Orange County NC Website
Community Advisory Committee Quarterly/Annual <br /> Visitation Report <br /> County: Orange Facility Type: ❑Family Care Home Carol Woods <br /> ❑Nursing Home xAdult Care Home 750 Weaver Dairy Road, Chapel Hill, NC 27514 <br /> Visit Date: 1/24/2023 Time spent in facility: 1 hr Arrival time: 2:15 ❑ am ® pm <br /> Name of person exit interview was held with: Jessica Fines-Crawford <br /> Interview was held: x in Person ❑ Phone <br /> ❑Admin. ® SIC(Supervisor in Charge) ❑ Other Staff Rep. <br /> Committee Members Present: MaryLou Gelblum, Karen Green-McElveen Report Completed by: Shade Little <br /> Number of Residents who received personal visits from committee members: 6(six) <br /> Resident Rights Information is clearly visible:x Yes ❑ No Ombudsman Contact Info is correct and clear) posted: ®Yes No <br /> The most recent survey was readily accessible: ® Yes ❑ No Staffing information clearly posted: x Yes ❑ No <br /> (Required for Nursing Homes Only) <br /> Resident Profile Comments/Other Observations <br /> Do the residents appear neat,clean and odor free? Y <br /> Did residents say they receive assistance with personal care activities? Ex. <br /> brushing their teeth, combing their hair, inserting dentures or cleaning Y <br /> their eyeglasses? <br /> Did you see or hear residents being encouraged to participate in their care N <br /> by staff members? <br /> Were residents interacting with staff,other residents&visitors? Y <br /> Did staff respond to or interact with residents who had difficulty Y <br /> communicating or making their needs known verbally? <br /> Did you observe restraints in use? N/A <br /> If so, did you ask staff about the facility's restraintpolicies? N/A <br /> Resident Living Accommodations Yes/No/NA Comments/Other Observations <br /> 1. Did residents describe their living environment as homelike? Y The residents are very comfortable. <br /> 2. Did you notice unpleasant odors in commonly used areas? N <br /> 3. Did you see items that could cause harm or be hazardous? N <br /> 4. Did residents feel their living areas were too noisy? N <br /> 5. Does the facility accommodate smokers? Y <br /> Where? ® Outside only❑ Inside only❑ Both Inside/Outside <br /> 6. Were residents able to reach their call bells with ease? N/A <br /> 7. Did staff answer call bells in a timely&courteous manner? N/A <br /> If no, did you share this with the administrative staff? <br /> Resident • • • Observations <br /> 8. Were residents asked their preferences or opinions about the Y <br /> activities planned for them at the facility? <br /> 9. Do residents have the opportunity to purchase personal items of Y <br /> their choice using their monthly needs funds? <br /> Can residents access their monthly needs funds at their Y <br /> convenience? <br /> 10. Are residents asked their preferences about meal/snack choices? Y <br /> Are they given a choice about where they prefer to dine? <br /> 11. Do residents have privacy in making and receiving hone calls? Y The ONLY complaint on the visit was <br /> 12. Is there evidence of community involvement from other civic, Y/N Families are visiting, but no evidence of the robust <br /> volunteer or religious groups? outside involvement as in the past. <br /> 13. Does the facility have a Resident's Council? Y <br /> Family Council? <br /> Areas of • • <br /> /NA Exit Summary <br /> Are there resident issues or topics that need follow-up or review at a later N Staff only one short. The facility is very well <br /> time or during the next visit? maintained. Residents have a wide range of <br /> activities available. <br />