Purpose: To clarify staff awareness and the current status of facilities regarding end-of-life care and the planning for severely disabled children and adults. Methods: A questionnaire survey on ACP was conducted on all 466 staff members of a residential facility for children with medical disabilities. Results: The response rate was 77.0%; 20.2% of direct support staff and 50.9% of indirect support staff answered that they had never heard of ACP (or life conferences). The respondents had experienced discussions with the patient and family members about medical treatment and care in the last stage of life was 27.1%. The content of the discussions was more often about the family's values and wishes than about the patient's values and intentions, and the timing of the start of the discussions was often when death was approaching .More than 70% of the direct supporters wished to participate in ACP, discussions, and they wished to receive training in advance of ACP implementation .The majority of staff agreed that surrogate decision-making in the absence of family members should be discussed by a multidisciplinary medical and care team, and that the results should be approved by an ethics committee. Conclusion: Training for staff is necessary for the promotion of ACP in medical-type residential care facilities for children with disabilities.