Home health assessment Mr. Amid Age: 86 years old

1. Kitchen - get rid of / secure the throw rug on the floor - Clean dirty dishes - Place large knife in appropriate & safe spot (NOT lying on the table) - Hire pest control / rat exterminator (rats running around in the kitchen) - Safely dispose of insulin syringes in sharps container - fix tipped over chair - dispose of any old foods on tables, counters, sinks

2. Laundry Room - Clear “pile of clutter” (fall risk) - Drain open washer with water in it - Dump and clean bucket full of rancid water with rags

3. Bathroom - drain the bathtub full of water & clean bathtub - Place hand-holds in bathtub - Place nonslip mat in bathtub - Get rid of throw rug - Unplug hair dryer that is plugged in & take it out the sink - Safely dispose of used insulin syringes - Fix broken window - Place electric heater away from the tub and sink - Clean the toilet that is full of feces - Clear the bathroom floor of electrical extension cords (fall risk and fire hazard)

4. Bedroom - Clean pet feces on the floor - fix old air conditioner with frayed cords or get rid of it - Secure or get rid of throw rug - Remove cables on tables that are next to curtains (fire hazard), place in a safer location. Or don’t use candles, instead recommend a safe alternative - Pick up the piles of dirty clothes on the floor —> laundry - Secure the painting above bed that is falling off the wall - Remove old trash

5. Front Yard - Get rid of garbage piles appropriately - Fix broken fence - Trim overgrown bushes - Pick out weeds and mow long grass - Hire pest control / rat exterminator (rat holes under house) - Remove shovel and rake from the walkway (fall risk) - Clear clutter in front of front door - Fix broken railing on porch steps

6. Living Room - Clean up old food in the cracks of the couch - Clean cat urine & feces on the floor - Get rid of TV with broken glass and frayed wires (unsafe) - Safely dispose of insulin syringes in a sharps container

7. Backyard - Unplug chain saw and place it in a safe and secure spot - Dispose of 5-gal bucket full of dirty water - Pick weeds and mow long grass - Secure the unsecured ladder outside of house - Clear the ground of tools (that are scattered on the ground) - Clean old bird bath - roll up the garden hose and place in secure spot (garden hose lying in the grass)

8. Stairs - Clear cobwebs on ceiling - Remove pile of magazines on the stairs - Fix broken window at the end of the hall - Fix loose railing - Clean litter box on the landing that is full of poop. Also, place litter box in a safer location - Clean the stained carpet on the stairs - Relocate the wheelchair (instead of being in front of the stairs0 - Secure or remove throw rug