A solid Florida ALF inspection checklist turns the first hour of an AHCA survey from a fire drill into a routine. Most deficiencies in Florida ALF surveys come from the same handful of records. If you know which records, what surveyors ask for first, and which FAC section each ask maps to, the survey loses its surprise factor. This guide is the checklist plus a 30-day prep plan.
Key takeaways
- An AHCA survey starts with medication and resident records. Get those two right and the rest follows.
- FAC 59A-36.008 governs medication practices. FAC 59A-36.015 governs records.
- FAC 59A-36.007 covers resident care standards. 59A-36.010 covers staffing. 59A-36.014 covers the physical plant.
- Retention rules: contracts kept 5 years (FS 429.24(1)). Other resident records kept 2 years after departure (FAC 59A-36.015).
- A 30-day prep plan that runs in 15-minute blocks beats a frantic weekend before the survey.
The Florida ALF inspection checklist, area by area
Print this table. Run your file room against it. Anything red gets fixed in this week's shift schedule, not next month.
| Area | What the surveyor checks | Citation |
|---|---|---|
| Medication practices | The MOR is current. Refusals have reasons. PRN follow-ups exist. Stock OTC dose is logged on the MOR. | FAC 59A-36.008 |
| Medication observation record | Resident name, allergies, provider name and phone, every med with dose and directions, refusals, missed doses, errors. | FAC 59A-36.008(5) |
| Resident care standards | Significant-changes record is updated. Method-of-administration changes are written. | FAC 59A-36.007(1)(f) |
| Resident records | Admission packet, weight on admission and semi-annual, discharge log, emergency management plan. | FAC 59A-36.015 |
| Resident contracts (retention) | 5 years after expiration. Cannot be destroyed earlier. | FS 429.24(1) |
| Other resident records (retention) | 2 years after the resident leaves. | FAC 59A-36.015 |
| Staffing | Minimum weekly direct-care hours. Awake staff overnight in facilities of 17+ residents. Level 2 screening for every employee. | FAC 59A-36.010 |
| Physical plant | Florida Building Code and NFPA fire safety. Linens free of tears and stains. Hazard-free environment. | FAC 59A-36.014 |
| Adverse incidents | Preliminary report within 1 business day. Full report within 15 days. | FS 429.23 |
The medication record asks first
The first hour is almost always medication. The MOR is the showstopper.
FAC 59A-36.008(5)
The daily medication observation record for each resident has to include the resident's name and known allergies, the prescriber's name and phone, the medication name, strength, and directions, and a chart for recording each dose, missed doses, refusals, or medication errors. The record has to be updated immediately each time a medication is offered or administered. Plain-language summary, not legal advice.
Operators trip up on three sub-rules. Subsection (4) wants observation: trained staff watches the resident take the medication and reports any concern to the prescriber. Subsection (5) wants the MOR. The pill-organizer log (if you manage organizers) needs a fill signature and a check signature.
The records ask second
Right after medication, the surveyor wants resident and facility records. Subsections of FAC 59A-36.015 cover everything from admission documents through discharge logs.
FAC 59A-36.015
Facility records cover staff and operations. Resident records cover everyone who lives in the building. Personnel records include level 2 background screening compliance, freedom from communicable-disease signs, and elopement drill participation. Resident records keep the weight log (initiated on admission, semi-annual for residents receiving assistance). The discharge log lists date, reason, and destination, or date of death. Retention: resident contracts 5 years, other resident records 2 years after departure. Plain-language summary, not legal advice.
Resident care standards
The significant-changes record under FAC 59A-36.007(1)(f) is the most-missed piece of paper in a Florida ALF. It is the running log of anything that changed about a resident's status, illness, medication method, or service level.
FAC 59A-36.007(1)(f)
The facility has to keep a written record, updated as needed, of any significant changes, any illnesses that resulted in medical attention, changes in the method of medication administration, or other changes that resulted in the provision of additional services. Plain-language summary, not legal advice.
Staffing and training
FAC 59A-36.010 sets the staffing floor. Minimum weekly hours of direct care, based on total residents. A staff member with record access on premises at all times. In a facility of 17 or more residents, awake staff at all hours. Administrators may supervise up to three facilities. Level 2 background screening for every employee.
FAC 59A-36.010
Florida ALFs have to meet minimum weekly direct-care hours based on resident census. At least one staff member with access to facility and resident records has to be in the building whenever residents are. Facilities of 17 or more residents must have at least one staff member awake at all hours. Level 2 background screening applies to every employee. All staff have to meet the training requirements of FAC 59A-36.011 (the 26-hour core training and the 75 percent competency test apply to administrators and managers). Plain-language summary, not legal advice.
Physical plant
Physical plant under FAC 59A-36.014 is mostly about being safe. The Florida Building Code, the Uniform Fire Safety Standards (Chapter 69A-40), and the relevant NFPA codes apply. Linens have to be in good condition. The environment, including outdoor space residents access, has to be hazard-free.
The 30-day prep plan
Run this plan in 15-minute blocks. Operators who try to do it all in one afternoon never finish it.
Days 30 to 21. Medication
Walk every cart. Cross-check every label against the active MOR. Pull the previous month's MOR for every resident and read each line. Look for missing initials, refusals without reasons, PRNs without follow-ups, and stock OTC doses that were not logged on the resident's MOR. Fix what you find with a clean late-entry marker.
Days 20 to 11. Records
Pull every resident chart. Confirm admission, weight, significant-changes, and discharge logs are current. For each former resident in the last 24 months, confirm the file is still on premises and retrievable in under five minutes. For contracts, confirm the file goes back five years.
Days 10 to 6. Staff and training
Pull every staff file. Confirm the level 2 screening, the food-handler if applicable, the in-service training log, and the FAC 59A-36.011 core-training certificate for the administrator and managers. Anything expired or missing gets scheduled before the survey.
Days 5 to 1. Walk the building
Check the physical plant. Temperatures, exits, fire drill log (drills as required), the resident bill of rights poster, the abuse-hotline poster, and any hazards on the walking paths. Pull last year's deficiencies and confirm every plan of correction is closed.
Two operator scenarios
Renata runs a 16-bed standard ALF in Orange County. She lost a star in 2024 on a missing pill-organizer fill signature. Her 2025 fix was a Friday-afternoon "check the cart" routine: 15 minutes per week, signed by the supervisor. Her 2026 survey closed with one minor deficiency unrelated to medication. The cart routine had a year of clean signatures on it.
Antoine owns a 24-bed ALF in Hillsborough County. His weakest area was the significant-changes record. The fix was a one-screen template on the tablet that any caregiver could fill at the moment a change happened, signed by the resident manager at end of shift. His 2026 survey closed in two days with no resident-record findings. The surveyor noted the template specifically.
How Marpass fits
Marpass runs the MOR on a tablet at the cart. Refusals, PRNs, errors, and OTC stock all live on one screen, with the FAC sections labeled on each entry. The significant-changes record is its own template, also one screen, with the date and signature stamped automatically. Resident contracts, training files, and the 5-year and 2-year retention rules are handled in the cloud, with indexed exports for any time window. Pricing is flat per home and posted on the site.
Want a Florida ALF that is always survey-ready? Join the waitlist.
