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Community Advisory Committee Quarterly/Annual Visitation Report County: ORANGE Facility Type: Facility Name/Address: ❑Family Care Home ®Nursing Home Parkview Health & Rehabilitation Center ❑Adult Care Home 1716 Legion Road, Chapel Hill, NC 27517 Visit Date: 12/05/2023 Timespent in facility: 70 min. Arrival time: 1:00 ❑ am ® pm Name of person exit interview was held with: Interview was held: ® in Person ❑ Phone ❑Admin. ® SIC Supervisor in Charge) ❑ Other Staff Rep. Sekeithia Jones Committee Members Present: Karen Green-McElveen, Shade Little Report Completed by: Shade Little Number of Residents who received personal visits from committee members: 15 Resident Rights Information is clearly visible: ®Yes ❑ No Ombudsman Contact Info is correct and clear) posted: ®Yes ❑ No The most recent survey was readily accessible: ®Yes ❑ No Staffing information clearly posted: ®Yes❑ No Re uired for Nursinq Homes Only) Resident • •/NA Comments/Other Observations 1. Do the residents appear neat,clean and odor free? Y The residents were easy to talk with. 2. Did residents say they receive assistance with personal care activities? Ex. brushing their teeth, combing their hair,inserting dentures or cleaning Y their eyeglasses? 3. Did you see or hear residents being encouraged to participate in N their care by staff members? 4. Were residents interacting with staff,other residents&visitors? Y 5. Did staff respond to or interact with residents who had difficulty NA communicating or making their needs known verbally? 6. Did you observe restraints in use? N 7. If so,did you ask staff about the facility's restraint policies? NA Resident Living Accommodations Yes/No/NA Comments/Other Observations 1. Did residents describe their living environment as homelike? Y Many residents are having laundry done by family 2. Did you notice unpleasant odors in commonly used areas? N members. 3. Did you see items that could cause harm or be hazardous? N An unpleasant odor near an exit on 900 hall (cross 4. Did residents feel their living areas were too noisy? N from room 908)was noted and reported on the exit 5. Does the facility accommodate smokers? N interview. Where? ❑ Outside only❑ Inside only❑ Both Inside/Outside 6. Were residents able to reach their call bells with ease? Y 7. Did staff answer call bells in a timely&courteous manner? Y If no, did you share this with the administrative staff? Resident • • Observations 1. Were residents asked their preferences or opinions about the Y The residents appreciated the staff workers very activities planned for them at the facility? much, and stated they were very good and attentive. 2. Do residents have the opportunity to purchase personal items of Y The OT and PT services were also mentioned their choice using their monthly needs funds? favorably. Can residents access their monthly needs funds at their Y convenience? 3. Are residents asked their preferences about meal/snack choices? Y Are they given a choice about where they prefer to dine? Y 4. Do residents have privacy in making and receiving hone calls? Y 5. Is there evidence of community involvement from other civic, Y volunteer or religious groups? 6. Does the facility have a Resident's Council? Y Family Council? Areas of • Yes/No/NA Exit Summary Are there resident issues or topics that need follow-up or review at a later Yes Room 704 needs repairs near window time or during the next visit? his Document is PUBLIC RECORD.Do not identify any Resident(s)by name or inference on this form. Bottom Copy is for the CAC's Records.