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FIG 10.3 Home safety checklist. (Adapted from Rebuilding Together: www.rebuildingtogether.org/downloads/home-safety-
checklist.pdf; from Ralph K Davies Medical Center: Occupational/physical therapy home evaluation form, San Francisco, 1993; and Alta
Bates Hospital: Occupational therapy home evaluation form, Albany, CA, 1993.)

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 FIG 10.4 Home evaluation checklist. (Adapted from Ralph K Davies Medical Center: Occupational/physical therapy home
evaluation form, San Francisco, 1993; and Alta Bates Hospital: Occupational therapy home evaluation form, Albany, CA, 1993.)

Much of the information can also be obtained by interviewing the client and family members
after a client's trial home visit (a visit that must be approved by the insurance company). The family
member or caregiver may be instructed to complete the home visit checklist during the trial home
visit and provide photographs or sketches of the rooms and their arrangements. Problems
encountered by the client during a trial home visit should be discussed and the necessary
recommendations for their solution made. If a home evaluation is not possible while the client is in
the hospital, the home assessment may also be referred to the home health agency that will provide
home care services to the client.
The client and a family member should be interviewed prior to the home evaluation to determine
the client's and family's expectations and the roles the client will assume in the home and
community. The family's values or those of their culture regarding people with disabilities may
influence role expectations and whether independence will be encouraged. Willingness to make
modifications in the home can also be determined. The purposes and procedure of the home
assessment should also be clearly explained to the client and caregivers prior to the actual visit.

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