How to tour an adult family home (checklist)

A good tour of an adult family home lasts 30–45 minutes and teaches you more about the home in the first 10 minutes than most families realize. Most of what you’ll notice isn’t on the walls — it’s in how the staff moves, what the residents look like, and what questions the provider can (or can’t) answer on the spot. This checklist is what we use when we tour AFHs on behalf of families in Pierce County.

Before the tour

• Ask for the home’s DSHS license number and look up the recent inspection report at dshs.wa.gov.
• Confirm the home’s specialty designation (Dementia, Mental Health, Developmental Disability) if relevant.
• Ask the home to send the care-services contract and monthly rate sheet in writing beforehand.
• If possible, schedule the tour at mealtime or late afternoon — you see how the staff handles a busy hour, not just the quiet mid-morning.

The first 10 minutes — what to watch

• How the provider greets you. Relaxed and friendly, or distracted? Does the provider know the residents’ names as they walk past?
• The smell. Strong cleaning-product smell masking something, or the reasonable mix of a home with 6 residents (some cooking, some hand soap, some laundry)? Neither extreme is ideal; clean-adjacent neutral is the right baseline.
• The residents themselves. Are they dressed and groomed? Do they look engaged — even if not active? Lethargy across the whole house is a warning sign.
• The staff. Is more than one caregiver visible during the tour? Do they move with purpose without rushing? Do they acknowledge the tour without breaking from whatever resident they were working with?

What to ask the provider

About the home’s operations

• How long have you been operating this home?
• What’s your caregiver-to-resident ratio during the day? Overnight?
• What’s caregiver turnover in the past 12 months?
• How do you handle an emergency — medical, behavioral, fire?
• Who’s the backup caregiver when the primary is off-shift?

About care specifics

• How do you handle two-person transfers? (Relevant if applicable.)
• What’s your experience with dementia and sundowning?
• How do you manage medication reconciliation?
• Can you describe a recent care plan change? What prompted it and how did you communicate with family?
• What happens if my parent’s care needs increase beyond what your home can provide?

About cost and contracts

• Is your rate all-inclusive, or are there add-ons?
• What’s your process for rate increases?
• Do you accept new Medicaid residents? If not, would my parent be able to stay after spending down?
• What’s your discharge policy — under what circumstances would you ask my parent to leave?

What to see on the tour

• Rooms residents actually live in — not just the marketing room. Ask to see an occupied room (with the resident’s permission) to understand what the space feels like in practice.
• Common spaces at rest. Is the TV blaring? Are residents clustered together with attention, or scattered and disengaged?
• The kitchen. Is food being prepared? Is the pantry stocked? Do dietary restrictions show up in the meal plan?
• The bathroom used by residents. Grab bars, accessibility, cleanliness, modifications appropriate to the residents’ needs.
• Outdoor space. Is there a patio or garden? Can residents access it? Is it secured if the home serves dementia residents with exit-seeking risk?

After the tour

• Request the care-services contract in writing. Read it. Especially the discharge and rate-increase clauses.
• Ask for the current caregiver schedule with hours — it’s not usually shared, but some homes will.
• Ask for references from current families. Not every home will provide them; the ones that do often are confident in their quality.
• Compare notes with your placement advisor if you’re working with one.

Red flags

• Provider can’t answer basic operations questions (turnover rate, ratio overnight, emergency process).
• Residents look unkempt or lethargic across the house.
• Strong masking smell — air freshener covering something.
• Staff visibly stressed or inattentive during the tour.
• Care contract has language giving the home broad authority to raise rates mid-year without notice.
• Recent DSHS survey with unresolved deficiencies.
• Provider pushes you toward immediate deposit “to hold the bed” on the first tour.

Touring with a placement advisor

When we accompany families on tours, we usually ask the questions above and watch for the red flags. Having someone whose only job is to observe the home — not sell to the family, not manage the resident — changes the signal-to-noise ratio. Families often notice things in hindsight (“the caregiver never smiled”) that an observer would’ve flagged in real time.

If you’d like us to help with tours, start here. Free consultation.