CNA ADL Documentation Sheet

Shift-based CNA flowsheet for documenting activities of daily living (ADLs), assistance provided, resident response, and follow-up notes with a clear audit trail.

Shift and Resident Identification

• Shift Date
• Shift Start Time
• Shift End Time
• Resident Identifier
  Use the facility-approved resident ID or chart identifier. Avoid entering unnecessary PII.
• Unit or Room

ADL Assistance Provided

• Which ADLs were completed during this shift?
• Bathing assistance level
• Dressing assistance level
• Toileting assistance level
• Transfer assistance level
• Ambulation assistance level
• Feeding assistance level
• Oral care assistance level
• Incontinence care provided?

Observations and Resident Response

• Resident tolerated care?
• Skin, mobility, or safety observations
  Document only observable findings relevant to care, such as redness, pain, refusal, or transfer concerns.
• Follow-up needed?
• Follow-up details

Attestation and Submission

• Documented by
  Enter your name or employee identifier according to facility policy.
• Role
• I attest that this documentation is accurate and reflects the care provided during this shift.