Legg Mason

Lighting Entry to the Home

Have a specific need? Slect a category to the Right

Driveway	Yes No
Garage	Yes No
Walkways	Yes No
At all doors	Yes No
Near the trash area	Yes No
Any other areas of the yard that are used after dark?	Yes No

Driveway Entry to the Home

Is the driveway smooth and evenly paved?	Yes No
Is the transition between the driveway and surrounding surfaces (such as the yard), smooth and even, free of ruts and other things (rocks) that could cause tripping?	Yes No
Is the slope of the driveway low enough that it does not cause a problem?	Yes No

Walkways to and around home Entry to the Home

Are walkways smooth and level (no cracks, gaps or other tripping hazards)?	Yes No
Are steps along walkways clearly visible?	Yes No
Do they have handrails?	Yes No
Are transitions between different surfaces (a patio and sidewalk, concrete and asphalt, walkway and grass, etc.) even and level?	Yes No
If there are steeply inclined walkways, do they have sturdy, easy-to-grasp handrails?	Yes No
Are shrubs, bushes and grass trimmed back or removed so they do not infringe on or obstruct the walkway (potential tripping hazard)?	Yes No

Steps to the doors Entry to the Home

Do all steps (even single steps) have sturdy, easy-to-grasp (cylindrical) rails on both sides?	Yes No
Are the stairs and multiple steps of equal height?	Yes No
Are the stair treads sturdy, level and in good condition?	Yes No

Garage Entry to the Home

Are there adequate overhead lights in the garage?	Yes No
Is there a clear pathway to walk through?	Yes No
Do entry stairs or ramps to the house have railings?	Yes No
Are ramps rising at a minimum slope of 12:1 (12 inches of ramp length for every one inch of height is standard. However, 16:1 is recommended.)	Yes No
Do ramps have sturdy rails on both sides?	Yes No
Are the rails cylindrical for easy grasping?	Yes No

Ramps (if applicable) Entry to the Home

Do ramps have smooth transitions from ramp surface to ground surface?	Yes No
Do ramps have non-skid surfaces or have non-skid strips been added?	Yes No
Do ramp railings extend beyond the ramp to help people transition off the ramp?	Yes No
Do ramps have sufﬁcient width of at least 36 inches between handrails?	Yes No

Entry porches/decks/landings Entry to the Home

	Front	Rear
Have all potential tripping hazards, such as clutter and overgrown bushes, been removed?	Yes No	Yes No
Is the landing wide and deep enough to safely open the door?	Yes No	Yes No
Is there a clearly visible, easily reachable doorbell?	Yes No	Yes No
Do porches and decks have railings or barriers to prevent someone from stepping or falling off?	Yes No	Yes No
Are the railings securely fastened?	Yes No	Yes No
Does the decking have secure, even ﬂoorboards with no protruding nails?	Yes No	Yes No
Is there a non-skid surface on the porch/deck/landing?	Yes No	Yes No
Do doormats have non-skid backing, with no upturned corners?	Yes No	Yes No

Exterior doors Entry to the Home

	Front	Rear
If necessary, are doorways wide enough to accommodate wheelchairs?	Yes No	Yes No
Is a lock or deadbolt present on interior of door?	Yes No	Yes No
Are locks in good working order and easy to use?	Yes No	Yes No
Are latches and door handles in good condition and easy to use?	Yes No	Yes No
If someone has trouble turning a doorknob, are there lever handles?	Yes No	Yes No
Do the doors open and close easily without sticking?	Yes No	Yes No
Do doors on springs close slowly enough (so they don’t close on someone going through the door)?	Yes No	Yes No
Is the threshold at the door less than one inch high?	Yes No	Yes No
Are the doors easy to open?	Yes No	Yes No

Other outdoor area concerns Entry to the Home

	Front	Rear
If there is a patio or deck, is it level, smoothly surfaced and free of tripping hazards?	Yes No	Yes No
Are garbage and recycling areas well lit?	Yes No	Yes No
Do these areas have safe, accessible stairs and railings?	Yes No	Yes No
Have working chimneys been professionally inspected and cleaned within the last year?	Yes No	Yes No

Entryways and vestibules Inside The Home

	Front	Rear
Have throw rugs (potential tripping hazards) been removed?	Yes No	Yes No
Is there a clear pathway (devoid of clutter) through the entry hall?	Yes No	Yes No
Are all cords and wires out of the pathway?	Yes No	Yes No
Are thresholds low enough (less than 1 inch) so someone does not trip over them?	Yes No	Yes No
Is there adequate lighting?	Yes No	Yes No
Is the light switch at the entrance to the room?	Yes No	Yes No
If necessary, is the entryway wide enough for a wheelchair/walker?	Yes No	Yes No

Hallways Inside The Home

	#1	#2	#3
If people need support, are there handrails along the hall?	Yes No	Yes No	Yes No
Are halls free of clutter and other tripping obstacles?	Yes No	Yes No	Yes No
Are carpet runners tacked down or do they have anti-skid backing?	Yes No	Yes No	Yes No
Are thresholds less than one inch, so they are not tripping hazards?	Yes No	Yes No	Yes No
If necessary, are halls wide enough for a wheelchair/walker?	Yes No	Yes No	Yes No
Is there adequate lighting?	Yes No	Yes No	Yes No
Is there a light switch at both ends of the hall?	Yes No	Yes No	Yes No

Doors/doorways Inside The Home

Do all doors open easily?	Yes No
Are thresholds less than one inch?	Yes No
Are latches and door handles in good condition and easy to use?	Yes No
If someone has trouble turning a doorknob, are there lever handles?	Yes No

Interior stairs Inside The Home

	2nd ﬂoor	Basement	Other
Do stairs have sturdy rails on both sides that are securely fastened?	Yes No	Yes No	Yes No
Do rails continue onto the landings?	Yes No	Yes No	Yes No
Are the stair treads sturdy, not deteriorating or broken?	Yes No	Yes No	Yes No
Are edges of stair treads clearly visible (no dark, busy patterns)?	Yes No	Yes No	Yes No
Are stair pads in good repair (tacked down, in one piece)?	Yes No	Yes No	Yes No
(If bare wood) Are stair treads slip-resistant?	Yes No	Yes No	Yes No
(If carpeted) Is carpet securely attached, not worn/frayed?	Yes No	Yes No	Yes No
Are top and bottom steps highlighted?	Yes No	Yes No	Yes No
Are stairs free of clutter?	Yes No	Yes No	Yes No
If stairs have a low, overhanging beam that people could bump their heads on, has it been padded?	Yes No	Yes No	Yes No
Are stairs and landings well lit, with light switches at both top and bottom?	Yes No	Yes No	Yes No

Living room (LR) and dining room (DR) Inside The Home

	LR	DR
Is the lighting adequate?	Yes No	Yes No
Is there a light switch at the entrance to the room?	Yes No	Yes No
Is there a clear, unobstructed path through the room (no clutter, cords, wires, baskets or other things to trip over)?	Yes No	Yes No
Are thresholds minimal and carpet binders tacked down?	Yes No	Yes No
Are carpets in good condition (not frayed or turned up, torn, or with worn spots that someone could trip over)?	Yes No	Yes No
Are plastic runners/carpet protectors tacked down (not folded or turned up at edges)?	Yes No	Yes No
Do throw rugs have anti-skid backing and no upturned corners?	Yes No	Yes No
Is tile/linoleum free of chips or tears, and not slippery?	Yes No	Yes No
Are bare wood ﬂoors slip resistant?	Yes No	Yes No
Is there at least one comfortable chair people can get in and out of safely and easily?	Yes No	Yes No
Is furniture stable?	Yes No	Yes No
Do tables have rounded edges that are clearly visible (no sharp edges, not made of glass)?	Yes No	Yes No
Do windows open easily?	Yes No	Yes No
Are shades and blinds easy to open and securely attached?	Yes No	Yes No
Are electrical cords run behind furniture and not across the ﬂoor or under the rug?	Yes No	Yes No

Family room (FR) and other room(s) Inside The Home

	FR	Other
Is the lighting adequate?	Yes No	Yes No
Is there a light switch at the entrance to the room?	Yes No	Yes No
Is there a clear, unobstructed path through the room (no clutter, cords, wires, baskets or other things to trip over)?	Yes No	Yes No
Are thresholds minimal and carpet binders tacked down?	Yes No	Yes No
Are carpets in good condition (not frayed or turned up, torn, or with worn spots that someone could trip over)?	Yes No	Yes No
Are plastic runners/carpet protectors tacked down (not folded or turned up at edges)?	Yes No	Yes No
Do throw rugs have anti-skid backing and no upturned corners?	Yes No	Yes No
Is tile/linoleum free of chips or tears, and not slippery?	Yes No	Yes No
Are bare wood ﬂoors slip resistant?	Yes No	Yes No
Is there at least one comfortable chair people can get in and out of safely and easily?	Yes No	Yes No
Is furniture stable?	Yes No	Yes No
Do tables have rounded edges that are clearly visible (no sharp edges, not made of glass)?	Yes No	Yes No
Do windows open easily?	Yes No	Yes No
Are shades and blinds easy to open and securely attached?	Yes No	Yes No
Are electrical cords run behind furniture and not across the ﬂoor or under the rug?	Yes No	Yes No

Bathrooms - General considerations Inside The Home

	Bath #1	Bath #2
Is there a light switch at the entry?	Yes No	Yes No
Is there adequate lighting overall?	Yes No	Yes No
… At the sink?	Yes No	Yes No
… Over the tub/shower?	Yes No	Yes No
Is there a night-light?	Yes No	Yes No
Is the door threshold less than one inch?	Yes No	Yes No
Is the room free of clutter and tripping hazards?	Yes No	Yes No
Is the ﬂooring non-slip/non-skid (including throw rugs), even when wet?	Yes No	Yes No
Are there grab bars in other areas of the room as needed?	Yes No	Yes No
Is the room kept warm during bathing (heat lamp, towel warmers, etc.)?	Yes No	Yes No

Bathrooms - Sinks Inside The Home

	Bath #1	Bath #2

Are sink faucets easy to reach?	Yes No	Yes No
Is it easy to determine where the hot and cold areas of the faucet are?	Yes No	Yes No
Is it easy to mix the temperature?	Yes No	Yes No
If necessary, have anti-scald devices been installed?	Yes No	Yes No
Is the sink wheelchair accessible or can someone sit at the sink?	Yes No	Yes No
Are mirrors at an appropriate height?	Yes No	Yes No

Bathrooms - Tub/shower Inside The Home

	Bath #1	Bath #2
Are there sturdy grab bars in the tub and/or shower, if needed?	Yes No	Yes No
Is the shower curtain bottom out of the way, so it is not a tripping hazard?	Yes No	Yes No
Are toiletries in the tub easily reached from sitting and standing positions?	Yes No	Yes No
Is there a non-skid bathmat in the bathtub?	Yes No	Yes No
Is there a hand-held shower head?	Yes No	Yes No
Are tub/shower faucets easy to use and read (hot & cold clearly marked)?	Yes No	Yes No
If needed, is there a tub or shower seat?	Yes No	Yes No
If shower/tub doors are present, are they made of a non-shattering material?	Yes No	Yes No
Toilet
Are there sturdy grab bars at the toilet (or toilet arms and a raised seat)?	Yes No	Yes No
Is toilet paper easily reachable from the toilet seat?	Yes No	Yes No
Is the toilet seat in good condition and securely fastened?	Yes No	Yes No

Bathrooms - Toilet Inside The Home

	Bath #1	Bath #2
Are there sturdy grab bars at the toilet (or toilet arms and a raised seat)?	Yes No	Yes No
Is toilet paper easily reachable from the toilet seat?	Yes No	Yes No
Is the toilet seat in good condition and securely fastened?	Yes No	Yes No

Kitchen Inside The Home

Are frequently used items visible and easily reached (front of pantry and refrigerator)?	Yes No
Are sink faucets easy to reach?	Yes No
Is it easy to determine where the hot and cold areas of the faucet are?	Yes No
Is it easy to mix the temperature?	Yes No
If necessary, have anti-scald devices been installed or the hot water temperature lowered?	Yes No
If necessary, have timers been installed on the oven and cooktop?	Yes No
Are burners and control knobs clearly labeled and easy to use?	Yes No
Are the controls on the front of the stove, not the back?	Yes No
Is there a close resting place nearby for hot vessels coming out of the oven?	Yes No
Is glass cookware being used so the person can see the food being cooked?	Yes No
Is the microwave easy to read, reach and operate?	Yes No
Are towels, curtains, potholders and other objects that might catch ﬁre located away from the range?	Yes No
Is there a step stool that is stable and in good repair?	Yes No
Is kitchen ventilation system or range exhaust functioning properly?	Yes No
Is there good lighting over work areas?	Yes No

Laundry Inside The Home

Is there a light switch at the entry?	Yes No
Is there sufﬁcient lighting?	Yes No
Is the route to the laundry safe (including any/all stairs and railings)?	Yes No
Are the appliances at the right height, so it is easy to get clothes in/out of the washer and dryer?	Yes No
Are the control knobs easy to reach, read and operate?	Yes No
Are laundry supplies easy and safe to reach?	Yes No
Is there a non-slip ﬂoor surface?	Yes No
Are tripping hazards off the ﬂoor (laundry basket or dirty clothes)?	Yes No

Bedroom(s) Inside The Home

	Bed #1	Bed #2
Is there a light at the entrance to the room?	Yes No	Yes No
Is a light reachable from the bed?	Yes No	Yes No
Can bureau drawers be reached (height of the drawer) and opened easily?	Yes No	Yes No
Is there a clear, unobstructed path through the room (clutter and furniture are out of the way)?	Yes No	Yes No
Are cords and wires off the ﬂoor?	Yes No	Yes No
Do throw and area rugs have non-slip backing and no upturned corners?	Yes No	Yes No
Are wood and linoleum ﬂoors non-skid?	Yes No	Yes No
Is carpet smooth (no folds or holes) and tacked down?	Yes No	Yes No
Are curtains and bed coverings off the ﬂoor, so they are not tripping hazards?	Yes No	Yes No
Is there support for getting in and out of bed, if needed?	Yes No	Yes No
Is there a place to sit and get dressed, if needed?	Yes No	Yes No
Are windows easy to open and close?	Yes No	Yes No
Are window blinds and shades working properly and easy to open?	Yes No	Yes No
Are blinds and shades properly secured?	Yes No	Yes No
Is there a telephone within reach of the bed?	Yes No	Yes No
Are any assistive walking devices (cane, walker, wheelchair) within reach of the bed?	Yes No	Yes No
Is there a ﬂashlight or some other form of non-electric lighting within reach of the bed in case of a power outage?	Yes No	Yes No
Are electric blankets folded, covered by other objects or “tucked in” when in use? Is the power cord pinched or crushed by the bed, between a wall or the ﬂoor?	Yes No	Yes No

Closet(s) Inside The Home

	Closet #1	Closet #2
Are shelves and clothes poles easy to reach?	Yes No	Yes No
Have closet organizers been installed to maximize use of space?	Yes No	Yes No
Are closets organized so clothes are easy to ﬁnd?	Yes No	Yes No
Are clutter and other tripping hazards off the ﬂoor?	Yes No	Yes No
Do closets have lights that are easy to ﬁnd and reach?	Yes No	Yes No
Are closet doors easy to open?	Yes No	Yes No
If closet has sliding doors, do they stay on track?	Yes No	Yes No

Overall Home Safety Concerns Inside The Home

Can an older adult contact someone in an emergency (medi-alert, names and numbers by phone, picture telephone, etc.)?	Yes No
Are smoke detectors installed and working on every level of the home, outside sleeping areas and inside bedrooms?	Yes No
Are carbon monoxide (CO) alarms installed and working on every level of the home, outside sleeping areas and inside bedrooms?	Yes No
Is there a ﬁre extinguisher in the house?	Yes No
Is there a safe place outside to hide a key to the house for emergency entry?	Yes No
Are emergency numbers posted on or near all telephones?	Yes No
Are telephones positioned low enough so they can be reached if a fall occurs?	Yes No
Is there a ﬁre extinguisher in the kitchen?	Yes No
Are all portable space heaters and wood burning heating equipment at least three feet from walls, furniture, curtains, rugs, newspapers or other ﬂammable materials?	Yes No
Are all medications in child-resistant containers clearly marked with the medication name and dose?	Yes No
Is the area where medications are kept well lit?	Yes No
Is the water heater set to no more than 120 degrees Fahrenheit?	Yes No
Are containers of ﬂammable and combustible liquids stored outside of the house?	Yes No
Are portable generators not operating in the basement, garage, or anywhere near the house?	Yes No
Is there an emergency exit plan?	Yes No
Are small appliances, such as hair dryers, toasters, etc. unplugged when not in use?	Yes No
Are electrical outlets or switches in good working order, and not unusually warm or hot to the touch?	Yes No
Do all electrical outlets and switches have cover plates installed so no wiring is exposed?	Yes No
Are all Ground-Fault Circuit Interrupter (GFCI) receptacles working properly?	Yes No

Home safety assessment

Bed/Chair Pad

The SimplyHome System

Personal Emergency Response System