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Community Advisory Committee Quarterly/Annual Visitation Report <br />County: Orange <br />Census: 13/17 (licensed) <br />Facility Type: Adult Care Home Facility Name/Address: Adorable Senior Care <br />401 West Queen Street <br />Hillsborough, NC <br />Visit Date: 01 /30/ 2019 Time spent in facility: hr 45 min Arrival time: 3:00pm <br />Name of person exit interview was held with: Maria Martin Interview was held: in Person <br />SIC (Supervisor in Charge) <br />Committee Members Present: Will Lang, Gloria Brown <br /> <br /> Report Completed by: Will Lang <br />Number of Residents who received personal visits from committee members: 5 <br />Resident Rights Information is clearly visible: Yes Ombudsman Contact Info is correct and clearly posted: Yes <br />The most recent survey was readily accessible: Yes No <br />(Required for Nursing Homes Only) <br />Staffing information clearly posted: NA <br /> Resident Profile Yes/No/NA Comments/Other Observations <br />1. Do the residents appear neat, clean and odor free? <br />Yes <br />1. Most residents were gathered in the <br />common area upon our arrival. All <br />appeared well groomed and dressed in <br />clean clothing. <br /> <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. Most residents require some assistance with <br />ADLs. Staff are attentive and provide assistance <br />as needed. <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? Yes <br />3. One resident left the group stating she was <br />going to the bathroom. We observed staff <br />recognizing her actions and moving to assist. <br />4. Were residents interacting with staff, other residents & visitors? <br />Yes <br />4. Our arrival coincided with a staff shift change. <br />We observed staff interacting with each resident <br />in the common area, inquiring about their day and <br />personal status. <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 <br />7. If so, did you ask staff about the facility’s restraint policies? NA <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? No <br />11. Did residents feel their living areas were too noisy? No <br />12. Does the facility accommodate smokers? <br />Where? Outside only Inside only Both Inside/Outside <br />No 12. There does not appear to be any resident <br />smokers or clearly defined “smoking area.” <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 />Yes <br /> <br /> <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. Residents would prefer to have singing <br />everyday, yet the staff provide other options for <br />variety. <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 />Yes <br /> <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. Residents are able to dine in their rooms if <br />that is their preference. <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 indicate that weekly prayer service <br />provided by an outside pastor is a favorite of <br />residents.