Activity Participation Attendance Log

Daily log for recording resident attendance at scheduled activities, engagement level, and brief participation notes for senior living programming and MDS Section F documentation.

Log Details

• Date of Activity Session
  Select the date on which this activity took place.
• Staff Member Completing Log
• Staff Title / Role
• Unit / Neighborhood
  Select the unit or neighborhood where the activity was held.

Scheduled Activity Information

• Activity Name
• Activity Category
  Select the category that best describes this activity for programming analysis.
• Scheduled Start Time
• Scheduled End Time
• Actual Duration (minutes)
• Activity Location
• Activity Format
• Adaptive Equipment or Accommodations Used
  Select all accommodations provided to support resident participation (ADA reasonable accommodation).

Attendance and Participation

• Total Residents Invited / Scheduled
• Total Residents Who Attended
• Total Residents Who Declined
• Total Residents Unable to Attend (health, appointment, etc.)
• Individual Resident Participation Log
  Enter one row per resident who attended. Engagement levels: 4 = High (active, enthusiastic); 3 = Moderate (engaged, responsive); 2 = Low (present, minimal interaction); 1 = Passive (present, no observable interaction). Aligns with MDS Section F0400 coding guidance.
• Overall Group Engagement Rating
  Rate the overall engagement level of the group during this session (1 = Very Low, 5 = Excellent).

Follow-Up and Review

• Notable Observations or Behavioral Changes
• Is Follow-Up Action Required?
• Type of Follow-Up Needed
  Select all that apply.
• Follow-Up Details
• Programming Feedback (for Activity Director Review)
  This feedback is used to evaluate and improve the activity calendar. It is not part of the resident clinical record.
• Flag for Supervisor Review
  Check this box if this log entry requires review by the Activity Director or Department Head before filing.
• Staff Signature
  By signing, you confirm that the information recorded in this log is accurate and complete to the best of your knowledge.
• Log Submission Time
  Automatically recorded when the form is submitted. Used for audit trail purposes.