Most families tour two to four assisted living communities before making a placement decision. Most families also leave those tours having asked fewer than a third of the questions that actually matter. This is not a criticism — the tour experience is designed to be a guided marketing presentation, not an interrogation. The sales counselor controls the agenda, the timing, and the sequence of rooms you see. If you do not have your own questions ready, you will leave with a brochure and a feeling, not the information you need.
This checklist is what we actually use when touring on behalf of Phoenix-area families. It covers the seven categories of questions that consistently separate good communities from communities that look good on tour. Print it and bring it. On a two-hour tour, you have time for all 47.
Before you go: ADHS Care Check
Before you set foot in any Arizona ALF, pull the facility's inspection history from the ADHS Care Check portal at azdhs.gov. Search the facility name and download the most recent survey report and any complaint investigation reports. Read the deficiencies — not just whether there are any, but whether they are "Immediate Jeopardy" level (the most serious), "Actual Harm," or lower-level paperwork issues. One paperwork deficiency in three years is meaningfully different from an Immediate Jeopardy finding eighteen months ago. Have the specific deficiencies in hand when you tour — it gives you the factual basis for Question 47.
Staffing questions (1–10)
- What is the caregiver-to-resident ratio during the day shift? The evening shift? The overnight shift? Arizona requires a minimum staffing level, but the minimum is a floor, not a standard. Ask for the actual posted ratio, not what is required.
- How does the ratio change on weekends? Many communities run skeleton crews on Saturday and Sunday nights. That is when most incidents occur.
- Are the caregivers employees or agency staff? Agency staff (contracted through a staffing agency) typically have higher turnover and less community-specific training. What percentage of your current staff are employees vs. agency?
- What is the average tenure of your caregiving staff? Below 12 months is a red flag; above 24 months is a positive indicator.
- How is dementia care training handled for staff who work with memory-impaired residents in the general population? (Asked even if touring a non-memory-care setting — because most ALFs have some residents with cognitive impairment.)
- What happens when a caregiver calls in sick? How is coverage managed? The answer reveals whether the community has a reliable float pool or whether they simply reduce ratio.
- Is a licensed nurse on site 24 hours a day? Arizona does not require 24-hour nursing in ALFs (it is required in skilled nursing facilities). If the answer is no, ask: what is the on-call nurse availability, and what is the response time if a resident has a health emergency at 2 a.m.?
- Who is the director of nursing and how long have they been in this role? High turnover at the clinical leadership level is a significant indicator of management instability.
- What is the current administrator's tenure at this community? Same logic: an administrator who has been there 18 months has a very different institutional knowledge than one who started last quarter.
- Is this community part of a corporate chain or independently owned? Neither is inherently better — but the answer affects who makes decisions about staffing levels, food quality, and building maintenance when finances are tight.
Care and assessment (11–18)
- How is the initial care assessment conducted? Who performs it? Look for a licensed professional (RN or MSW), not just an admissions counselor. The assessment drives the level-of-care pricing — a cursory assessment is a liability for both the resident and the family.
- How often is the care plan reviewed and updated? The Arizona minimum is every 12 months. Best practice is every 6 months or with any significant change in condition. Ask how they handle the in-between: what triggers an unscheduled reassessment?
- What conditions or care needs would cause you to recommend discharge to a higher level of care? Get a specific answer. A community that says "we work with all care levels" is not giving you useful information.
- Do you have a hospice relationship? Can a resident remain here on hospice? Most Arizona ALFs can accommodate hospice, but arrangements vary. If your parent has a terminal diagnosis or is likely to receive one, this is critical.
- How do you handle a fall? What is the notification protocol for the family? The answer should be: notify the family within 24 hours, document in the care record, complete a fall investigation, and modify the care plan. If the answer is vague, probe further.
- How are medications stored and administered? Ask specifically: are medications in a locked cart or a locked room? Who administers them — a licensed nurse, a medication aide, or a caregiver? Arizona allows trained medication aides to administer medications in ALFs; the training requirement is specific.
- Do you accept residents with colostomies, catheters, feeding tubes, or insulin-dependent diabetes? If your parent has any of these, ask directly — not all ALFs are equipped to manage them.
- Have you ever had a resident pass away in this community? How is that handled? Most families are not prepared to ask this, but the answer reveals the community's culture around end of life. A community that handles death with dignity and clear family communication is telling you something important about its values.
Physical environment (19–25)
- Can I see a unit that is not staged — a current resident's room, if they're willing? Staged model rooms are curated. A real room tells you how space actually feels and whether residents are comfortable personalizing it.
- How is the outdoor space maintained and accessible? In Phoenix, outdoor space design matters enormously — shaded, cooled, or irrigated outdoor areas versus hot concrete with no shade are not equivalent.
- What is the temperature policy indoors during summer? Arizona ALFs must maintain safe indoor temperatures, but "safe" and "comfortable" are not the same. A community that keeps the thermostat at 80°F in July is technically compliant but physically uncomfortable for residents who move slowly or have circulation issues.
- How are shared bathrooms maintained between uses? (Relevant in any community that has shared bathrooms, which lower-cost communities often do.)
- What is the pest management protocol? Phoenix has scorpions. The answer should be monthly professional treatment and a clear escalation protocol if a resident is stung.
- How is laundry handled? What is the policy on lost or damaged clothing? Lost laundry is one of the most common family complaints after move-in. The answer tells you how organized their systems are.
- Is there secure storage for valuables in each unit? If your parent has jewelry, cash, or sentimental items, ask directly where they should be stored and what the theft reporting process is.
Dining and nutrition (26–31)
- Can I stay for a meal? Always ask. If they say no without a specific reason, that is notable. A community confident in its dining program will welcome you to sit down.
- How are dietary restrictions and allergies managed? Is there a registered dietitian on staff or on retainer?
- What is the process if a resident stops eating or loses significant weight? The answer should reference a clear escalation: monitoring, dietitian consultation, family notification, and if needed, a physician referral.
- Are meals served at fixed times, or is there flexible dining? For residents who sleep late or need more time at meals, flexible dining windows matter significantly.
- What happens if a resident refuses to come to the dining room consistently? Room service, caregiver-assisted eating, family notification — ask what the protocol is.
- Can family members join for meals? Is there a guest meal fee? Community that encourages family presence at meals is telling you something positive about its culture.
Activities and programming (32–36)
- May I see the activity calendar for this month? A real calendar tells you what actually happens, not what is theoretically offered. Look for variety across time of day and type (social, physical, creative, spiritual).
- What is the activities-to-resident ratio? Is there a full-time activities director?
- How are residents who decline activities engaged? Passive presence in a common area with a TV is very different from one-on-one engagement by a trained activities aide. Ask specifically.
- Is there a faith or spiritual component to programming? Is it optional or assumed? Relevant depending on your parent's background and preferences.
- What transportation is provided? How often, and to where? Medical appointments, shopping, and community outings — ask for specifics. Some communities provide broad transportation; others offer only medical transport on certain days.
Contracts and costs (37–43)
- What is the community fee, and is any portion refundable? In Arizona, community fees are typically non-refundable. Confirm this in writing before signing.
- Walk me through a sample invoice — every line item that appears on a typical month-two bill. This is the most important financial question. The published base rate is the starting point. You need to see medication management, incontinence supplies, transportation, and level-of-care add-ons to understand the real monthly cost.
- What is the annual rate-increase history for the past three years? Ask for specific percentages. Compare to your budgeting assumptions. See our cost guide for 2026 Phoenix benchmarks.
- What does the contract say about rate increases? How much notice is required? Some Arizona ALF contracts allow rate increases with 30 days' notice. Others require 60 or 90 days. Read the clause before signing.
- Under what circumstances can the community require a resident to move out? Involuntary discharge is regulated in Arizona — ask for the specific grounds listed in the contract and how much notice is provided.
- What is the refund policy if a resident dies or moves within the first 30 days? Policies vary significantly. Some communities pro-rate the monthly fee; others have a 30-day minimum billing period regardless of occupancy.
- Do you accept ALTCS? If so, which MCOs? Is there a waitlist for ALTCS-funded beds? If ALTCS is a current or near-future funding source, the answer to this question is determinative. See our ALTCS guide for background on the three Arizona MCOs.
Regulatory and complaint history (44–47)
- Has this community been cited for any Immediate Jeopardy or Actual Harm deficiencies in the past three years? You already know the answer from the ADHS Care Check pull you did before the tour. Asking in person gives you a chance to see how leadership discusses the regulatory history — defensively or transparently.
- Has this community ever had its license suspended, restricted, or placed on conditional status by ADHS?
- Have there been any wrongful death lawsuits filed against this community in the past five years? Arizona court records are public. Ask directly; you can verify independently at the Maricopa County Superior Court online case search.
- If I shared the specific ADHS deficiency from [date] — [topic] — can you walk me through what changed as a result of that finding? A community with a genuine quality-improvement culture will answer this specifically and with ownership. A community that is defensive, minimizes the finding, or cannot describe the corrective action in concrete terms is telling you something important.
What to do after the tour
After each tour, score the community on the questions that mattered most to your situation. Compare three things: the care model (staffing ratios, care plan process), the environment (physical design, outdoor space, dining quality), and the contract (cost structure, rate-increase history, discharge policy). The community with the best sales presentation is not always the best community. The community with the most specific, transparent answers to hard questions consistently is.
If you want to tour with an advisor who asks these questions professionally and can debrief the findings with you afterward, our Phoenix team does exactly this at no cost to families. We also know which communities currently have openings that match your budget, geographic preference, and care type — which can save you from touring communities that ultimately cannot accommodate your parent's needs or timeline. Reach out via the contact page to schedule.