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Run: Functional Cognition Performance Assessment

Functional Cognition Performance Assessment template for documenting how a person starts, plans, sequences, and safely completes real-world kitchen or execut...

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Assessment Setup and Safety

Assessment purpose and task selected are documented

Record the real-world task(s) selected for observation and the reason for assessment.

Environment is safe and appropriate for observation critical (required)

Workspace is free of immediate hazards, with adequate lighting, stable surfaces, and no unsafe distractions.

Yes No N/A

Required materials and tools are available

All items needed to complete the selected task are present and accessible.

Yes No N/A

PPE or adaptive equipment used as indicated

Document whether gloves, mobility aids, adaptive utensils, timers, or other supports were used.

Yes No N/A

Baseline level of assistance established

Select the highest level of assistance anticipated at task start.

Task Initiation and Planning

Initiates task within a reasonable time

Assesses whether the person begins without excessive delay, refusal, or repeated prompting.

Identifies task goal and required steps

Demonstrates understanding of what needs to be completed and the general plan.

Yes No N/A

Organizes materials before starting

Observes whether items are gathered and arranged in a logical order before task execution.

Requires cues to begin or continue

Select the highest level of cueing needed during initiation and early planning.

Plans sequence before acting

Shows evidence of mentally or verbally organizing the order of steps before starting.

Yes No N/A

Sequencing and Task Execution

Completes steps in logical order critical (required)

Observe whether steps are completed in a correct and efficient sequence.

Maintains task set without losing place

Does not repeatedly forget the current step or abandon the task midstream.

Yes No N/A

Completes task with minimal errors

Rates the frequency and impact of errors such as omissions, reversals, or incorrect actions.

Self-corrects errors when recognized

Identifies and corrects mistakes without external intervention when possible.

Yes No N/A

Completes task within expected time

Record the observed completion time in minutes.

Safety Awareness, Judgment, and Problem-Solving

Recognizes and avoids immediate safety hazards critical (required)

Includes awareness of heat, sharp objects, spills, appliance use, and unsafe reach or posture.

Yes No N/A

Uses safe judgment with appliances, heat, or sharp tools critical (required)

Observe whether decisions reflect safe use of kitchen equipment and tools.

Responds appropriately to unexpected changes or errors

Examples include missing ingredients, misplaced items, or a change in instructions.

Requests help when needed

Asks for assistance at an appropriate time rather than persisting unsafely or becoming stuck.

Yes No N/A

Demonstrates awareness of personal limits

Select the best description of insight into limitations affecting task performance.

Task Completion, Assistance Level, and Observations

Overall task completion status critical (required)

Select the final outcome of the observed task.

Highest level of assistance required

Document the most support needed at any point during the task.

Behavioral observations

Record relevant observations such as frustration tolerance, attention, persistence, distractibility, or impulsivity.

Recommendations and follow-up

Document suggested supports, supervision needs, therapy recommendations, or environmental modifications.

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