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<br /> <br />Facility / Date: Signature 7/ 18/2017 <br /> <br /> <br /> <br /> <br />Resident Services Yes <br />No <br />N/A <br />Comments/Other Observations (please <br />number comments) <br />15. Were residents asked their preferences or opinions <br /> about the activities planned for them at the facility? <br />Yes <br />15b Two activities preceded our arrival at <br />11AM. Afternoon activities were scheduled. <br /> <br />17: In a resident’s room a cup of cranberry <br />juice labeled 7/17/2017 was sitting next to <br />today’s juice cup labeled 7/18/2017. This was <br />discussed at exit interview. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />15a. Was a current activity calendar posted in the facility? Yes <br />15b. Were activities scheduled to occur at the time of <br />your visit actually occurring? <br />N/A* <br />16. Do residents have the opportunity to purchase personal <br /> items of their choice using their monthly needs funds? <br />N/A <br />16a.Can residents access their monthly needs funds at <br />their convenience? <br />N/A <br />17. Are residents asked their preferences about meal & <br />snack choices? <br />Yes* <br />17a. Are they given a choice about where they prefer to dine? Yes <br />17b. Did residents express positive opinions regarding <br />their dining experience? <br />Yes <br />17c. Is fresh ice water available and provided to residents? Yes <br />18. Do residents have privacy in making and receiving <br /> phone calls? <br />Yes <br />19. Is there evidence of community involvement from other <br />civic, volunteer or religious groups? <br />Yes <br />20. Does the facility have a functioning: Resident and <br />Family Council? <br />Yes <br /> <br /> <br /> <br />