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Community Advisory Committee Quarterly/Annual Visitation Report County Orange 401 W Queen St, Hillsborough, NC 27278 Facility Type Family Care Home Adult Care Home Nursing Home Facility Name: Adorable Senior Living (Villines) Census – current/licensed: 12/17 Visit Date and day of the week Tuesday Jan 3, 2017 Time spent in facility hours 35 minutes Arrival time 1:00 PM Name of person(s) with whom exit interview was held Louise Murphy, Administrator **Under New Ownership Interview was held in person Committee members present: Deborah Stewart Gloria Brown Suzanne Haff Number of residents who received personal visits from committee members 5 Report completed by: Deborah Stewart Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly posted: Yes The most recent survey was readily accessible N/A (Required for NHs only – record date of most recent survey posted) : Staffing information clearly posted? N/A Resident Profile Yes No N/A Comments/Other Observations (please number comments) 1. Do the residents appear neat, clean and odor free? Yes 1. Everyone was up, dressed neatly, moving around, watching TV or visiting with family. 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? Yes 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? Yes 5a Did staff members wear nametags that are easily read by residents and visitors? No 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 No Resident Living Accommodations Yes No N/A Comments/Other Observations (please number comments) 8. Did residents describe their living environment as homelike? Yes 8. Rooms were very tidy with all beds made. 10a. Meds and charts are in a locked closet across from administrator's office. 13. Home does not use call bells since staff can hear someone calling them. 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? N/A 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? Yes 12. Does the facility accommodate smokers? Note: By regulation smoking is only permitted outside of the Building No 13. Were residents able to reach their call bells with ease? N/A 14. Did staff answer call bells in a timely & courteous manner? N/A 14a If no, did you share this with the administrative staff? *** N/A equals not applicable, not asked, not observed