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Community Advisory Committee Quarterly/Annual Visitation Report County Orange 750 Weaver Dairy Rd. Chapel Hill, NC 27514 Facility Type Family Care Home Adult Care Home Nursing Home Facility Name: Carol Woods (Bldgs 5, 6 & 7) Census – current/licensed: 31/36 in Bldg 5 ("Central A.L."); 22/24 in Bldgs 6 & 7 ("Garden A.L.") combined Visit Date and day of the week Wednesday May 10, 2017 Time spent in facility 1 hours minutes Arrival time 5:05 Name of person(s) with whom exit interview was held no official exit interview - nothing to report Interview was held in person Committee members present: Gloria Brown, Beverly Foster, Deborah Stewart Number of residents who received personal visits from committee members 2 Report completed by: Deborah Stewart Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly posted: No The most recent survey was readily accessible N/A (Required for NHs only – record date of most recent survey posted) : Staffing information clearly posted? Yes Resident Profile Yes No N/A Comments/Other Observations (please number comments) 1. Do the residents appear neat, clean and odor free? Yes 1. Residents appeared neat and clean 4. Staff were interacting with resident while residents were dining. 5a. In addition to nametags, there were signs with pictures and names of staff on duty posted near entrance. 2.Did residents say they receive assistance with personal care activities? (i.e. brushing their teeth, combing their hair, inserting dentures or cleaning their eyeglasses) Yes 3. Did you see or hear residents being encouraged to participate in their care by staff members? N/A 4.Were residents interacting with staff, other residents & visitors? Yes 5.Did staff respond to or interact with residents who had difficulty communicating or making their needs known verbally? N/A 5a Did staff members wear nametags that are easily read by residents and visitors? Yes 6. Did you observe restraints in use? No 7. If so, did you ask staff about the facility’s restraint policies? Note: Do not ask about confidential information without consent N/A Resident Living Accommodations Yes No N/A Comments/Other Observations (please number comments) 8. Did residents describe their living environment as homelike? Yes 8. One resident noted, affectionately, "I'm comfortable here."The buildings are designed to promote socialization while also allowing for residents' privacy. 10. Immediately after dinner clean-up, there were droplets of water on floor but this did not seem to pose a hazard due to the type of flooring used. 10b. One bathing room had extra wheelchairsand equipment stored in it but the room was not being used at the time. 13. Residents wear alert pendants. 9. Did you notice unpleasant odors? No 10. Did you see items that could cause harm or be hazardous? No 10a. Were unattended med carts locked? Yes 10b. Were bathrooms clean, odor-free and free from hazards? Yes 10c. Were rooms containing hazardous materials locked? Yes 11. Did residents feel their living areas were kept at a reasonable noise level? N/A 12. Does the facility accommodate smokers? Note: By regulation smoking is only permitted outside of the Building N/A 13. Were residents able to reach their call bells with ease? Yes 14. Did staff answer call bells in a timely & courteous manner? N/A 14a If no, did you share this with the administrative staff?