PROGRESS ADULT CARE HOME
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PROGRESS ADULT CARE HOME
13140 SW DEL MAR CT
BEAVERTON, OR 97008
(503) 329-9166

Does Provider/Owner live in home? Yes / No

Do you accept / Medicaid Yes / No

Licensed for what level? I  II  III

How long has home been in business? 

Number of private rooms none One Private Room Two Private Rooms Three Private Rooms Four Private Rooms Five Private Rooms

Number of shared rooms none One Shared Room Two Shared Rooms Three Shared Rooms Four Shared Rooms Five Shared Rooms

Do children live in the home? Yes / No

Number of private bathrooms none One Two Three Four Five+

Number of shared bathrooms none One Two Three Four Five+

Tub   Walk in Shower

Pets Yes / No  If so what kind?

Check the conditions that you accept in your home.

You will accept residents in your home that need Complete Assistance in:

Which of the following do you have experience with?

     Click here for the Assessment Form

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