Orange County NC Website
Community Advisory Committee Quarterly/Annual Visitation Report <br />County: Orange Co Facility Type: <br />Family Care Home Nursing Home <br />Adult Care Home <br />Facility Name/Address: Signature Nursing Home <br /> 1602 E. Franklin St. <br /> Chapel Hill, N 27514 <br />Visit Date: 6/25/2019 Time spent in facility: 1 hr 5 min Arrival time: 1 : 30 am pm <br />Name of person exit interview was held with: Interview was held: in Person Phone <br /> Admin. SIC (Supervisor in Charge) Other Staff Rep. Carissa Campbell, MSW <br />Committee Members Present: Bill Morgan, Stephanie Boswell <br /> <br /> Report Completed by: Bill Morgan <br />Number of Residents who received personal visits from committee members: 6 <br />Resident Rights Information is clearly visable: Yes No Ombudsman Contact Info is correct and clearly posted: <br />Yes No <br />The most recent survey was readily accessible: Yes No <br />(Required for Nursing Homes Only) <br />Staffing information clearly posted: Yes No <br /> Resident Profile Yes/No/NA Comments/Other <br />Observations <br />1. Do the residents appear neat, clean and odor free? Yes 1. Most residents were up and <br />dressed when we visited <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 were up and <br />dressed, and clean when we visited. <br />Most residents indicated they <br />received care they needed. <br />One resident indicated that they had <br />a negative experience with one of <br />the staff hired in the facility. The <br />resident indicated that the staff <br />member did was abrupt and curt. <br />The resident indicated that they felt <br />comfortable in addressing their <br />concerns with the administration but <br />had not done so. The resident also <br />indicated that the majority of staff <br />who provide care do so in a <br />professionally. <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? n/a <br />4. Were residents interacting with staff, other residents & visitors? Yes <br />5. Did staff respond to or interact with residents who had difficulty <br />communicating or making their needs known verbally? N/A <br />6. Did you observe restraints in use? No <br />7. If so, did you ask staff about the facility’s restraint policies? N/A <br />Resident Living Accommodations Yes/No/NA Comments/Other <br />Observations <br />8. Did residents describe their living environment as homelike? n/a <br />9. Did you notice unpleasant odors in commonly used areas? No Facility looked and smelled clean <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 />Yes <br />13. Were residents able to reach their call bells with ease? Yes