Loading...

Run: Functional Cognition Performance Assessment

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

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Assessment Setup and Safety

Workspace should allow safe observation of the task without immediate hazards.
Examples may include kettle, cup, water source, utensils, ingredients, or written instructions.
Rate the participant's initial comprehension of the task goal and steps.
Select any observed risks present before task initiation.

Task Initiation and Planning

Assess whether the participant begins the task in a timely manner.
Observe whether the participant can state or demonstrate the correct order of steps.
Evaluate whether materials are gathered and arranged efficiently.
Record the highest level of cueing required during task initiation and planning.

Sequencing, Problem-Solving, and Safety

Assess whether the participant follows the expected order of operations.
Examples include overfilling, forgetting a step, using the wrong item, or unsafe handling.
Observe attention to heat, water, sharp objects, spills, and appliance use.
Examples include missing item, changed instructions, or minor spill.

Task Completion and Assistance Level

Select the highest level of assistance required during the assessment.
Indicate whether the participant completed the observed task to an acceptable standard.
Assess the end result of the task, such as prepared beverage, meal component, or organized materials.

Observations, Recommendations, and Follow-Up

Document strengths such as attention, memory, problem-solving, or self-correction.
Document barriers such as poor sequencing, distractibility, impulsivity, or reduced insight.
Select supports that may improve task performance or safety.
Indicate whether reassessment, referral, or additional intervention is recommended.

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Generated with MangoApps Templates — browse 250+ free
Ask AI Product Advisor

Hi! I'm the MangoApps Product Advisor. I can help you with:

  • Understanding our 40+ workplace apps
  • Finding the right solution for your needs
  • Answering questions about pricing and features
  • Pointing you to free tools you can try right now

What would you like to know?