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Community Advisory Committee Quarterly/Annual Visitation Report County: ORANGE Facility Type: Facility Name/Address: ❑Family Care Home ❑Nursing Home The Stratford ❑x Adult Care Home 405 Smith Level Road, Chapel Hill, NC 27516 Visit Date: 8/28/2023 Time spent in facility: 50 min Arrival time: 2:00 Elam ❑x m Name of person exit interview was held with: Interview was held: ❑X in Person ❑Phone ❑Admin. ❑x SIC (Supervisor in Charge) ❑Other Staff Rep. Crystal Tinnen Committee Members Present: Karen Green-McElveen, MaryLou Gelblum, Shade Little Report Completed by: Shade Little Number of Residents who received personal visits from committee members: 15 Resident Rights Information is clearly visible: ❑x Yes❑No Ombudsman Contact Info is correct and clear) posted: 0 Yes❑No The most recent survey was readily accessible: ❑Yes❑No Staffing information clearly posted: Z Yes❑No Re uired for Nursing Homes Onl Resident •file Yes/No/NA Comments/Other Observations 1. Do the residents appear neat, clean and odor free? Y 2. Did residents say they receive assistance with personal care activities? Ex. brushing their teeth, combing their hair, inserting NA dentures or cleaning 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 restraintpolicies? NA Resident Living Accommodations Yes/No/NA Comments/Other Observations 1. Did residents describe their living environment as homelike? N 2. Did you notice unpleasant odors in commonly used areas? Y Memory Care Unit: Strong offensive odor was 3. Did you see items that could cause harm or be hazardous? N present initially, but after it was mentioned to staff, 4. Did residents feel their living areas were too noisy? N most of the odor was eliminated by the time we left. 5. Does the facility accommodate smokers? Y New chairs with arms and Ieatherlike seats(for easy Where?❑x Outside only❑Inside only❑Both Inside/Outside cleaning)were present, replacing uncomfortable and 6. Were residents able to reach their call bells with ease? NA limited alternative seating a few years ago. 7. Did staff answer call bells in a timely&courteous manner? NA If no, did you share this with the administrative staff? Resident •/NA Comments/Other Observations 1. Were residents asked their preferences or opinions about the NA There was a TV turned on in the sitting area off the activities planned for them at the facility? dining room, but the picture was bluish and the TV 2. Do residents have the opportunity to purchase personal items of Y very small.The Director said the larger TV had been their choice using their monthly needs funds? broken. Can residents access their monthly needs funds at their Y The dayroom was full of participants,4 or 5 playing convenience? cards(card games are serious business), some 3. Are residents asked their preferences about meal/snack choices? N watching TV, others sitting near each other in Are they given a choice about where they prefer to dine? N wheelchairs.The library room is also being used. 4. Do residents have privacy in making and receiving hone calls? Y Residents agreed the food was good,there was 5. Is there evidence of community involvement from other civic, N plenty of it, and that they could go to administration volunteer or religious groups? 1 with complaints or requests. 6. Does the facility have a Resident's Council? Y Family Council? Areas of • • /NA Exit Summary Are there resident issues or topics that need follow-up or review at a later N time or during the next visit? Community Advisory Committee Quarterly/Annual Visitation Report This Document is PUBLIC RECORD.Do not identify any Resident(s)by name or inference on this form. Top Copes is for the Regional Ombudsman's Record.Bottom Copy is for the CAC's Records.