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Community Advisory Committee Quarterly/Annual Visitation Report County: Orange Facility Type: Facility Name/Address: ❑Assisted Living Carol Woods Bldg 4,floor 2 and Bldg 5,6,7 750 Weaver Dairy Rd. Chapel Hill,27514 Visit Date: 12/16/23 Time spent in facility: 1 hr 20 min Arrival time: ❑ 1:00 pm Name of person exit interview was held with: Melanie Johnson (DON) Interview was held: X in Person X Admin: Jessica Fine❑ Committee Members Present: Shade Little and Jackie Podger Report Completed by: Jackie Podger Number of Residents who received personal visits from committee members: 12 Resident Rights Information is clearly visible: X Yes ❑ No Ombudsman Contact Info is correct and clear) posted: X Yes The most recent survey was readily accessible: X Yes Staffing information clearly posted:X Yes Required for Nursing Homes Onl Resident •file Yes/No/NA 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? NO 7. If so, did you ask staff about the facility'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? YES 11. Did residents feel their living areas were too noisy? NO 12. Does the facility accommodate smokers? YES Where?X Outside only 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 • - • • • • • 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 their choice using their monthly needs funds? YES 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? 18. Do residents have privacy in making and receiving hone calls? YES 19. Is there evidence of community involvement from other civic, YES volunteer or religious groups? 20. Does the facility have a Resident's Council? YES Family Council? Areas of • Are there resident issues or topics that need follow-up or review at a later Discuss items from"Areas of Concern"Section time or during the next visit? as well as any changes observed during the visit CAC Members toured all assisted living facilities in 3 different areas. Did 1. not find any resident right violations and the residents as well as the facilities received good care.w