Occupational Therapy Initial Evaluation Checklist

Comprehensive occupational therapy evaluation including ADL assessment, cognitive screening, and individualized treatment planning.

  • Industry: Healthcare
  • Frequency: Initial evaluation
  • Estimated Time: 45-60 minutes
  • Role: Occupational Therapist
  • Total Items: 31
  • Compliance: AOTA Practice Framework, CMS Documentation Requirements, State Practice Act

Occupational Profile

Patient history and goals

  • Prior level of function documented?
  • Living situation documented?
  • Occupational roles identified?
  • Patient/caregiver goals identified?

Performance Skills

Skills assessment

  • Motor skills assessed?
  • Process/cognitive skills assessed?
  • Sensory function assessed?

ADL Assessment

Activities of daily living

  • Basic ADLs assessed (bathing, dressing, feeding)?
  • IADLs assessed (cooking, cleaning, money)?
  • Safety with ADLs assessed?

Treatment Plan

Intervention planning

  • Measurable goals established?
  • Interventions planned?
  • Frequency and duration specified?

Pre-Assessment Information

Initial assessment documentation and patient/facility identification

  • Assessor Name / Credentials
  • Assessment Date
  • Department / Unit
  • Assessment Type (Routine/Annual/Complaint)
  • Previous assessment findings reviewed?

Infection Prevention & Control

Verify infection control practices per CDC and Joint Commission standards

  • Hand hygiene compliance observed?
  • Appropriate PPE available and properly used?
  • Isolation precautions properly implemented?
  • Sharps containers available and not overfilled?
  • High-touch surfaces properly disinfected?

Patient Safety & Identification

Verify patient safety protocols and identification procedures

  • Two patient identifiers used before procedures?
  • Fall risk assessment completed?
  • Call light within patient reach?
  • Bed in lowest position with brakes locked?

Medication Safety & Management

Verify medication handling and administration practices

  • Medications stored securely and at proper temperature?
  • Controlled substances properly secured and counted?
  • No expired medications in stock?
  • High-alert medications properly labeled?

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