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Community Advisory Committee Quarterly/Annual Visitation Report <br /> County: ORANGE Facility Type: Facility Name/Address: Signature HealthCARE <br /> Family Care Home X Nursing Home 1602 E Franklin St, <br /> Adult Care Home Combination Home Chapel Hill, NC 27514 <br /> Visit Date: 10/1712022 Time spent in facility: 1 hr 30 min Arrival time: 11:00AM <br /> Name of person exit interview was held with: Interview was held: Moses Muhairwe <br /> Committee Members Present: Jackie Podger,Vibeke Talley Report Completed by: Jackie Podger <br /> Number of Residents who received personal visits from committee members: 7 residents and 1 family member <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 Staffing information clearly posted: YES <br /> (Required for Nursing Homes Only) <br /> Resident Profile Yes/No/NA Comments/Other Observations <br /> 1. Do the residents appear neat, clean and odor free? Yes <br /> 2. Did residents say they receive assistance with personal care <br /> activities? Ex. brushing their teeth, combing their hair, inserting Yes <br /> dentures or cleaning their eyeglasses? <br /> 3. Did you see or hear residents being encouraged to participate in Yes <br /> their care by staff members? <br /> r � <br /> 4. Were residents interacting with staff, other residents &visitors? Yes <br /> r � <br /> 5. Did staff respond to or interact with residents who had difficulty Yes <br /> communicating or making their needs known verbally? <br /> 6. Did you observe restraints in use? N/A <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 Observations <br /> 8. Did residents describe their living environment as homelike? Yes A family member expressed that the facility decor <br /> left something to be desired. It was noted that <br /> there are some areas that require some paint. <br /> The Administrator indicated that the interior <br /> painting had just begun. <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?YES Yes If the resident is mobile, the resident can use the <br /> Where?Outside in designated area. designated area without assistance. If the <br /> resident requires assistance, a staff member <br /> must accompany the resident. <br /> 13. Were residents able to reach their call bells with ease? Yes <br />