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Community Advisory Committee Quarterly/Annual Visitation Report County: Orange Facility Type: Family Care Home Nursing Home X Adult Care Home Facility Name/Address: Carillon 1911 Orange Grove Rd Hillsborough NC 27278 59 enrolled 96 licensed and 24 in Memory Care Visit Date: 1 /30 /2019 Time spent in facility: 1 hr. 15 min Arrival time: 2:00 pm Name of person exit interview was held with: Brianna Southerland, New Admin.. Interview was held: x in Person (Name & Title) Committee Members Present: Will Lang and Gloria Brown Report Completed by: Gloria Brown Number of Residents who received personal visits from committee members: 8 Resident Rights Information is clearly visible: X Yes Ombudsman Contact Info is correct and clearly posted: X No correct info The most recent survey was readily accessible: Yes No (Required for Nursing Homes Only) Staffing information clearly posted: No Resident Profile Yes/No/NA Comments/Other Observations 1. Do the residents appear neat, clean and odor free? Yes All the residents appeared neat, clean, and odor free and enjoying their personal time in their room or in the Memory Care Area. 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? Yes We arrived during a shift change and in the Memory Care Unit the staff were making sure that the residents knew who was coming to care for them. 4. Were residents interacting with staff, other residents & visitors? Yes In the entire center. 5. Did staff respond to or interact with residents who had difficulty communicating or making their needs known verbally? Yes 6. Did you observe restraints in use? No 7. If so, did you ask staff about the facility’s restraint policies? No Resident Living Accommodations Yes/No/NA Comments/Other Observations 8. Did residents describe their living environment as homelike? Yes Residents shared how long they have been a resident and that they like it feels like home. 9. Did you notice unpleasant odors in commonly used areas? No 10. Did you see items that could cause harm or be hazardous? No Doors are locks for cleaning chemicals and meds. 11. Did residents feel their living areas were too noisy? No Residents have plenty of places to go for a quiet area. 12. Does the facility accommodate smokers? Where? Outside only Inside only Both Inside/Outside No 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? NA 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 They can make suggestions on where they want to go. I happened to see the Carillon bus stopped at the Dollar Store in Hillsborough on my way to visit. 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? Yes Yes 17. Are residents asked their preferences about meal/snack choices? Are they given a choice about where they prefer to dine? Yes Alternative items are posted on the daily posted menu items and snack for the day. In the assisted living area there is fresh water, fruit, and healthy snacks in small bags. 18. Do residents have privacy in making and receiving phone calls? Yes