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<br /> <br />Community Advisory Committee <br />Quarterly/Annual Visitation Report <br />County: Orange Facility Type: <br /> Family Care Home <br /> Adult Care Home <br />X Nursing Home <br />Facility Name: Signature <br /> <br /> <br />Census – current/licensed: 76/108 <br />Visit date and day of the <br />week: <br />October 16, 2017 (Monday) <br />Time spent in facility: <br />1 hour <br />Arrival time: 1 PM <br />Name of person(s) with whom exit interview was held: <br /> <br />Lee Cole, Administrator <br />Interview was held: in person <br />Committee members present: <br />Jacqulyn (Jackie) Podger, Karen Macklin, Molly Stein, Vibeke Talley <br /> <br />Number of residents who received personal visits from committee members: <br />13 residents and 2 family members <br /> Report completed by: Vibeke Talley <br />Resident Rights information is clearly posted? The <br />hall, where information is normally posted, is being <br />painted so therefore information is not posted during <br />visit. <br />Ombudsman contact information is correct and clearly posted: <br />The hall, where information is normally posted, is being painted so <br />therefore information is not posted during visit. <br />The most recent survey was readily accessible: Yes <br />(Required for NHs only – record date of most recent <br />survey posted): 7/17/2017 and 7/18/2017 <br />Staffing information clearly posted? The hall, where information <br />is normally posted, is being painted so therefore information is not <br />posted during visit. <br /> <br /> <br /> <br /> <br />Resident Profile Yes <br />No <br />N/A <br />Comments/Other Observations (please <br />number comments) <br />1. Do the residents appear neat, clean and odor free? No* 1: One resident and one area of a hall were noted to <br />have an odor. This was discussed with the <br />Administrator at exit interview. She stated that the <br />carpet in that hall had an odor they could not get rid of <br />but it would be replaced soon as the remodeling <br />progresses. <br />2.Did residents say they receive assistance with personal care <br />activities? (i.e. brushing their teeth, combing their hair, inserting <br />dentures or cleaning their eyeglasses) <br /> Yes <br />3. Did you see or hear residents being encouraged participate in <br />their care by staff members? N/A <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