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Community Advisory Committee Quarterly/Annual Visitation Report County: Orange Facility Type: Family Care Home Nursing Home X Adult Care Home Combination Home Facility Name/Address: Signature Healthcare of Chapel Hill 1602 E Franklin St, Chapel Hill, NC 27514 Visit Date: 06/30/2018 Time spent in facility: 1 hr 10 min Arrival time: 10:00 am Name of person exit interview was held with: Carissa Campbell, Social Worker Interview was held: in Person X SIC (Supervisor in Charge) Committee Members Present: Stephanie Miller, Jacqulyn Podger, Molly Stein, Vibeke Talley Report Completed by: Vibeke Talley Number of Residents who received personal visits from committee members: 10 Resident Rights Information is clearly visible: Yes X No Ombudsman Contact Info is correct and clearly posted: Yes X No The most recent survey was readily accessible: Yes X No (Required for Nursing Homes Only) Staffing information clearly posted: Yes No X Staffing info posted was from 6/28/18. No info posted from today. Resident Profile Yes/No/NA Comments/Other Observations 1. Do the residents appear neat, clean and odor free? Yes 2. Did residents say they receive assistance with personal care activities? Ex. brushing their teeth, combing their hair, inserting dentures or cleaning their eyeglasses? Yes 3. Did you see or hear residents being encouraged to participate in their care by staff members? NA 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? NA 6. Did you observe restraints in use? No 7. If so, did you ask staff about the facility’s restraint policies? Resident Living Accommodations Yes/No/NA Comments/Other Observations 8. Did residents describe their living environment as homelike? Yes 9. Did you notice unpleasant odors in commonly used areas? No 10. Did you see items that could cause harm or be hazardous? Yes* 10: One door to a bio-hazard trash storage room was left unlocked. 11. Did residents feel their living areas were too noisy? No 12. Does the facility accommodate smokers? Where? Outside only Inside only Both Inside/Outside Yes. Outside only 13. Were residents able to reach their call bells with ease? Yes 14. Did staff answer call bells in a timely & courteous manner? If no, did you share this with the administrative staff? Yes/no* 14: Most residents reported that call bells were answered in a timely manner. Two of the residents interviewed reported that the time it takes to answer a call bell is too long. Resident Services Yes/No/NA Comments/Other Observations 15. Were residents asked their preferences or opinions about the activities planned for them at the facility? Yes 16. Do residents have the opportunity to purchase personal items of their choice using their monthly needs funds? Can residents access their monthly needs funds at their convenience? NA NA 17. Are residents asked their preferences about meal/snack choices? Are they given a choice about where they prefer to dine? Yes* Yes 17: A new feature is the display of several options for alternate meals that the resident may request. 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