Pleasant Vally Joint Fire District

Helping our community prevent falls!

Pleasant Valley Joint Fire District – Falls Prevention

Welcome to our Home Safety Survey and thank you for your participation! It will take just a few minutes to finish. Fill in your information below to get started.


Trip Hazards

Do you keep walking areas (hallways/stairs) clear of trip hazards like throw rugs, papers, books, cords, and shoes?

Clear Access

Is the path from your bed to the bathroom dark?


When it's dark in your home, do you turn lighting on before walking?

Bath Hazards

Is your tub or shower floor slippery?

Bathroom Assistance Needs

Do you have to hold onto a sink or other surface when getting up from the toilet?

Do you have grab bars in tubs, showers and near toilets?


Do you wear slippers/socks when walking around the home?

Overhead Storage

Can you reach items in the kitchen without climbing or standing on something?

Purposeful Movements

Do you take your time when getting up from bed or a chair?

Walking Aids

Do you use a walking aid to walk indoors at home like a walker or a cane?

Fall Frequency

How many times have you fallen in the last year?