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Community Advisory Committee Quarterly/Annual Visitation Report <br />County: Orange <br />Census: 13/17 (licensed) <br />Facility Type: Family Care Home <br /> Nursing Home <br />X Adult Care Home <br />Facility Name/Address: Adorable Senior Care <br />410 West Queen Street <br />Hillsborough, NC 27278 <br />Visit Date: 10 /29/ 2018 Time spent in facility: 1hr 0 min Arrival time: am 2:00 pm <br />Name of person exit interview was held with: Marie Martin Interview was held: X in Person Phone <br />Admin. XSIC (Supervisor in Charge) Other Staff Rep. (Name & Title) <br />Committee Members Present: Gloria Brown, Will Lang Report Completed by: Will Lang <br />Number of Residents who received personal visits from committee members: 7 <br />Resident Rights Information is clearly visable: XYes No Ombudsman Contact Info is correct and clearly posted: XYes No <br />The most recent survey was readily accessible: Yes No <br />(Required for Nursing Homes Only) <br />Staffing information clearly posted: Yes No XNA <br /> Resident Profile Yes/No/NA Comments/Other Observations <br />1. Do the residents appear neat, clean and odor free? <br />Yes <br />1. Upon our arrival all residents were <br />congregated in the communal area and were <br />dressed, clean and interacting with staff and each <br />other. <br />2. Did residents say they receive assistance with personal care <br />activities? Ex. brushing their teeth, combing their hair, inserting <br />dentures or cleaning their eyeglasses? <br />Yes <br />2. Residents indicate that staff are very helpful <br />and resident appearance supports such help. <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? Yes 3. Staff were actively engaged with residents <br />while they were in the communal area. <br />4. Were residents interacting with staff, other residents & visitors? Yes 4.One family member was visiting a resident and <br />discussing care with staff. <br />5. Did staff respond to or interact with residents who had difficulty <br />communicating or making their needs known verbally? Yes <br />6. Most residents have some difficulty <br />communicating. Staff appear well prepared in <br />supporting these residents. <br />6. Did you observe restraints in use? No <br />7. If so, did you ask staff about the facility’s restraint policies? No <br />Resident Living Accommodations Yes/No/NA Comments/Other Observations <br />8. Did residents describe their living environment as homelike? Yes <br />9. Did you notice unpleasant odors in commonly used areas? No <br />10. Did you see items that could cause harm or be hazardous? <br />11. Did residents feel their living areas were too noisy? No 11. A new “quiet room” is being created to allow <br />residents to be away from any unwanted noise. <br />12. Does the facility accommodate smokers? <br />Where? Outside only Inside only Both Inside/Outside <br />NA 12. We did not observe residents smoking <br />anywhere on the premises. <br />13. Were residents able to reach their call bells with ease? Yes <br />14. Did staff answer call bells in a timely & courteous manner? <br />If no, did you share this with the administrative staff? <br /> <br />NA <br />14. No residents used call bells during our visit. <br />Resident Services Yes/No/NA Comments/Other Observations <br />15. Were residents asked their preferences or opinions about the <br />activities planned for them at the facility? <br />Yes 15. Staff are working to increase the activities <br />available to residents. Staff uses resident <br />participation in activities to determine their <br />preferences. <br />16. Do residents have the opportunity to purchase personal items of <br />their choice using their monthly needs funds? <br />Can residents access their monthly needs funds at their <br />convenience? <br /> <br />Yes <br /> <br /> <br />17. Are residents asked their preferences about meal/snack choices? <br />Are they given a choice about where they prefer to dine? <br />Yes 17. Most residents eat in the main dining area as <br />some need staff assistance with eating. <br />Residents have the option of their meals being <br />served in their room. Individual resident dietary <br />needs are incorporated into all meals. <br />18. Do residents have privacy in making and receiving phone calls? Yes <br />19. Is there evidence of community involvement from other civic, <br />volunteer or religious groups? <br />Yes 19. Staff are working to increase community <br />involvement.