Your safety, comfort, and independence come first

RaindangoPlan for safer living at home

Every question we ask

This is the whole free home check, listed before you start. It takes about 15 minutes. Everyone is asked 64 questions; the other 49 appear only when an earlier answer makes them relevant, so most people see fewer than the 113 below.

The questions are worded here as if you are answering for yourself. If you fill it in for someone else, each one asks about them instead.

The Contractor's Bid Sheet asks nothing new; it is written from these same answers. The Full Review adds a room-by-room walk-through with a tape measure. Every walk-through question is listed below, after the free ones.

Start the free home check

The free home check

Getting started

Welcome — let's make this home safer, together.

  1. Who is this home plan for?

    Choices: Me · My parent(s) · Someone else

  2. Are you staying in your home or moving?

    Choices: Staying in my home · Moving in with family · Moving to a new home · Not sure yet

  3. When would you like the most important changes done? Only if it applies.

    Choices: Within a month · In 1–3 months · In 3–6 months · Not sure yet

  4. Your move date, if you know it Only if it applies.

    You type the answer.

  5. Who are they to you? Only if it applies.

    Choices: My spouse or partner · My grandparent · My brother or sister · My aunt or uncle · My in-law · A friend · A neighbor · A client (I care for them professionally) · Other — I'll type it

  6. How would you describe it? Only if it applies.

    You type the answer.

  7. What is your first name?

    You type the answer.

  8. What's your email address?

    You type the answer.

  9. Your date of birth

    You type the answer.

  10. What's the home's ZIP code?

    You type the answer.

Getting started

Tell us about your home's layout.

  1. How many stories is your home?

    Choices: Single story (ranch) · Two stories · Three or more stories · Split-level · Not sure

  2. Do you have a basement?

    Choices: No basement · Yes, unfinished · Yes, finished and livable · Not sure

  3. Is there livable space in the attic?

    Choices: No attic space · Storage only · Finished, livable space · Not sure

  4. Do you have a garage?

    Choices: No garage · Attached garage · Detached garage · Not sure

Your daily life

Let's start with how you get around.

  1. Do you use any of these to help you move around?

    Choices: None — I walk without help · Cane · Walker · Manual wheelchair · Power wheelchair · Scooter · Something else

  2. What else do you use? Only if it applies.

    You type the answer.

  3. How often do you actually use it — all the time, or only sometimes? Only if it applies.

    Choices: All the time · Only sometimes

  4. When you move from a chair to standing, or getting in and out of bed, how does that go?

    Choices: I do it on my own · I need something to push up from or hold onto · I need someone to help me · Someone has to lift me · Not sure · Prefer not to say

Your daily life

Any falls, slips, or close calls?

  1. In the last year, how many times have you fallen, slipped, stumbled, or had a close call — even little ones you never mentioned to anyone?

    Choices: None · Once · Twice · Three times · Four or more · Not sure

    Why we ask: A fall or a near miss, even a small one, is the clearest sign of where a home needs changes first. It moves those changes up the list.

  2. What happened — where, when, was anyone hurt? Only if it applies.

    You type the answer.

  3. Do you ever feel unsteady or lose your balance, like when turning, reaching, or standing up?

    Choices: No, I feel steady · Sometimes · Yes, often · Not sure · Prefer not to say

    Why we ask: Feeling unsteady changes where grab bars and handrails matter most, and how soon.

  4. Do you ever worry about falling?

    Choices: Not really · Sometimes · Yes, and it keeps me from doing things · Prefer not to say

Your daily life

How is your vision and hearing?

  1. How is your vision, with glasses or contacts if you use them?

    Choices: Good enough to see clearly · Hard to see some things even with glasses · Worse in dim light or at night · Blind or nearly blind · Prefer not to say

  2. How is your hearing, with hearing aids if you use them?

    Choices: Good enough for conversation · I miss some things, especially in groups · Deaf or nearly deaf · Prefer not to say

Your daily life

How is your memory and thinking day to day?

  1. How is your memory and thinking day to day?

    Choices: Sharp — no concerns · Some forgetfulness, but I manage · I have a memory diagnosis · Not sure · Prefer not to say

    Why we ask: So the plan can include simple safeguards, like a stove that turns itself off and lights that come on at night. This is not a memory test.

  2. Anything like a stove left on, food burned, doors unlocked, or getting turned around at night? Only if it applies.

    You type the answer.

Your daily life

Nighttime bathroom trips.

  1. Do you ever have urgency getting to the bathroom, or accidents?

    Choices: No issues · Sometimes urgency — I need to get there quickly · Yes, accidents happen · Prefer not to say

    Why we ask: Hurried trips to the bathroom at night are when many falls happen. The answer shapes the lighting and the path from bed to bathroom.

Your daily life

Size and weight.

  1. Is there anything about your size or weight that means the toilet, chairs, or grab bars might not hold safely?

    Choices: Yes · No · Not sure

    Why we ask: Toilets, seats and grab bars are rated for weight. The answer makes sure the plan asks for ones rated to hold safely.

  2. About how much, and does anything already not hold? Only if it applies.

    You type the answer.

Your daily life

Looking ahead.

  1. Over the next few years, do you expect things to stay the same, improve, or get harder?

    Choices: Stable — about the same · Slowly changing — some things getting harder · Changing quickly · Recovering — getting better · Not sure

    Why we ask: If things may get harder, building for it now, such as a wider doorway, can cost less than redoing the work later.

  2. Do you expect any equipment changes in the next few years — a walker, a power chair? Only if it applies.

    You type the answer.

Your daily life

Health conditions.

  1. Do you have any of these conditions?

    Choices: None of these · Arthritis · Stroke · Parkinson's · Heart condition · Diabetes · COPD or breathing problems · Osteoporosis · Something else

    Why we ask: Some conditions change which home changes help most. Arthritis, for example, makes lever handles and easy-grip faucets matter more.

  2. What else? Only if it applies.

    You type the answer.

Your daily life

Who's around to help.

  1. Who lives with you, or helps you at home?

    Choices: I live alone · My spouse or partner, and they can help if needed · My spouse or partner, but they need help too · Family lives with me · A paid caregiver comes in · Other arrangement · Prefer not to say

  2. Who checks in? Only if it applies.

    Choices: Family or friends visit · A neighbor looks in · Phone or video calls · Several of these · No one regularly · Prefer not to say

  3. How often? Only if it applies.

    Choices: Every day · A few times a week · About once a week · A few times a month · Less often than that · Not sure

Entrance

Getting into the home.

  1. How many steps to get into the home?

    Choices: None — it's level · 1 step · 2 steps · 3 steps · 4 steps · 5 steps · 6 steps · More than 6 · Not sure

  2. How many steps are there? Only if it applies.

    You type the answer.

  3. Are there handrails? Only if it applies.

    Choices: No handrails · One side · Both sides

  4. Would handrails help on those steps? Only if it applies.

    Choices: Yes · No · Not sure

  5. What would a handrail attach to? Only if it applies.

    Choices: Brick or stone · Wood siding · Vinyl or other siding · Nothing beside them — it would bolt to the steps · Something else · Not sure

  6. Is the entry covered from rain/snow?

    Choices: Yes · No · Not sure

  7. Is there any zero-step entrance (garage, back door)?

    Choices: Yes · No · Not sure

  8. Is there a ramp at any entrance?

    Choices: No ramp · Yes, and it works well · Yes, but it's steep, narrow, or hard to use · Not sure

Entrance

The walk up to the door.

  1. What is the walk up to the door made of?

    Choices: Solid and even — concrete, pavers, or a smooth path · Cracked, uneven, or lifting · Gravel, bark, or loose stone · Grass or dirt · Not sure

  2. Is the walk up to the door on a slope?

    Choices: Yes · No · Not sure

  3. Is the walk to the door clear of things to step over?

    Choices: Yes · No · Not sure

  4. After dark, is there enough light at the door to find the lock?

    Choices: Yes · No · Not sure

  5. Is the door easy to lock and unlock?

    Choices: Yes · No · Not sure

  6. Is there a raised lip at the bottom of the door to step over?

    Choices: Yes · No · Not sure

Throughout the home

Doorway widths.

  1. About how wide is the narrowest doorway you'd need to go through?

    Choices: About 20 inches · About 24 inches · About 26 inches · About 28 inches · About 32 inches · About 36 inches or wider · A different width — I'll type it · Not sure

  2. How wide is it, in inches? Only if it applies.

    You type the answer.

  3. Which doorway is that? Only if it applies.

    Choices: Bathroom · Bedroom · Closet · Somewhere else

  4. Which doorway is it? Only if it applies.

    You type the answer.

Bathroom

The main bathroom.

  1. Which bathroom are we talking about?

    Choices: It's the only bathroom in the home · The one off the bedroom · The main hall bathroom · A guest bathroom · Another one

  2. What's in the main bathroom you typically use?

    Choices: Tub only · Tub/shower combo · Shower with a curb/step · Walk-in shower, no step · Separate tub and shower · No working tub or shower

  3. Which of these fits best? Only if it applies.

    Choices: There is one, but it's broken or leaking · There isn't one in this bathroom · There is one that works, but I can't get in or out of it · Not sure

  4. Is it difficult getting in and out? Only if it applies.

    Choices: Yes · No · Not sure

  5. Are there grab bars where you bathe? Only if it applies.

    Choices: No grab bars · Some grab bars · Yes, well-placed and secure

  6. Is there a bench or seat to sit on in the tub or shower? Only if it applies.

    Choices: No, nothing to sit on · Yes, a built-in bench or ledge · Yes, a shower chair or tub seat we put in · Yes, a transfer bench that sits over the tub edge · Not sure

  7. Is there a handheld showerhead on a hose? Only if it applies.

    Choices: Yes · No · Not sure

  8. Is the toilet a comfortable height to get on and off of?

    Choices: Yes · No · Not sure

  9. Is there open floor space to move around in the bathroom?

    Choices: Yes · No · Not sure

  10. Is this bathroom on the main floor you live on? Only if it applies.

    Choices: Yes · No · Not sure

Bathroom

That same bathroom — the floor, the walls and the door.

  1. Are there grab bars beside the toilet?

    Choices: No · Yes, on one side · Yes, on both sides · Not sure

  2. What is the wall right beside the toilet? Only if it applies.

    Choices: Painted drywall · Tile · Wood panelling · There's no wall right beside it · Something else · Not sure

  3. What are the walls around the tub or shower made of? Only if it applies.

    Choices: Tile · A one-piece fiberglass or plastic surround · Large solid panels · Something else · Not sure

  4. What is the bathroom floor?

    Choices: Tile · Vinyl or linoleum · Wood or laminate · Carpet · Concrete · Something else · Not sure

  5. Does that floor get slippery when it's wet?

    Choices: Yes · No · Not sure

  6. Which way does the bathroom door open?

    Choices: It swings into the bathroom · It swings out into the hall · It slides · There isn't a door · Not sure

  7. At the bathroom sink, are the faucet handles levers or knobs you twist?

    Choices: Levers · Knobs you twist · One of each · Not sure

Kitchen

The kitchen.

  1. Is there good light over the stove and sink?

    Choices: Yes · No · Not sure

  2. Are the stove controls easy to reach from the front?

    Choices: Yes · No · Not sure

  3. Could you work at the counter or sink while seated, if needed?

    Choices: Yes · No · Not sure

  4. Could you prepare food sitting at the kitchen table, or somewhere else you can sit down? Only if it applies.

    Choices: Yes · No · Not sure

  5. Can you reach the things you use every day without stretching or bending far down?

    Choices: Yes · No · Not sure

  6. Do you need a step stool to reach anything in the cabinets? Only if it applies.

    Choices: Yes · No · Not sure

  7. Is anything in the refrigerator or freezer hard to reach? Only if it applies.

    Choices: Yes · No · Not sure

  8. Is it hard to open cans and jars?

    Choices: Yes · No · Not sure

  9. Is it hard to use a knife to cut or slice? Only if it applies.

    Choices: Yes · No · Not sure

  10. What kind of handles are on the cabinets and drawers?

    Choices: Round knobs · D-shaped or bar pulls · A mix of both · Not sure

Throughout the home

Doors inside the home.

  1. What kind of handles are on the doors inside?

    Choices: Round knobs · Lever handles you push down · A mix of both · Not sure

  2. Are any of the doors hard to open?

    Choices: Yes · No · Not sure

  3. Which ones, and what happens? Only if it applies.

    You type the answer.

Stairs

Stairs inside the home.

  1. Are there stairs inside the home you need to use? Only if it applies.

    Choices: Yes · Yes, but I stay on the first floor · No · Not sure

  2. Are there handrails on the stairs? Only if it applies.

    Choices: No handrails · One side · Both sides

  3. Can you reach your bedroom and a bathroom without using the stairs? Only if it applies.

    Choices: Yes · No · Not sure

  4. How many steps in the stairs to the upper floor, up to the first landing? Only if it applies.

    Choices: Fewer than 6 · About 6 to 10 · About 11 to 15 · More than 15 · Not sure

  5. What are the stairs to the upper floor made of? Only if it applies.

    Choices: Wood · Carpet · Something else · Not sure

  6. Do the stairs to the upper floor feel steep to you? Only if it applies.

    Choices: Yes · No · Not sure

  7. How many steps in the basement stairs, up to the first landing? Only if it applies.

    Choices: Fewer than 6 · About 6 to 10 · About 11 to 15 · More than 15 · Not sure

  8. What are the basement stairs made of? Only if it applies.

    Choices: Wood · Carpet · Something else · Not sure

  9. Do the basement stairs feel steep to you? Only if it applies.

    Choices: Yes · No · Not sure

Throughout the home

Floors and walkways.

  1. Are there any throw rugs or mats on the floors?

    Choices: Yes · No · Not sure

  2. Anything else underfoot that could catch a toe?

    You type the answer.

  3. Any raised door thresholds that could trip someone?

    Choices: Yes · No · Not sure

  4. Is there a step down into any room, or out to a patio or garage?

    Choices: Yes · No · Not sure

Throughout the home

Lighting at night.

  1. Is the path from bedroom to bathroom lit at night?

    Choices: Yes · No · Not sure

  2. Can you turn a light on as you walk into each room, without crossing the room in the dark?

    Choices: Yes · No · Not sure

Laundry

Laundry.

  1. Where is the laundry? Only if it applies.

    Choices: Main floor · Basement · Upstairs · No laundry in the home

Throughout the home

Pets in the home.

  1. Are there any pets in the home?

    Choices: Yes · No · Not sure

  2. What kind? Only if it applies.

    Choices: Dog · Cat · Something else

  3. What kind of pet? Only if it applies.

    You type the answer.

  4. Do they get underfoot, or have you ever nearly tripped over them or their things? Only if it applies.

    Choices: Yes · No · Not sure

  5. Anything else about them worth knowing? Only if it applies.

    You type the answer.

Throughout the home

Home safety equipment.

  1. Working smoke detectors?

    Choices: Yes, working · Have them, not sure they work · No · Not sure

  2. A carbon monoxide detector?

    Choices: Yes, working · Have one, not sure it works · No · Not sure

  3. A fire extinguisher?

    Choices: Yes, easy to reach · Have one, hard to reach · No · Not sure

  4. Any medical alert button or pendant?

    Choices: A wearable pendant or watch · A fixed button by the bed or in the bath · Both · None · Not sure

Throughout the home

Cameras for safety monitoring.

  1. Would you be comfortable with an indoor camera?

    Choices: Yes · No · Not sure · Prefer not to say

  2. What about an outdoor camera (entryways, driveway)?

    Choices: Yes · No · Not sure · Prefer not to say

  3. Who should be able to see the camera footage? Only if it applies.

    Choices: No one but me — I don't want it shared · Just me · My spouse or partner · My adult children · A caregiver who helps me · Someone else

  4. Who else should be able to see it? Only if it applies.

    You type the answer.

The Full Review walk-through

147 questions, about 30 to 45 minutes with a tape measure. Some appear only when they apply to your home. Answers marked private are never shown to a contractor.

Getting started

Before you start

  1. Do you have a tape measure handy?

    Choices: Yes · No, I'll estimate

    Private: never shown to a contractor.

  2. Is anyone walking through the home with you?

    Choices: I'm doing it on my own · A family member or friend is helping · Someone else is filling this in for me

    Private: never shown to a contractor.

  3. Do you own or rent this home?

    Choices: I own it · I rent it · A family member owns it · Other

    Private: never shown to a contractor.

  4. Could you get the owner's OK in writing for changes like grab bars or a ramp? Only if it applies.

    Choices: Yes · Probably · No · Not sure

    Private: never shown to a contractor.

  5. Which of these does the home have that you use?

    Choices: A living or family room · A separate dining area · A porch, patio or deck · A yard or garden · A walk-in closet · None of these

    Private: never shown to a contractor.

Daily life

How things go day to day

  1. How does bathing or showering go?

    Choices: On my own · On my own, with equipment · With some help from a person · Someone does it for me · I don't do this · Prefer not to say

    Private: never shown to a contractor.

  2. How does getting on and off the toilet go?

    Choices: On my own · On my own, with equipment · With some help from a person · Someone does it for me · I don't do this · Prefer not to say

    Private: never shown to a contractor.

  3. How does getting dressed go, including shoes and socks?

    Choices: On my own · On my own, with equipment · With some help from a person · Someone does it for me · I don't do this · Prefer not to say

    Private: never shown to a contractor.

  4. How does making a simple meal go?

    Choices: On my own · On my own, with equipment · With some help from a person · Someone does it for me · I don't do this · Prefer not to say

    Private: never shown to a contractor.

Daily life

Reaching, bending, carrying

  1. Can you carry a full laundry basket or a bag of groceries through the home?

    Choices: Yes, easily · Yes, but it's hard · No · Someone else does this

    Private: never shown to a contractor.

  2. Can you reach a shelf at shoulder height and take something down?

    Choices: Yes, easily · Yes, but it's hard · No · Not sure

    Private: never shown to a contractor.

  3. Can you bend down and pick something up from the floor?

    Choices: Yes, easily · Yes, but it's hard · No · Not sure

    Private: never shown to a contractor.

  4. Is it hard to turn a key, a round doorknob or a small light switch?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

Daily life

Strength and steadiness

  1. Is one side of your body stronger or steadier than the other?

    Choices: My left side is stronger · My right side is stronger · About the same · Not sure

    Private: never shown to a contractor.

  2. If you were down on the floor, could you get back up on your own?

    Choices: Yes · Yes, but it's hard · No · I don't know, and I wouldn't try · Prefer not to say

    Private: never shown to a contractor.

  3. Can you walk from one end of the home to the other without stopping to rest?

    Choices: Yes · I need to stop and rest · Only with someone's help · No

    Private: never shown to a contractor.

Daily life

Night and equipment

  1. On a typical night, how many times do you get up?

    Choices: None · Once · Twice · Three or more times · Prefer not to say

    Private: never shown to a contractor.

  2. Do you use any of these at home?

    Choices: Raised toilet seat · Toilet safety frame · Bedside commode · Bed rail · Lift or riser recliner · Hospital-style bed · Reacher or grabber · Oxygen with tubing · None of these

    Private: never shown to a contractor.

  3. Could you call for help from the bathroom and from the bedroom?

    Choices: Yes, from both · Only from one of them · From neither · Not sure

    Private: never shown to a contractor.

Entrance & outside

The door you use

  1. Which door do you use most to come and go?

    Choices: Front door · Side or back door · Through the garage · Another door

  2. How wide is the opening of that door?

    You measure it, in inches. An estimate is fine.

  3. How tall is one step at that door? Only if it applies.

    You measure it, in inches. An estimate is fine.

  4. From the ground up to the door sill, how high is it in total? Only if it applies.

    You measure it, in inches. An estimate is fine.

  5. Is there flat, open ground beside or in front of the steps where a ramp could go? Only if it applies.

    Choices: Yes, plenty · Some, but not much · No · Not sure

  6. At the top of the steps, is there a flat area big enough to stand on while you open the door? Only if it applies.

    Choices: Yes · No · Not sure

  7. If you hold the handrail and lean on it, does it stay solid? Only if it applies.

    Choices: Solid · It moves or wobbles · Not sure

  8. How high is the lip at the bottom of the door? Only if it applies.

    You measure it, in inches. An estimate is fine.

  9. What kind of handle does that door have?

    Choices: A lever · A round knob · A thumb latch you press · Not sure

  10. Can you see who's at the door before you open it?

    Choices: Yes, through a window or peephole I can use · Yes, with a doorbell camera · No · Not sure

  11. Is there somewhere by the door to set things down, or sit to take off shoes?

    Choices: A table or shelf · A bench or chair · Both · Neither

Entrance & outside

Getting to the door

  1. Can the house number be read from the street at night?

    Choices: Yes · No · Not sure

  2. How do you get your mail?

    Choices: A mailbox at the door · A slot in the door · A mailbox at the curb or street · A cluster box or post office down the street · Someone brings it to me

  3. Where do you get in and out of a car at home?

    Choices: In the garage · On the driveway · On the street · I don't use a car at home

  4. Is the path from there to the door lit at night? Only if it applies.

    Choices: Yes · No · Not sure

  5. How wide is the walk up to the door, at its narrowest? Only if it applies.

    You measure it, in inches. An estimate is fine.

  6. Add a photo of the door you use most, taken from the walk.

    An optional photo.

Living areas

Where you sit

  1. Does the chair you sit in most have armrests to push up from?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  2. Is it hard to get up from that chair?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  3. With your walker or cane, is there room to walk between the furniture? Only if it applies.

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  4. Do any cords cross the places you walk? Only if it applies.

    Choices: Yes · No · Not sure

  5. To turn on a lamp, do you have to reach behind furniture or cross a dark room? Only if it applies.

    Choices: Yes · No · Not sure

  6. Are tall pieces, like bookcases or the TV, fastened to the wall? Only if it applies.

    Choices: Yes, all of them · Some · No · Nothing tall · Not sure

Living areas

Meals

  1. Where do you eat most meals?

    Choices: At a table · At a counter, on stools · In my chair, on a tray · Somewhere else

    Private: never shown to a contractor.

  2. Do the chairs at that table have armrests? Only if it applies.

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  3. Add a photo of the room you spend the most time in, from its doorway.

    An optional photo.

Bedroom & closets

Your bedroom

  1. Which floor is the bedroom you sleep in on?

    Choices: The main floor · Upstairs · The basement · Not sure

  2. Is there a full bathroom on the same floor as that bedroom?

    Choices: Yes · No · Not sure

  3. How high is the top of your mattress from the floor?

    You measure it, in inches. An estimate is fine.

    Private: never shown to a contractor.

  4. Can you get in and out of bed from either side?

    Choices: Either side · Only one side · Not sure

    Private: never shown to a contractor.

  5. Is there open space beside the bed for your walker or wheelchair to turn? Only if it applies.

    Choices: Yes · No · Not sure

  6. From bed, can you turn on a light without getting up?

    Choices: Yes · No · Not sure

  7. Is there a phone and a flashlight you can reach from bed?

    Choices: Both · Only a phone · Only a flashlight · Neither

    Private: never shown to a contractor.

  8. Can the bedroom window be opened easily, in case you needed to get out that way?

    Choices: Yes · It's stuck or hard to open · It doesn't open · Not sure

Bedroom & closets

Closet

  1. Is there a light in the closet you use?

    Choices: Yes · No · Not sure

  2. Can you reach the clothes rod and the shelves you use without stretching or a step stool?

    Choices: Yes · No · Not sure

  3. Is there somewhere to sit while you get dressed?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  4. Add a photo of the bed and the way to the bedroom door.

    An optional photo.

Bathroom

Measure the bathroom

  1. How high is the toilet seat?

    You measure it, in inches. An estimate is fine.

  2. How wide is the bathroom doorway?

    You measure it, in inches. An estimate is fine.

  3. How high is the side of the tub? Only if it applies.

    You measure it, in inches. An estimate is fine.

  4. How high is the step or curb into the shower? Only if it applies.

    You measure it, in inches. An estimate is fine.

  5. Could a 5-foot circle fit on the open floor? Only if it applies.

    Choices: Yes · No · Not sure

Bathroom

Holding on

  1. Do you ever hold a towel bar, the sink or a soap dish to steady yourself?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  2. Are any grab bars or handles held on with suction cups? Only if it applies.

    Choices: Yes · No · Not sure

Bathroom

Tub and shower

  1. What's across the tub or shower opening? Only if it applies.

    Choices: A glass door · A curtain · Nothing · Not sure

  2. Can you turn the water on and set the temperature before you step in? Only if it applies.

    Choices: Yes · No · Not sure

  3. Does the shower ever turn suddenly hot or cold, like when a toilet is flushed?

    Choices: Yes · No · Not sure

  4. Is there a night light in the bathroom?

    Choices: Yes · No · Not sure

  5. Can you reach the toilet paper while seated, without twisting?

    Choices: Yes · No · Not sure

  6. Is there another toilet you use, like a half bath?

    Choices: No · Yes, on the same floor · Yes, on another floor

Bathroom

Photos

  1. Add a photo of the tub or shower, taken from the bathroom doorway.

    An optional photo.

  2. Add a photo of the toilet and the walls on both sides of it.

    An optional photo.

Kitchen

Appliances

  1. Where is the microwave?

    Choices: Above the stove · On the counter · Built in at counter height or lower · In the wall above the counter · No microwave

  2. Where is the oven you use?

    Choices: In the stove, down low · In the wall, about waist height · I don't use an oven

  3. What kind of refrigerator is it?

    Choices: Freezer on top · Freezer on the bottom · Side by side · French doors · Not sure

  4. Do the stove and small appliances turn themselves off if left on?

    Choices: Yes · Some do · No · Not sure

Kitchen

Storage and safety

  1. Do the lower cabinets have pull-out drawers or shelves?

    Choices: Mostly pull-outs · Some · No, fixed shelves · Not sure

  2. Is there a fire extinguisher you can reach from the stove?

    Choices: Yes · No · Not sure

  3. How high is the counter where you prepare food? Only if it applies.

    You measure it, in inches. An estimate is fine.

  4. At a glance, can you tell where the counter edge ends and the floor begins? Only if it applies.

    Choices: Yes · No · Not sure

  5. Add a photo of the kitchen from the doorway, showing the stove and sink.

    An optional photo.

Hallways, doors & floors

Hallways

  1. How wide is the narrowest hallway you use?

    You measure it, in inches. An estimate is fine.

  2. How wide is your walker or wheelchair? Only if it applies.

    You measure it, in inches. An estimate is fine.

  3. Are there light switches at both ends of the hallways?

    Choices: Yes · No · Not sure

Hallways, doors & floors

Switches and outlets

  1. What kind of light switches does the home mostly have?

    Choices: Small flip switches · Wide rocker switches you press · A mix · Not sure

  2. Do you have to bend down near the floor to plug things in?

    Choices: Yes · No · Not sure

Hallways, doors & floors

Clutter, windows, power cuts

  1. Are there piles of things on floors or along the walls where you walk?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  2. Are the windows you open easy to open and close?

    Choices: Yes · Some are hard · Most are hard · I don't open them

  3. Is there a flashlight in more than one room?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  4. Add a photo of the hallway from the bedroom toward the bathroom.

    An optional photo.

Stairs

The stairs

  1. What shape are the stairs? Only if it applies.

    Choices: Straight · They turn at a landing · They curve or wind around · Not sure

  2. What's on each side of the stairs? Only if it applies.

    Choices: Walls on both sides · A wall on one side, open railing on the other · Open on both sides · Not sure

Stairs

Measure the stairs

  1. How tall is one step? Only if it applies.

    You measure it, in inches. An estimate is fine.

  2. How deep is one step, front to back? Only if it applies.

    You measure it, in inches. An estimate is fine.

  3. How wide are the stairs? Only if it applies.

    You measure it, in inches. An estimate is fine.

Stairs

Using the stairs

  1. Can you turn the stair lights on from both the top and the bottom? Only if it applies.

    Choices: Yes · No · Not sure

  2. Do the handrails run past the top and bottom steps? Only if it applies.

    Choices: Yes · No · Not sure

  3. Can you easily see where each step's edge is? Only if it applies.

    Choices: Yes · No · Not sure

  4. Do you carry things up or down these stairs? Only if it applies.

    Choices: Often · Sometimes · Never

    Private: never shown to a contractor.

  5. Add a photo of the stairs from the bottom. Only if it applies.

    An optional photo.

Laundry

Laundry

  1. Who does the laundry? Only if it applies.

    Choices: I do · Someone who lives here · Someone who comes in · A laundry service

    Private: never shown to a contractor.

  2. What kind of washer and dryer are they? Only if it applies.

    Choices: Top-loading washer · Front-loading, on the floor · Front-loading, raised on pedestals · Stacked · Not sure

  3. Can you reach the detergent without lifting a heavy jug from the floor or a high shelf? Only if it applies.

    Choices: Yes · No · Not sure

  4. Is there a place to fold clothes at a comfortable height? Only if it applies.

    Choices: Yes · No · Not sure

  5. Add a photo of the washer and dryer. Only if it applies.

    An optional photo.

Garage & parking

Garage

  1. How many steps from the garage into the house? Only if it applies.

    Choices: None · 1 · 2 · 3 · 4 or more · There's no door into the house

  2. Is there a handrail on those steps? Only if it applies.

    Choices: No · One side · Both sides

  3. From the garage floor up to the door sill, how high is it in total? Only if it applies.

    You measure it, in inches. An estimate is fine.

  4. Does the garage door open with a button, and stop if something is in the way? Only if it applies.

    Choices: Yes, both · It has an opener, not sure about the safety stop · No opener · Not sure

  5. Can you turn on the garage light from the door to the house? Only if it applies.

    Choices: Yes · No · Not sure

  6. Is there room to open the car door all the way and get out? Only if it applies.

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  7. Add a photo of the steps from the garage into the house. Only if it applies.

    An optional photo.

Yard & upkeep

Upkeep

  1. Who takes care of the yard, snow and gutters?

    Choices: I do · Family · A paid service · The landlord or homeowners association · No one right now

    Private: never shown to a contractor.

  2. Do you climb a ladder or step stool for anything, like gutters, light bulbs, smoke alarms or high shelves?

    Choices: Often · Sometimes · Never

    Private: never shown to a contractor.

  3. Does your area get snow or ice?

    Choices: Every winter · Some winters · Rarely or never

  4. How far do you take the trash and recycling bins?

    Choices: Not far, they're by the door · Down a driveway to the curb · Someone else does it

    Private: never shown to a contractor.

Yard & upkeep

Porch and patio

  1. Is the porch, patio or deck surface even and in good repair? Only if it applies.

    Choices: Yes · No · Not sure

  2. Add a photo of the porch, patio or deck, and the step out to it. Only if it applies.

    An optional photo.

Home systems & safety

Water and electricity

  1. Is the water heater set at 120°F or lower?

    Choices: Yes · No · I don't know

  2. Do the outlets by the sinks have TEST and RESET buttons?

    Choices: All of them · Some · None · Not sure

  3. Do lights flicker, breakers trip often, or any outlets or switches feel warm?

    Choices: Yes · No · Not sure

  4. Can you reach the breaker panel easily, and are the switches labeled?

    Choices: Yes, easy to reach and labeled · Easy to reach, not labeled · Hard to reach · I don't know where it is

Home systems & safety

Alarms

  1. Does the home have any of these?

    Choices: A gas stove or oven · A gas or oil furnace or water heater · A fireplace or wood stove · An attached garage · None of these · Not sure

  2. Is there a carbon monoxide alarm on each level, including near the bedrooms? Only if it applies.

    Choices: Yes · On some levels · No · Not sure

  3. Is there a smoke alarm on every level and near every bedroom?

    Choices: Yes · In some places · No · Not sure

  4. In bed, with the door closed, would you hear the smoke alarm?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  5. If the main door were blocked, is there another way out of the home?

    Choices: Yes · No · Not sure

Home systems & safety

Comfort and power

  1. Is any room you use too hot or too cold to be comfortable?

    Choices: Yes · No · Not sure

  2. Can you reach and read the thermostat?

    Choices: Yes · No · Not sure

  3. Does anything you rely on need electricity?

    Choices: An oxygen machine · A power chair or scooter charger · A lift chair or hospital-style bed · Something else · Nothing

    Private: never shown to a contractor.

  4. If the power went out, would you still have a working phone?

    Choices: Yes, a charged cell phone · Yes, a landline that works without power · No · Not sure

    Private: never shown to a contractor.

  5. Is there internet (Wi-Fi) in the home?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  6. Would any of these help you?

    Choices: A video doorbell · A lock that opens with a code or phone · Lights you can turn on by voice · A thermostat you control from a phone · A doorbell or alarm with a flashing light · None of these

    Private: never shown to a contractor.

Planning

Your plans

  1. How long do you hope to live in this home? Only if it applies.

    Choices: Less than a year · 1 to 5 years · 5 to 10 years · More than 10 years · As long as possible

    Private: never shown to a contractor.

  2. Roughly how much could you spend on changes to the home?

    Choices: Under $1,000 · $1,000 to $5,000 · $5,000 to $15,000 · $15,000 to $50,000 · More than $50,000 · Not sure yet · Prefer not to say

    Private: never shown to a contractor.

  3. How might the work be paid for?

    Choices: Savings · Help from family · Long-term care insurance · Veterans benefits · A local or state program · A loan or home equity · Not sure · Prefer not to say

    Private: never shown to a contractor.

  4. Have you, or a spouse, served in the U.S. military?

    Choices: Yes · No · Prefer not to say

    Private: never shown to a contractor.

  5. Who decides on changes to the home?

    Choices: Me · Me, together with family · A family member · Someone with power of attorney · Not sure

    Private: never shown to a contractor.

Planning

Getting it done

  1. Is there someone handy who could do small jobs, like putting in night lights or securing rugs?

    Choices: Yes · No · Not sure

    Private: never shown to a contractor.

  2. Would you rather have the work done all at once, or in stages?

    Choices: All at once · In stages, most urgent first · Not sure

    Private: never shown to a contractor.

  3. If the bathroom were out of use for a week or two, could you manage?

    Choices: Yes, there's another bathroom here · Yes, I could stay somewhere else · No · Not sure

    Private: never shown to a contractor.

  4. Does a homeowners association or historic district have to approve outside changes, like a ramp?

    Choices: Yes · No · Not sure · There isn't one

Planning

Getting around

  1. How do you usually get to appointments and the store?

    Choices: I drive · Family or friends drive me · A taxi or ride app · A bus, train or senior ride service · I walk · I don't go out much

    Private: never shown to a contractor.

  2. Do you expect to stop driving in the next few years? Only if it applies.

    Choices: Yes · Maybe · No

    Private: never shown to a contractor.

Planning

Looking ahead

  1. Is anything coming up in the next six months that will change how you get around, like a surgery, a hospital stay or new equipment?

    Choices: Yes · No · Not sure · Prefer not to say

    Private: never shown to a contractor.

  2. Which room or task worries you most?

    Choices: Getting in and out of the home · The bathroom · The stairs · The kitchen · Getting around at night · Something else

    Private: never shown to a contractor.

  3. Anything else about the home or your routine we should know?

    You type the answer.

    Private: never shown to a contractor.