Hi,
Welcome to the Forum.
Is this sentence correct?
It enables our clients to make major improvements in residents and staff safety, residents satisfaction and independence, and streamlining processes to achieve operational excellence.
My friend says it is not. Here is what she said: When you have a list like that, each item in the list should be the same grammatically (like 3 nouns). Right now you have 2 nouns and 1 verb (1. safety 2. satisfaction and independence 3. streamlining). It should be “streamlined processes.”
It enables our clients to make major improvements in residents and staff safety . . .
This sounds like you are going to get improved residents. 
Say It enables our clients to make major improvements in resident and staff safety . . .
Generally speaking, I agree with your friend. I suggest this.
It enables our clients to make major improvements in resident and staff safety, resident satisfaction and independence, and operational processes. The latter will be streamlined to achieve excellence.
Best wishes, Clive