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Facility / Date: Resident Services Yes No N/A Comments/Other Observations (please number comments) 15. Were residents asked their preferences or opinions about the activities planned for them at the facility? Yes 15b. The first activity of the day (Workout) was scheduled to begin at 10:00 and we were there ear- lier. 17a. Residents who require help with eating are fed in a designated dining room. 17b. Additional morning coffee was not provided despite requests from resident. 19. Some evidence was present but residents reported not enough. -Resident cried out to advisory committee member asking for help in removing tray table from her knees. Resident indicated the CNA had brought her breakfast, pinning her legs un- der the tray table. Advisory committee mem- ber moved the tray table up and away from the resident allowing her to move her legs. Resi- dent was also not seated in a position that would not allow an open airway thereby risk- ing choking. Resident indicated her call but- ton had not been working and that she had tried using it minutes before she was helped. 15a. Was a current activity calendar posted in the facility? Yes 15b. Were activities scheduled to occur at the time of your visit actually occurring? Yes* 16. Do residents have the opportunity to purchase personal items of their choice using their monthly needs funds? Yes 16a.Can residents access their monthly needs funds at their convenience? Yes 17. Are residents asked their preferences about meal & snack choices? Yes 17a. Are they given a choice about where they prefer to dine? Yes* 17b. Did residents express positive opinions regarding their dining experience? No* 17c. Is fresh ice water available and provided to residents? Yes 18. Do residents have privacy in making and receiving phone calls? Yes 19. Is there evidence of community involvement from other civic, volunteer or religious groups? Yes* 20. Does the facility have a functioning: Resident’s Council? Family Council? Yes Yes