Select State Alabama
Terr. of the Pac.
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Check Items you would like:
Things To Do List: (item #M1)
This one-page form will help keep you organized!
One to One Log: (item #D4)
A simple one-page form to monitor your One-to-One visits.
Lending Library List: (item #A1)
A great tool to keep track of all the books and materials you lend to the residents.
Recreation Documentation Tracking Form: (item
A one-page simple form to make sure you are timely with your required documentation.
List of Activities: (item #A2)
This 5 page
document lists over 200 different recreational
activities by category. It is a great tool to
utilize to ensure a well-balanced calendar!
Individual Education Record: (item # M11)
one-page form helps you to keep track of the
in-services your staff have attended. Each time
an employee attends a facility in-service, write
it on the form and keep it in the employee's
file. You can type in the mandatory in-services
and have the employee sign and date this form,
Form (item # A3)
This is a simple
way to keep track of your entertainers. It has
space to write the entertainers name, phone number,
address, specialty/type of music, and more.
Staff Schedule Form (item # M9)
form accommodates twelve employees. It is easy
to use and helps you identify your staffing needs.
Department Staff Profile (item #M17)
This one page document is an example of how you
can analyze your staffing needs.
Calendar Template (item #M18)
monthly Activity Calendar Template is done in
Microsoft publisher on 8 ½ x
Calendar Template (item #M19)
monthly Activity Calendar Template is done in
Microsoft Word on 8 ½ x 14 paper.
Petty Cash Monitoring Tool (item #
M20)This simple one page form will help you monitor
how much petty cash is being spent, how and
where the money is spent, and reimbursement
Weekly Recreation Assignment Schedule (item
# M21)This one page form is designed to assign the
Activity Staff to certain units/floors for
a week at a time so that the Activity Director
knows which units are covered and those that
are not. It also helps the Activity Staff to
prepare for their activities if they know what
their assignments are ahead of time.
Recreation Documentation Audit-Short Form
(item # D11)
This is a simple form used to determine
if Recreation Documentation is performed timely.
Volunteer List (item # V1)
This one page
form helps you keep track of your current volunteers.
Equipment Distribution List (item
This form is designed to monitor the equipment
and supplies that are given to various units
or Activity Staff.
Equipment Sign-Out Sheet (item # M23)
is a one-page form that helps monitor the use
of activity supplies and equipment
Day Room Activity Planning Form (item #
This form helps the Activity Staff plan
for daily activities.
Family RSVP Form (item # A8)This form is necessary for planning special
programs that include family members.
Performance Appraisal Tracking Tool (item
Having trouble keeping track of Performance
Appraisal deadlines? This simple form will
help keep the Activity Director up to date
on all appraisals.
Resident Special Needs Checklist (item #
M25)This 8 ½ by 14 checklist
is designed to assist the Activity Professional
programming for residents with special needs
such as: residents who are ventilator-dependent,
those with oxygen, residents with feeding tubes,
Request for Physician's Order (item # M26)
This is a one page form that is utilized to request
a Physician's order to provide Recreation Therapy
treatment services. The CTRS simply fills out
the form and gives it to Nursing who then gets
the order from the Physician.
In-service Sign-In Sheet (item # M27)
form serves as the in-service participant sign-in
record as well as the in-service
topic outline. It’s easy to use and demonstrates
proof that your employees attended the session
along with the topic(s) covered!
Departmental Training/In-Service Tracking Form
form is a method of tracking the entire department’s
attendance at mandatory and additional in-services.
glance the manager can see who attended what
and when and can be altered to meet the individual
requirements of your facility.
Community Groups Contact List (item #V2)
This one page form will help you maintain a list of community groups so that you can easily contact them to schedule special events, intergenerational programs and other community activities.
Policy and Procedure Format (# M30)
This format is easy to use and will help you write thorough policies and procedures for your department.
Activity Word Scramble with Clues(# M31)
This word scramble is great for educating staff and residents about the variety of activities you may offer in your facility. Clues are included as well as the answer sheet. Tip: Have residents and staff complete the word scramble, put name on top and enter into a raffle drawing. What a great activity for National Activity Professionals Week!