Fiscal constraints, service withdrawal, and litigation in the health care sector have created an unquestionable need for accountability in health services. Therefore, this paper presents a method of quality assurance for use in community occupational therapy. Detailed attention is given to methodological issues, particularly those related to selecting an approach. A process audit approach was chosen for this study, and the results of its pilot application to a sample of depressed patients are presented and discussed. In addition, preliminary work on reliability and validity of the method are presented. Test-retest and interrater reliabilities were found to be .734 and .728, respectively, and assertions of normative and criterion validity were supported. The results of the audit are presented to illuminate aspects of the method that need further refinement.