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Community Advisory Committee <br />Quarterly/Annual Visitation Report <br />County ORANGE <br />401 West Queen Street <br />Hillsborough, NC 27278 <br />Facility Type <br />Family Care Home <br />Adult Care Home <br />Nursing Home <br />Facility Name: <br />Adorable Senior Living <br />Census: 15 / 17 <br />Visit Date and day of the week <br />Thursday May 11, 2017 <br />Time spent in facility <br />35 min <br />Arrival time <br />4:40 pm <br />Name of person(s) with whom exit interview was held <br />Elsie Ogbonna- Administrator in Charge <br />Interview was held in person: <br />Committee members present: <br /> Will Lang, Max Mason, Debbie Rider, James Bartow <br /> Number of residents who received personal visits from committee members: 13 Report completed by: <br />Will Lang <br />Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly <br />posted: Correct only on one of two posted copies <br />The most recent survey was readily accessible <br />(Required for NHs only – record date of most recent survey <br />posted) : NA <br />Staffing information clearly posted? Yes <br /> <br />Resident Profile Yes <br />No <br />N/A <br />Comments/Other Observations <br />(please number comments) <br /> 1. Do the residents appear neat, clean and odor free? Yes 1. Arrived at dinner and nearly all <br />residents were being, or waiting to <br />be, fed. All appeared neat, clean <br />and odor free. <br />2. All residents we saw were being <br />treated with respect and care. <br /> <br />4. Residents, whether eating or <br />waiting to eat appeared <br />comfortable and were interacting <br />with staff and visitors. <br />5. Residents with lower mental or <br />physical capacity were being <br />treated equally well as those with <br />greater capacity. <br /> <br />2. Did residents say they receive assistance with personal care <br />activities? (i.e. brushing their teeth, combing their hair, <br />inserting dentures or cleaning their eyeglasses) <br />NA <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? Yes <br />4. Were residents interacting with staff, other residents & visitors? Yes <br />5. Did staff respond to or interact with residents who had <br />difficulty communicating or making their needs known <br />verbally? <br />Yes <br />5a. Did staff members wear nametags that are easily read by <br />residents and visitors? No <br />6. Did you observe restraints in use? No <br />7. If so, did you ask staff about the facility’s restraint policies? <br />(note: Do not ask about confidential information without <br />consent) <br />NA <br /> <br />Resident Living Accommodations Yes <br />No <br />N/A <br />Comments/Other Observations <br />(please number comments) <br /> 8. Did residents describe their living environment as homelike? Yes 8. All rooms that were observed <br />appeared neat and tidy. <br /> <br />10a. Meds are kept in a closet <br />which was locked at the time of our <br />visit. <br />10b. Shared bathrooms, yet clean <br />and uncluttered. <br />10c.One closet was unlocked <br />although did not appear to contain <br />any hazardous materials. <br /> 9. Did you notice unpleasant odors? No <br />10. Did you see items that could cause harm or be hazardous? No <br />10a. Were unattended med carts locked? NA <br />10b. Were bathrooms clean, odor-free and free from hazards? Yes <br />10c. Were rooms containing hazardous materials locked? Yes <br />11. Did residents feel their living areas were kept at a reasonable <br />noise level? <br />Yes <br />12. Does the facility accommodate smokers? No <br />12a. Where? (Outside / inside / both) <br />13. Were residents able to reach their call bells with ease? NA <br />14. Did staff answer call bells in a timely & courteous manner? NA <br />14a. If no, did you share this with the administrative staff? NA <br />