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<br /> <br /> <br />Community Advisory Committee Quarterly/Annual Visitation Report <br />County: Orange Facility Type: <br /> <br />Family Care Home X Nursing Home <br />Adult Care Home Combination Home <br />Facility Name/Address: <br />Brookshire Senior Living <br />300 Meadowland Dr <br />Hillsborough, NC 27278 <br />Visit Date: 07/31 /2018 Time spent in facility: 1.25 hrs Arrival time: 10:30 x am pm <br />Name of person exit interview was held with: Interview was held: X in Person Phone <br />X Executive Director - Betty Stevens <br />Committee Members Present: Jerry Ann Gregory, Carol Kelly, Karen Macklin Report Completed by: Karen Macklin <br />Number of Residents who received personal visits from committee members: 11 plus 1 family member <br />Resident Rights Information is clearly visable. X Yes No Ombudsman Contact Info is correct and clearly posted: X Yes No <br />The most recent survey was readily accessible: X Yes No <br />(Required for Nursing Homes Only) <br />Staffing information clearly posted: X Yes No <br /> Resident Profile Yes/No/NA Comments/Other Observations <br />1. Do the residents appear neat, clean and odor free? Yes <br />2. Did residents say they receive assistance with personal care <br />activities? Ex. brushing their teeth, combing their hair, inserting <br />dentures or cleaning their eyeglasses? <br />Yes <br /> <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 difficulty <br />communicating or making their needs known verbally? Yes <br />6. Did you observe restraints in use? No <br />7. If so, did you ask staff about the facility’s restraint policies? N/A <br />Resident Living Accommodations Yes/No/NA Comments/Other Observations <br />8. Did residents describe their living environment as homelike? Yes <br />9. Did you notice unpleasant odors in commonly used areas? No <br />10. Did you see items that could cause harm or be hazardous? No <br />11. Did residents feel their living areas were too noisy? No <br />12. Does the facility accommodate smokers? <br />Where? Outside only Inside only Both Inside/Outside <br />No