Assess Your Needs

We know you want to make the right decision for your loved one, but with so many care options out there, it’s not an easy task. We’re here to help!

Answer some questions in our Care Assessment (only takes a few minutes), and a local senior care advisor will contact you right away and walk you through the process, or simply give us a call at (619) 660-8814.

What do you get?

A pre-screened list of licensed care providers with immediate openings that match your loved one’s unique needs and budget
Professional assistance and support as long as you need it
All for FREE with no obligation!

Care Assessment

Fields marked with * are required

Your First Name *

Your Last Name *

Your Phone Number *

Your Email *

Where are you seeking Care?

Enter city or zip code

How quickly do you need to make a decision?

The senior in need of care is currently at:

I'm seeking care at a:

How many seniors are you seeking care for?

I'm inquiring for my:

Senior in need of care:

Name

Age

Gender

Male
Female

Approx. Weight

Is the senior or their spouse a Veteran?

Best describe their level of care needs:

Do they require injections?

In order to get the care they need, this person:

What are the biggest challenges you will face in making the transition? (select all that apply)

Paying for adequate care
Convincing my loved one that a change is required
Getting all family members in agreement on what to do
Finding the right facility that meets my loved one’s unique needs
Other

Based on your budget, what's the MINIMUM class of community you are looking for?

Please select your MAXIMUM PER PERSON monthly budget. (This will not stop us from finding lower cost options as long as they can provide adequate care for your loved one's needs)

What funding source(s) do you plan to use to cover the senior living costs? (select all that apply)

Private funds (income or savings)
Long-term care insurance
TRICARE (military)
Medicare/Medi-Cal
Supplemental Security Income (SSI)

Bathing

Accomplishes Alone
Needs Some Help
Needs Much Help

Getting Dressed

Accomplishes Alone
Needs Some Help
Needs Much Help

Feeding Self

Accomplishes Alone
Needs Some Help
Needs Much Help

Eating a nutritious diet

Accomplishes Alone
Needs Some Help
Needs Much Help

Walking

Accomplishes Alone
Needs Some Help
Needs Much Help

Using the toilet

Accomplishes Alone
Needs Some Help
Needs Much Help

Getting out of bed or a chair

Accomplishes Alone
Needs Some Help
Needs Much Help

Taking medications

Accomplishes Alone
Needs Some Help
Needs Much Help

Health

Good
Moderate
Poor

Mobility

Good
Moderate
Poor

Balance

Good
Moderate
Poor

Memory

Good
Moderate
Poor

Managing daily activities

Good
Moderate
Poor

Managing medications

Good
Moderate
Poor

Decision making

Good
Moderate
Poor

Managing finances

Good
Moderate
Poor

Any additional information you'd like us to know?