Visiting an Adult Day Center: A Checklist of What to Ask and Watch
What to check before, during and after a visit to an adult day care center.
A brochure and a phone call tell you very little about an adult day center. The only way to judge one is to visit while the program is running, ideally more than once, and to bring a list. This checklist covers what to verify before the visit, what to watch for while you are there, and what to ask the director. It is written for families, but it is just as useful for a participant who is choosing for themselves.
Before you visit: check the license or registration
Look the center up with the state agency first. In Texas, adult day centers are licensed by HHSC as Day Activity and Health Services facilities, and HHSC publishes directories of facilities with an active license, plus a list of closures (Texas HHSC: DAHS). In Missouri, the Department of Health and Senior Services licenses adult day care programs and publishes a directory (Missouri DHSS). In New York City, social adult day care programs must register with NYC Aging, which publishes the list of registered programs and takes complaints through 311 (NYC Aging). Other states use their health or social services department.
A listing here shows what the source says, such as a license number, licensed capacity, hours or an NPI. It does not rate quality. If a center you are considering is not on its state's list, ask it which license or registration it holds and confirm that with the state.
Fit: hours, days and transportation
- Which days and hours is the program open, and do they match your work schedule? Is there early drop-off or late pick-up, and does it cost more?
- Is there a minimum number of days per week?
- Does the center provide transportation, from which areas, and is it door-to-door with help in and out of the vehicle? How long is the longest ride?
- What happens on holidays and in bad weather?
Who the program serves
- How many participants attend on a typical day, and how many is the center licensed for? (Missouri and Texas listings here show the licensed capacity.)
- What are the participants like: age range, how many have dementia, how many use wheelchairs? Would your family member find peers here?
- Are there admission criteria, an assessment, or a doctor's form? What conditions would mean a participant has to leave, and how much notice is given?
Staffing and care
- How many direct care staff are on the floor at a time? Missouri's rule, for comparison, requires at least two direct care staff when 2 to 16 participants are present and one more for each additional eight participants or part of eight (19 CSR 30-90.040).
- Is there a nurse on site, and for how many hours? In Texas, DAHS services are overseen by a licensed nurse.
- Who gives medications, and how are they stored and recorded?
- What training do staff have in dementia care, transfers and first aid? How long have the director and key staff been there?
- Is help with toileting, bathing or incontinence available, and does it cost extra?
Dementia care and safety
- How are exits secured, and what is the plan if a participant tries to leave?
- Is there a separate group or room for people with dementia? In Missouri, a program that markets dementia care must file an Alzheimer's special care disclosure with the state, covering staff training, activities, environment, safety and costs. Ask to see it.
- How does staff handle agitation or distress? Ask for an example.
Activities and meals
- Ask for this month's activity calendar, and check whether what you see on your visit matches it.
- Are activities adapted for different abilities, or is everyone doing the same thing?
- Is there exercise, outdoor time, music, art, or something the participant already enjoys?
- What is served for lunch and snacks? Can the kitchen handle diabetic, low-salt, pureed or cultural diets?
What to watch for during the visit
- Are participants engaged, or mostly sitting in front of a television?
- Do staff speak to participants by name, at eye level, with patience?
- Is the building clean, well lit and free of strong odors? Are bathrooms accessible and close by?
- Is there a quiet space for rest, and somewhere to lie down?
Communication and emergencies
- How will the center tell you about the day: a notebook, an app, a phone call?
- Who decides to call 911, and how quickly will you be called?
- What is the plan for a fire, power cut or severe weather?
- Will you get a written care plan, and how often is it reviewed with you?
Cost and paperwork
- Get the full fee schedule in writing: daily rate, half-day rate, extras, enrollment fees, and the policy for absences and holidays.
- Which payers does the center accept: Medicaid, a Medicaid health plan, the VA, long-term care insurance? Our guide on paying for adult day care explains each.
- Read the enrollment agreement before signing, including how either side can end it.
Bring the participant, if you can
If the person who will attend is able to come along, bring them for at least part of a visit, or arrange a free trial day if the center offers one. Watch how staff greet them and whether they are drawn into an activity. Ask them afterwards what they liked and what worried them; their comfort matters as much as any checklist item.
After you choose
Plan a gradual start, perhaps a few half days, and expect an adjustment period. Keep talking to staff during the first weeks. If you have a concern about care or safety that the center does not resolve, contact the state agency that licenses or registers it; the link is on the center's profile here. If someone is in immediate danger, call 911.
General information only, current as of the date above. The information on Adult Day Care Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.