Initial Assessments

Part of the Anaya Care Handbook — the source of truth for how the product must behave. When the product needs to change, change this document first, then make the system match it.

What this covers

This page governs the initial assessment of a prospective client — the intake step where the agency first evaluates a person's care needs, and the source of every care proposal. An initial assessment is a shared client intake: the identical data shape carried, without re-entry, into the care proposal and (later) the client record.

An agency can fill an initial assessment in by hand, or run it as a guided AI conversation — the Guided Narrative (Assessment Mode) — which interviews the care manager and pre-fills the assessment. The completed intake then feeds AI-assisted care proposal generation.

Not to be confused with. The Initial Assessment on this page is the pre-client intake record in the funnel (/dashboard/initial-assessments). The per-client Simplified Routine Task Inventory (SRTI, route .../assessments/simplified-rti) is one of the six Care Assessments — the initial assessment merely embeds that same inventory at intake. Care Assessments owns the inventory's field model; this page does not restate it.

The six care assessments on every client's record are covered in Care Assessments; the notes care providers record when a client's condition changes are covered in Change of Conditions; the schedule on which a client is re-evaluated after they become active is covered in Reassessment & Care Plan Review Cycle; the care readiness quiz a care provider takes before a shift is covered in Scheduling & Shifts.

Key terms

• Initial assessment — the intake record for a prospective client, and a shared client intake: client demographics and photo, the Care Circle and responsible party, the requested service (with value-added services and a weekly schedule), a rate computation, an AI narrative, and a first Simplified Routine Task Inventory. Once completed, it clones losslessly into a care proposal.
• Care Circle — everyone involved in the client's care other than the client, each with a relationship and roles; the client is never a member, and a responsible party (a Care Circle member or the client themselves) must be resolved before the assessment can be completed. Defined in full on Clients.
• Simplified Routine Task Inventory (SRTI) — the GCS Capacity / Support now / Risk picture of a person's daily functioning that the intake embeds. Its field model is owned by Care Assessments; this page does not restate it.
• Guided narrative — the optional AI-guided intake conversation (the Guided Narrative, Anaya's Assessment Mode) that interviews the care manager across the client's care setting and six Life's Milestones, writes a warm narrative, and pre-fills the assessment — every structured field grounded in the interview transcript.
• Client photo — an optional profile photo on the intake; when none is uploaded a default avatar is generated automatically, and it travels with the intake on convert.
• Assessment Builder (future) — a possible future tool for an agency to define its own intake domains instead of the fixed GCS form. Not built; there is no agency-configurable form today.

How it works

Initial assessments (before someone is a client)

Agency staff create an initial assessment for a prospect on the web dashboard. It starts in Draft with an empty intake. Staff fill in the prospect's details and photo, the Care Circle and responsible party, the requested service (with value-added services and a weekly schedule), and the Simplified Routine Task Inventory — optionally helped by the Guided Narrative interview, which writes a narrative and pre-fills the fields. Drafts autosave freely, even when partly filled or invalid; the completeness checks apply only when the assessment is marked Completed. A completed assessment can be converted into a care proposal: conversion is a lossless deep clone of the whole intake — demographics, Care Circle, responsible party and proposal addressees, service, value-added services, weekly schedule, the rate computation (copied as-is, not recomputed), the narrative, and a snapshot of the inventory — onto a new Draft proposal whose assessment snapshot starts Completed.

A Completed assessment is not locked: it can be reopened to Draft explicitly, and editing any of its content (a field, the narrative, the inventory, or the rates) reopens it to Draft automatically. The one hard lock is conversion — once the assessment is linked to a care proposal, its status is frozen and it cannot be edited or converted again until the link is removed (by deleting the proposal).

Every status change is recorded in a permanent history with who made it and when.

When the proposal is later accepted and a client is created from it, the inventory travels with them: the client's Simplified Routine Task Inventory starts pre-filled from intake and already Completed.

Guided Narrative and AI generation

Intake runs on a fixed GCS-based form today — the Simplified Routine Task Inventory plus a guided interview over the client's care setting and six Life's Milestones. There is no agency-configurable Assessment Builder; that remains a possible future direction only.

• Guided Narrative. Instead of typing every field, a care manager can run the Assessment Mode interview: the assistant asks conversational questions until it has covered the seven gated topics (care setting + the six Life's Milestones), then writes a warm narrative and pre-fills the Simplified Routine Task Inventory, grounding every structured field in the interview transcript. It is optional — the assessment can be filled in by hand — and it does not by itself mark the assessment Completed.
• Durable generation with clarification-only review. Generation runs as a single durable job per assessment (only one in flight at a time). When a high-value fact is missing or ambiguous, the run pauses and asks the care manager one source-cited, choice-based clarifying question, then folds the answer back in — there is no separate approve/reject review gate. The generated draft auto-saves as a Draft for the care manager to edit and complete.

Rules

Implementation status — audited against apps/backend/src/initial-assessments, packages/shared/src/types/intake.ts, and apps/backend/src/ai/agents/initial-assessment on 2026-07-18. ✅ In code · ⚠️ Partial (built, but doesn't fully match the rule) · 🚧 Spec only (not yet built). Retired rules carry no tag.

1. AS-1 — An initial assessment is always created in Draft, with an empty intake, by agency staff on the web dashboard. (✅ In code)
2. AS-2 — An initial assessment can only be marked Completed when the prospect's first name, date of birth, and address, the service type, at least one complete Care Circle member (name, phone, a valid email, and relationship), at least one proposal addressee, and a resolved responsible party (the client or a Care Circle member) are all present — and every rated inventory leaf is filled (a Capacity and a Support now for each functional item, a status for equipment and home safety, or the memory-care Yes/No). Incomplete assessments must be rejected with a clear list of missing fields. (✅ In code — note email format is enforced only at completion; drafts accept any string)
3. AS-3 — Initial assessment status can only move along the lifecycle above: Draft ↔ Completed, Draft/Completed → Archived, Archived → Draft, Completed → Converted. A Completed assessment can be reopened to Draft — explicitly, or automatically when any of its content is edited. The one hard lock is conversion: once the assessment is linked to a care proposal, its status is frozen and it cannot be edited or converted again until the proposal is deleted. (✅ In code)
4. AS-4 — Only a Completed initial assessment can be converted into a care proposal. An Archived or Draft assessment can never be converted. (✅ In code)
5. AS-5 — An initial assessment can be converted at most once. While it is linked to a care proposal, its status cannot be changed and it cannot be converted again. (✅ In code)
6. AS-6 — Converting is a lossless deep clone of the whole intake onto a new Draft care proposal: identity, measurements, address, pets and client photo, the Care Circle, responsible party and proposal addressees, care-decision involvement and benefits, service type, value-added services and weekly schedule, the rate computation (copied as-is — nothing is recomputed), and the narrative; the inventory is snapshotted as the proposal's assessment (marked Completed) so later edits to either side do not affect the other. (✅ In code)
7. AS-7 — If the linked care proposal is deleted, the initial assessment returns to Completed, with an audit note, and may be converted again. (✅ In code)
8. AS-8 — Duplicating an initial assessment creates a fresh Draft copy owned by the person duplicating, with no link to any care proposal. (✅ In code)
9. AS-9 — Deleting an initial assessment can optionally delete the linked care proposal at the same time; the person deleting must choose explicitly. (✅ In code)
10. AS-10 — Every initial assessment status change is appended to a permanent history (status, note, time, author); the current status is always the newest entry. History is never rewritten. (✅ In code)
11. AS-11 — Staff with "view own" access see only initial assessments they authored; staff with "view all" access see every assessment in their business. There is no in-between tier. (✅ In code)
12. AS-12 – AS-17 — moved to Care Assessments as rules CA-1 – CA-6. Retired; must not be reused.
13. AS-18 – AS-22 — moved to Change of Conditions as rules COC-1 – COC-5. Retired; must not be reused.
14. AS-23 – AS-24 — moved to Scheduling & Shifts as rules SCH-37 – SCH-38 (the care readiness quiz is a shift-operations concern). Retired; must not be reused.
15. AS-25 — Retired. This rule previously required a Completed assessment to be immutable (never reopened to Draft). The product went the other way — editing a Completed assessment reopens it to Draft, and the prior state is kept in the status history — so immutability is not pursued. The lifecycle is now governed by AS-3; the only hard lock is conversion. Must not be reused.
16. AS-26 — Intake uses a fixed GCS-based form — the Simplified Routine Task Inventory plus the guided interview over the care setting and six Life's Milestones — the same for every agency. An agency-configurable "Assessment Builder" that would let agencies define their own intake domains is a possible future direction only, with no code today. (🚧 Spec only — the Assessment Builder is not built; the fixed GCS form is what ships)
17. AS-27 — An initial assessment may be filled in through the Guided Narrative (Assessment Mode): the assistant interviews the care manager and pre-fills the inventory. There is no mandatory review gate on the generated draft — the care manager owns and edits it directly, and completing the assessment is the separate deliberate action gated by AS-2. (✅ In code)
18. AS-28 — The intake's Simplified Routine Task Inventory (GCS Capacity / Support now / Risk) is the assessment that grounds AI generation once the assessment is converted: care-proposal care-plan generation reads the SRTI functional assessment. There is no separate Independent / Set-up / Partial / Full scale, and no RTI-E, ACL/ACLS-5, or ADM captured on the intake. (✅ In code — generation runs on the care-proposal side; see Care Proposals CP-30)
19. AS-29 — An initial assessment is a shared client intake — the identical data shape used by the care proposal and (later) the client record — so nothing is re-entered when it is converted. (✅ In code)
20. AS-30 — Contacts are captured as a Care Circle: everyone involved in the client's care other than the client, each with a relationship and one or more roles. The client is never a Care Circle member; where the client must be referenced (as responsible party or addressee) a reserved client reference is used. (✅ In code)
21. AS-31 — Every completed assessment must have a resolved responsible party — the client themselves or an existing Care Circle member. It is never auto-invented: an unset or stale pointer resolves to no one, and the platform must not fall back to the first contact. (✅ In code)
22. AS-32 — AI generation is a single durable run per assessment (only one in flight at a time). It requires a Guided Narrative transcript that has covered the seven gated topics (care setting + the six Life's Milestones), and it grounds every structured field in that transcript, saving the narrative and the extracted fields together. (✅ In code)
23. AS-33 — Human-in-the-loop during generation is clarification-only: the run may pause to ask the care manager a single source-cited, choice-based question when a high-value fact is unclear, and folds the answer back in. There is no approve/reject review gate, and generation does not by itself mark the assessment Completed. (✅ In code)
24. AS-34 — Drafts autosave freely with partial or invalid data (including malformed emails and incomplete Care Circle members); email format and required-field validation are deferred to completion (AS-2). Editing a Completed assessment reopens it to Draft (AS-3). (✅ In code)
25. AS-35 — A client photo is optional on the intake; when none is uploaded a default avatar is generated automatically, and the photo (or generated avatar) travels with the intake on convert. (✅ In code)
26. AS-36 — The intake captures the requested service with value-added services and a weekly schedule, plus a rate computation (previously proposal-only); all clone to the proposal on convert. Computing rates requires the initial-assessment manage permission and manual rate overrides require the care-proposal rates permission. (✅ In code)

Who can do what

Decisions needed

• Assessment Builder (AS-26). Whether to build agency-configurable intake domains at all, or commit to the fixed GCS form as canonical. There is no code intent toward a Builder today; the migration-path question only arises if one is ever built.