Providing preferred leisure activities is important to support and empower people receiving adult day services, and enable them to age in place. This study – the first of its kind — explored the conceptual basis for the development of an instrument to assess preferences for leisure activities. Specifically, researchers asked: What are the content and structure of preferences for leisure activities of adult day service participants? Based on input from people receiving services at three adult day centers, and using a concept mapping methodology, the team developed a conceptualization that divides preferences for leisure activities into 12 clusters (most important: “Revel in memories and catch up on the news”; least important: “Keep fit and cheer others on in sports”). Findings can guide research and practice in preference assessment, programming and outcome evaluation in adult day services.