Residences

What levels of care are provided in the home as licensed by the Department of Social Development? (Select all that apply):

Number of beds (Level 2)

Number of beds (Level 3B)

Number of beds (Level 3G)

Number of beds (Level 4)

What type of specialty bed services do you need in the home? (Select all that apply):

Number of beds (Relief beds)

Number of beds (Emergency beds)

What other long term care, housing or seniors services are offered on the property? (Select all that apply):

Number of units (Independent living retirement living or assisted living)

Number of beds (Nursing Home)

Number of units (Apartment(s))

What are the Language(s) spoken by residents in the home?

Please specify:

Please select all the additional charges to the basic monthly fees that you are willing to accept. (Select all that apply):

Clientele served in home: (Select all that apply):

Please Specify:

Select the age group(s) you are interested in (Select all that apply):

What are the current resident ages that you are seeking? (Select all that apply):

Which genders are you needing services provided for? (Select all that apply):

Which special diets are accommodated at the home? (Select all that apply):

Age of physical structure you are looking for. (Select all that apply):

Which floors (levels) are you interested in within the facility? (Select all that apply)

Does the Operator/Owner live onsite?

Which building style are you interested in? (Select all that apply):

What types of resident room(s) are onsite?

Enter number of rooms (Private basement/lower level)

Enter number of rooms (Shared basement/lower level)

Enter number of rooms (Private main level)

Enter number of rooms (Shared main level)

Enter number of rooms (Private Upper level(s))

Enter number of rooms (Shared Upper level(s))

Does the home have an elevator?

Is the main level of the home wheelchair accessible?

Can a resident bring their pet to live with them?

Please describe:

Please specify:

Does the home have a pet that lives on premises?

Please Specify:

Please specify:

The home located near a bus stop? (ten minutes walk)

The home is located near services/shop (ten minute walk)

Does the home offer any of the following services or amenities to residents? (Select all that apply)

Technology:

Living Spaces

Access to health care providers:

Patient and Health Monitoring Services

Services for residents

Adaptive Equipment:

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