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<br />Community Advisory Committee <br />Quarterly/Annual Visitation Report Addendum <br /> <br />Facility/ Date <br /> <br />Culture Change / Person Centered Thinking <br /> <br />Comments/Responses <br /> <br />1. Directed to residents – <br /> <br />a. What is one thing you would change here to make your <br />life better? <br /> <br /> <br />b. Are you offered choices and encouraged to make your <br />own decision about personal issues like what to wear or <br />when to go to bed? <br /> <br /> <br />c. What’s important to you while dining? <br /> <br /> <br />d. What would make your dining experience here <br /> more like home? <br /> <br />e. Is listening to music something you’ve enjoyed? <br /> <br /> <br /> <br />2. Directed to the administrator or supervisor-in-charge <br /> <br /> <br />a. What are you doing to incorporate residents’ wants and <br />needs in every aspect of their lives and assure a home- <br />like environment? <br /> <br /> <br /> <br />b. Are you providing for consistent-assignment of your <br />direct caregivers to take care of your residents? <br /> <br /> <br /> <br /> <br />c. What are you doing to make the dining experience a <br />pleasant one for your residents? <br /> <br /> <br /> <br />d. Are you offering personalized music to your residents? <br /> <br /> <br /> <br /> <br /> <br />Updated 1/2015