6A-ZRH
| User ID | Date | Name | Document ID | In the room, the stuff is not too close together, so there is plenty of running space and you do not always bump or stumble. | All furniture is well stable; lean on it or seek support goes without sliding or tilting. | The lazy chairs are not too deep, so getting up takes little effort. | There are no loose rugs on the ground over which you can stumble or slip. | The floor is sufficiently stiff, so that slipping is not possible. | The phone is in an easily accessible place. | Consent | Entry Date | Entry ID | User IP |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5 | 11/03/2025 | 1.234.567.890 | No difficulties | Few difficulties | Few difficulties | Few difficulties | Few difficulties | Few difficulties | checked | 11/03/2025 06:53 PM | 142 | 186.189.47.10 | |
| 8 | 22/02/2025 | 1.007.158.819 | No difficulties | Few difficulties | Few difficulties | Few difficulties | No difficulties | Few difficulties | checked | 22/02/2025 09:25 PM | 114 | 181.59.148.120 | |
| 10/01/2023 | 1.007.158.818 | Few difficulties | No difficulties | No difficulties | No difficulties | Few difficulties | Few difficulties | checked | 10/01/2023 09:38 PM | 63 | 186.170.209.18 | ||
| 40 | 09/12/2022 | 1.007.158.818 | Few difficulties | No difficulties | Severe difficulties | No difficulties | Few difficulties | Severe difficulties | checked | 09/12/2022 05:03 PM | 47 | 181.32.16.158 | |
| 40 | 07/12/2022 | 1.007.158.818 | No difficulties | Few difficulties | Severe difficulties | Impossible without assistance | No difficulties | Impossible without assistance | checked | 07/12/2022 01:57 PM | 35 | 186.170.219.49 | |
| 40 | 05/12/2022 | 1.007.158.818 | No difficulties | Few difficulties | Severe difficulties | Impossible without assistance | No difficulties | Few difficulties | checked | 05/12/2022 07:19 PM | 15 | 186.170.219.49 |
6B - ZRH
| User ID | Date | Name | Document ID | 1. Move yourself | 2. Prepare and eat food | 3. Take care of yourself and dress up | 4. Maintaining your home and doing household activities | 5. Assess and avoid danger | 6. Liaising with other persons | Consent | Entry Date | Entry ID | User IP |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5 | 11/03/2025 | 1.234.567.890 | No difficulties | No difficulties | No difficulties | No difficulties | No difficulties | No difficulties | checked | 11/03/2025 06:54 PM | 143 | 186.189.47.10 | |
| 8 | 22/02/2025 | 1.007.158.819 | Few difficulties | Few difficulties | Few difficulties | Impossible without assistance | Impossible without assistance | No difficulties | checked | 22/02/2025 09:26 PM | 115 | 181.59.148.120 | |
| 10/01/2023 | 1.007.158.819 | Few difficulties | Few difficulties | Few difficulties | Few difficulties | Few difficulties | No difficulties | checked | 10/01/2023 09:41 PM | 65 | 186.170.209.18 | ||
| 10/01/2023 | 1.007.158.819 | Few difficulties | Few difficulties | Few difficulties | Few difficulties | Severe difficulties | No difficulties | checked | 10/01/2023 09:40 PM | 64 | 186.170.209.18 | ||
| 8 | 10/01/2023 | 1.007.158.818 | No difficulties | Few difficulties | Few difficulties | Severe difficulties | Severe difficulties | No difficulties | checked | 10/01/2023 04:02 PM | 53 | 186.170.209.18 |
