journaling

__ Home decor

__ Rubber Stamping

__ Model Making

__ Crafty Crafts

__ Art Projects

__ Quilting

__ Holiday Crafts

__ Dancing

__ ___________________

Other

__ Movies

__ Documentaries

__ Fixing Things

__ Talk Radio

__ Music

__ ___________________

__ ___________________

__ Restaurants

__ Politics

__ ___________________

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