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Background: The elderly in long-term care facilities tend to have a diminished oral health status, with a high prevalence of dental caries and periodontal disease, as reduced cognitive function, joint mobility, and gait ability hinder the performance of oral hygiene. To improve the oral health of the elderly at long-term care facilities, it is necessary to have precise guidelines for oral health care and assessment; however, such guidelines are not readily available. Therefore, the present study aimed to develop an oral care assessment tool with verified reliability and validity. Methods: The participants in this study were 100 elderly patients at a care facilities and 10 clinical dental hygienists. Collected data were analyzed using the descriptive statistics, content validity index, and inter-rater reliability, as well as the analyses of intra-class correlation coefficient. Results: After a review of relevant literature, a preliminary questionnaire comprised of seven questions related to the evaluation of oral health was formed. After revising and supplementing the questions through a content validity test, a total of nine questions were selected. Conclusion: The novel assessment tool developed for the present study is anticipated to allow analyses of the level of problems related to oral health care before routine and professional care. Moreover, regular oral health status check-ups will enable the early diagnosis and treatment of diseases.