Daily Record Form – A New Client TEST








  • MM slash DD slash YYYY

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  • please comment







  • Did the client brush their teeth on their own?
  • CM specify level of support HERE| Prompt Level
  • Prompt Level needed to complete activity. Refer to Guidelines.
  • Detail how client and team have worked towards their goals – note goal number and title
  • Actions or Practice as Specified in Care Plan Guidelines – detail how client and team have followed their care plans
  • Temper/ behavioural outbursts complete a separate ABC, note here if separate ABC completed
  • Record cognitive difficulties observed below and strategies used to assist | Prompt Level
  • e.g. hydro, gym, note client ability / any problems / needed prompting | Prompt Level
  • Include Matters or Concerns Regarding CLIENTS Health and Well-Being or Requests Made for Assistance Over and Above That Agreed in The Care Plan
  • Brief description – Fill in form and email to CM/ACM
  • Note sleep hygiene