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Community Advisory Committee Quarterly/Annual Visitation Report County Orange Facility Type Family Care Home Adult Care Home Nursing Home X Facility Name: Signature Healthcare Census – current/licensed: 104/108 Visit Date and day of the week Thursday, 6/2/2016 Time spent in facility 1 hour Arrival time 1PM Name of person(s) with whom exit interview was held: Interview was held in person Committee members present: Number of residents who received personal visits from committee members 12 Report completed by: Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly posted: Telephone number correct but name is not. Information clearly posted. The most recent survey was readily accessible (Required for NHs only – record date of most recent survey posted) : July 7-9 2015. See note under exit in- terview. Staffing information clearly posted? Yes Resident Profile Yes No N/A Comments/Other Observations (please num- ber comments) 1. Do the residents appear neat, clean and odor free? Yes 6 and 7: Facility continues to have one resident who has hands restrained to prevent the resident from re- moving tracheostomy tube. 2.Did residents say they receive assistance with personal care ac- tivities? (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 par- ticipate 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? Yes* 7. If so, did you ask staff about the facility’s restraint pol- icies? Yes*