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Com unity Advisory Committee Quarterly/Annual Visitation Report County: Orange Facility Type: Facility Name/Address: Carol Woods ❑Family Care Home©Nursing Home 750 Weaver Dairy Road, Chapel Hill, NC 27514 ❑Adult Care Home ❑Combination Home Visit Date: 2/20/19 Time spent in facility: 1 hr. Arrival time: 10:00 X am ❑ pm Name of person exit interview was held with: Melanie Johnson, Lead Engagement Coach Interview was held: in Person ❑ Phone ❑Admin.N SIC(Supervisor in Charge) X Other Staff Rep.—Jennifer Fines-Crawford, Resident Life Coach Committee Members Present: Stephanie Miller, Susie Deter I Report Completed by: Susie Deter Number of Residents who received personal visits from committee members:4 residents& 1 family member Resident Rights Information is clearly visible: X Yes❑ No Ombudsman Contact Info is correct and clearly posted: Yes❑ No The most recent survey was readily accessible:X lYes❑ No Staffing information clearly posted: es❑ N (Required for Nursing Homes Only) Resident Profile 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 Yes dentures or cleaning their eyeglasses? 3. Did you see or hear residents being encouraged to participate in Yes their care by staff members? 4. Were residents interacting with staff,other residents&visitors? Yes 5. Did staff respond to or interact with residents who had difficulty Yes communicating or making their needs known verbally? 6. Did you observe restraints in use? N/A* 6. Carol Woods is a restraint free facility. 7. If so, did you ask staff about the facilit 's restraint policies? N/A 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? No 11. Did residents feel their living areas were too noisy? No 12. Does the facility accommodate smokers? Yes Where?©Outside only 0 Inside only❑ Both Inside/Outside 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 Resident •/NA Comments/Other Observations 15. Were residents asked their preferences or opinions about the Yes activities planned for them at the facility? 16. Do residents have the opportunity to purchase personal items of N/A their choice using their monthly needs funds? Can residents access their monthly needs funds at their convenience? 17. Are residents asked their preferences about meal/snack choices? Yes Are they given a choice about where they prefer to dine? Yes 18. Do residents have privacy in making and receiving hone calls? Yes 19. Is there evidence of community involvement from other civic, Yes 20. Since most residents are also living within volunteer or religious groups? the greater Carol Woods community,the general councils are considered to take the place of the Family Council. 20. Does the facility have a Resident's Council? Yes Family Council? No* Areas of Concern • /NA Exit Summary Are there resident issues or topics that need follow-up or review at a later No Discuss items from"Areas of Concern"Section time or during the next visit? as well as any changes observed during the visit ■ Residents expressed high levels of satisfaction&reported no concerns ■ Resident&family member reported a high level of satisfaction with the OT services provided ■ The dining room in all four pods had been repainted