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OT-COTA Skills Checklist

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF CLIENTS

Newborn/ Neonate (birth to 30 days)(Required)
Infant (31 days to 12 months)(Required)
Toddler/Preschool (13 months to 5 years)(Required)
School Age Child/adolescent (6 years to 18 years)(Required)
Young Adults Middle Adult (19 years to 64 years)(Required)
Older Adults/Elderly (65+ years)(Required)

WORK SETTINGS

General Acute Care(Required)
Adult / Adult ICU(Required)
Pediatrics / PICU(Required)
Children’s Hospital(Required)
Hand Therapy(Required)
Home Health Care(Required)
Outpatient Neuro(Required)
Outpatient Ortho(Required)
Psychiatric Hospital(Required)
Rehabilitation Hospital / Inpatient Rehabilitation Unit(Required)
Skilled Care Facility(Required)
School Setting(Required)
Early Intervention(Required)
Subacute(Required)

ADULT ORTHOPEDIC

Fractures(Required)
Osteoarthritis-Frozen Shoulder(Required)
Hand Injuries(Required)
Post Operative Care(Required)
Lower Back / Spinal Surgeries(Required)
Arthritis Programs(Required)
Knee Injuries & Total Knee Replacement(Required)
Hip Fractures & Total Hip Replacement(Required)
Prosthetics / Amputations(Required)

ADULT NEUROLOGIC

Stroke Rehabilitation(Required)
Cognitive Disorders(Required)
Head Trauma(Required)
Spinal Cord Injury(Required)
Neuromuscular Diseases(Required)
Alzheimer’s / Dementia(Required)
Adaptive Equipment-Wheelchair(Required)
Degenerative Diseases of the CNS(Required)
Multiple Sclerosis(Required)
Wheelchair Evaluation(Required)
Parkinson’s Disease(Required)
Stroke Rehabilitation(Required)
Traumatic Brain Injury(Required)

ADULT PROSTHETICS / ORTHOTICS

Upper Extremity Prosthetics(Required)

ADULT PROCEDURES / TREATMENTS

Splinting - Wrist(Required)
Splinting - Hand(Required)
Splinting - Elbow(Required)
Functional - Dynamic Splinting(Required)
Adaptive Equipment(Required)
Joint Mobilization(Required)
Myofascial Release(Required)
Soft Tissue Manipulation(Required)
Iontophoresis(Required)
TENS(Required)
Hydrotherapy - Whirlpool(Required)
Sterilization Techniques(Required)
Cryotherapy(Required)
Wound Management(Required)
Debridement(Required)
Ultrasound(Required)
Phonophoresis(Required)
Cognitive Techniques(Required)
Vision Therapy(Required)
Neurodevelopmental Techniques(Required)
Adaptive Equipment Assessment(Required)
Adaptive Equipment Training(Required)
Feeding Techniques(Required)
Exercise Programs(Required)
Postural Education(Required)
Home Safety Evaluation(Required)
Community Re-Entry(Required)
Group Treatment(Required)

PEDIATRIC ASSESSMENTS

Experience(Required)
Neurodevelopmental Testing(Required)
Developmental Screening(Required)
Feeding / Swallowing / Oral Motor(Required)
Sensory-Motor Testing(Required)
Seating & Positioning Assessment (i.e. W / C)(Required)
Visual Perceptual Testing(Required)

GERIATRIC SKILLED NURSING DOCUMENTATION

Medicare A(Required)
Medicare B(Required)
State Healthcare(Required)

OTHER

Cardiac Rehab(Required)
ICU Procedures(Required)
CCU Procedures(Required)
SICU Procedures(Required)
Burn Management(Required)
Work Hardening - Work Site Eval(Required)
Functional Capacity Eval(Required)
Transfers(Required)
Gait Training(Required)
Muscle Energy Techniques(Required)
Activities of Daily Living(Required)
Driving Evaluation(Required)
Home Assessments / Home Accessibility(Required)
Lymphedema Management(Required)
ADL(Required)
Energy Conservation / Work Simplification Techniques(Required)
Patient, Family, & Staff Training(Required)
Anodyne(Required)
Biofeedback(Required)
Electrical Stimulation(Required)
Fluidotherapy(Required)
Oral Motor Facilities(Required)
Paraffin Bath(Required)
Ultrasound(Required)
FIM Scoring(Required)
Geriatrics(Required)
Group Dynamics(Required)
IEP Skills(Required)
Patients in Isolation(Required)
Patients in Restraints(Required)
Initial Evaluation(Required)
End of Life Care / Palliative Care(Required)
Job Task Analysis(Required)
Inservice Education(Required)

COMPUTER CHARTING

Cerner(Required)
EPIC(Required)
McKesson(Required)
Meditech(Required)

NATIONAL PATIENT SAFETY GOALS

Accurate Patient Identification(Required)
Effective Communication(Required)
Pain Assessment & Management(Required)
Infection Control(Required)
Universal Precautions(Required)
Care of Patients in Isolation(Required)
Minimize Risk of Falls(Required)
Prevention of Pressure Ulcers(Required)

KNOWLEDGE OF PAYMENT SOURCES

Medicare(Required)
MDS(Required)
Medicaid(Required)

OTHER SKILLS

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