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Community Advisory Committee Quarterly/Annual Visitation Report County ORANGE Facility Type Family care home Facility Name: Cedar Grove Family Care Home 313-317 Saw Mill Road Cedar Grove, NC Census: 10 / 12 Visit Date and day of the week Thursday, October 20, 2016 Time spent in facility 50 minutes Arrival time 1:30 pm Name of person(s) with whom exit interview was held Betsy Collins Interview was held in person: Yes Committee members present: Will Lang, Yvonne Mendenhall, Jack Vogt Number of residents who received personal visits from committee members : 3 Report completed by: Will Lang Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly posted: Yes The most recent survey was readily accessible (Required for NHs only – record date of most recent survey posted) : NA Staffing information clearly posted? Did not see or ask to see this information. Emergency information clearly posted. Resident Profile Yes No N/A Comments/Other Observations (please number comments) 1. Do the residents appear neat, clean and odor free? Yes 1, and 3.-6., .Cedar Grove Family Care home is two houses separated by an outdoor area. Residents are all SSI eligible with referrals to the home from local hospitals. The age range of residents is 29-84. All residents appeared well cared for, clean and in clean clothes. Owners frequently access area thrift shops to supplement resident clothing needs. Residents were complimentary of care, food, and caregivers. 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) N/A 3. Did you see or hear residents being encouraged to participate in their care by staff members? No 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) Resident Living Accommodations Yes No N/A Comments/Other Observations (please number comments) 8. Did residents describe their living environment as homelike? Yes 8.-12a. The feel or environment of the two homes was indeed homelike. Resident rooms were clean and tidy Residents take meals together at a common dining room table. The kitchen is not locked residents are asked not to enter. Meds are kept in a locked closet. Both homes were slightly cluttered. Shades in resident rooms were drawn reducing exterior light which could present a tripping and safety risk. Bathrooms have wooden, rather than standard grab bars. Call bells were not seen, but the owners live in the house. 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? Yes 12. Does the facility accommodate smokers? Yes 12a. Where? (Outside / inside / both) Outside 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