Touring adult family homes is a critical step in finding the right care for your loved one. But with emotions running high and so much information to absorb, it's easy to forget important questions. This comprehensive checklist ensures you gather the information needed to make a confident decision.
Print this list before your tours and take notes on each home's responses. Comparing answers across multiple homes will help identify the best fit.
Care and Medical Questions
Basic Care
- What is your caregiver-to-resident ratio during the day? At night? (Look for 1:4 or better during day, 1:6 or better at night)
- How do you handle medication management? (Who administers? How are errors prevented?)
- What levels of care can you accommodate? (What happens if needs increase?)
- How do you handle medical emergencies? (Protocol, hospital relationships)
- What medical equipment or services can you support? (Oxygen, wound care, catheters, etc.)
Specialized Care
- Do you have experience with my loved one's specific conditions?
- What dementia/memory care training do staff have?
- Can you accommodate special dietary needs?
- How do you handle behavioral challenges?
- Do you coordinate with outside healthcare providers? (physicians, therapists)
Staffing Questions
- What training and certifications do caregivers have?
- How long have your current staff worked here? (Low turnover is a good sign)
- Is there always a caregiver awake overnight?
- Who is the backup if the primary caregiver is sick or on vacation?
- Do the same caregivers work with residents consistently?
Daily Life Questions
- What does a typical day look like for residents?
- What activities and engagement do you offer?
- How do you accommodate individual routines and preferences?
- Can residents personalize their rooms?
- What are the visiting hours? (Flexible policies are preferable)
- Can family members share meals with residents?
- How do you handle laundry and personal belongings?
Cost and Payment Questions
- What is the monthly rate, and what does it include?
- What additional services cost extra?
- How often do rates increase, and by how much typically?
- Do you accept Medicaid/COPES?
- What is your policy if someone transitions from private pay to Medicaid?
- Is there a move-in fee or deposit?
Administrative Questions
- Can I see your most recent state inspection report?
- What is your discharge policy? (Under what circumstances would someone need to leave?)
What to Observe During Tours
Beyond asking questions, pay attention to:
- Cleanliness: Is the home clean and well-maintained?
- Odors: Unpleasant smells can indicate care problems
- Resident appearance: Do they look clean and comfortable?
- Staff interactions: Are caregivers respectful and attentive?
- Atmosphere: Does it feel warm and welcoming?
- Safety features: Grab bars, non-slip floors, adequate lighting
After the Tour
- Check the DSHS licensing database for inspection history
- Read online reviews (Google, Facebook, Yelp)
- Ask for references from current families
- Visit again at a different time of day
- Trust your instincts about the feel of the place
Frequently Asked Questions
How many homes should I tour before deciding?
Tour at least 3-5 homes to get a sense of what's available and what feels right. Quality varies significantly, and seeing multiple options helps you recognize excellent care when you find it. Don't settle for the first one unless it truly stands out.
Should I bring my loved one on tours?
It depends on their cognitive status and emotional state. If they can participate meaningfully in the decision, including them can help with adjustment later. If they're likely to be confused or distressed, tour first and bring them to finalists. Some families do initial screening alone, then include their loved one for the final decision.
What's a reasonable caregiver-to-resident ratio?
For adult family homes (maximum 8 residents), a ratio of 1:4 or better during daytime hours is good. At night, 1:6 is acceptable if residents are stable and sleeping. Higher-acuity care requires better ratios. Compare this to large facilities where ratios can be 1:12 or worse.
How important are inspection reports?
Very important. Review reports for patterns of problems, not just isolated incidents. Serious violations (medication errors, abuse allegations, safety hazards) are red flags. Minor paperwork issues are less concerning. Also note how quickly problems were corrected. You can access Washington AFH inspection reports through the DSHS online lookup tool.
Can I visit unannounced?
You should be able to visit during normal waking hours without an appointment. Unannounced visits show you what daily life really looks like, not a prepared presentation. If a home strongly discourages unannounced visits, consider that a yellow flag.