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<br />Community Advisory Committee <br />Quarterly/Annual Visitation Report <br />County: ORANGE <br /> <br />1911 Orange Grove Rd. <br />Hillsborough, NC 27278 <br />Facility Type <br />Family Care Home <br />Adult Care Home <br />Nursing Home <br />Facility Name: <br />Carillon Assisted Living / Hillsborough <br />Census: Overall: 55 / 96 <br /> Memory Care: 23 / 24 <br />Visit Date and day of the week <br />Thursday, May 11, 2017 <br />Time spent in facility <br />1 hour <br />Arrival time 3:30 PM <br />Name of person(s) with whom exit interview was held <br />Laurie Sawyer, Executive Director <br />Interviews were held in person: Yes <br />Committee members present: James Bartow, Will Lang, Max Mason, Debbie Rider <br /> <br />Number of residents who received personal visits from committee members: <br />Approx. 20 <br />Report completed by: <br />Max Mason <br />Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly <br />posted: Yes <br />The most recent survey was readily accessible <br />(Required for NHs only – record date of most recent survey <br />posted) : N/A <br />Staffing information clearly posted? No <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 <br /> <br /> <br /> <br /> <br />4. A considerable amount of resident- <br />staff interaction was observed. <br />5a. Most administrative staff had <br />nametags, though direct care staff did <br />not. <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 />Yes <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? No <br />4. Were residents interacting with staff, other residents & visitors? Yes <br />5. Did staff respond to or interact with residents who had difficulty <br />communicating or making their needs known verbally? Yes <br />5a. Did staff members wear nametags that are easily read by residents <br />and visitors? Yes <br />6. Did you observe restraints in use? No <br />7. If so, did you ask staff about the facility’s restraint policies? (note: <br />Do not ask about confidential information without consent) N/A <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. Multiple residents had very <br />personalized rooms and commented on <br />feeling at home. <br /> <br />11. The facility was very quiet overall <br />with the positive exception of a guitar <br />performance in one of the activities <br />rooms. <br /> <br />13. Some residents had call bell <br />pendants and one individual indicated <br />that once summoned, staff typically <br />respond quickly. <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? Yes <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) N/A <br />13. Were residents able to reach their call bells with ease? Yes <br />14. Did staff answer call bells in a timely & courteous manner? N/A <br />14a. If no, did you share this with the administrative staff? N/A