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Community Advisory Committee Quarterly/Annual Visitation Report <br /> County:Orange Facility Type: Facility Name/Address: Peak Resources Brookshire, <br /> ❑Family Care Home X Nursing Home Hillsborough, NC <br /> ❑Adult Care Home ❑Combination Home <br /> Visit Date 09-11-2023 Time spent in facility: 1 hr Arrival time: 10 am <br /> Name of person exit interview was held with: Dereck Hammond Interview was held: X in Person <br /> X Admin. SIC(Supervisor in Charge) Other Staff Rep. (Name& Title) <br /> Committee Members Present: Carol Kelly and Vibeke Talley Report Completed by: Vibeke Talley <br /> Number of Residents who received personal visits from committee members: 9 residents and 2 family members <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 UL—c—ornments/Other Observations <br /> 1. Do the residents appear neat, clean and odor free? Yes <br /> 1. Did residents say they receive assistance with <br /> personal care activities? Ex. brushing their teeth, Yes <br /> combing their hair, inserting dentures or cleaning <br /> their eyeglasses? <br /> 1. Did you see or hear residents being encouraged to NA <br /> participate in their care by staff members? <br /> 4: Staff appeared attentive to needs and <br /> 1. Were residents interacting with staff, other residents Yes* they were described as friendly, caring and <br /> & visitors? having a positive attitude. <br /> 1. Did staff respond to or interact with residents who <br /> had difficulty communicating or making their needs NA <br /> known verbally? <br /> 1. Did you observe restraints in use? No <br /> 1. If so, did you ask staff about the facility's restraint NA <br /> policies? <br /> Resident Living Accommodations Yes/No/N Comments/Other Observations <br /> 1. Did residents describe their living environment as Yes* 8: The environment was described as <br /> homelike? welcoming and clean. <br /> 1. Did you notice unpleasant odors in commonly used areas? No <br /> 1. Did you see items that could cause harm or be hazardous? No <br /> 1. Did residents feel their living areas were too noisy? No <br /> 1. Does the facility accommodate smokers? No <br /> Where? ❑ Outside only ❑ Inside only ❑ Both <br /> Inside/Outside <br />