Orange County NC Website
Comm unit Advisory Committee Quarterly/Annual Visitation Report <br /> County: Orange Facility Type: Facility Name/Address: <br /> ❑Family Care Home X Nursing Home Peak Resources Brookshire <br /> ❑Adult Care Home 300 Meadowlands Drive <br /> Hillsborough, NC 27278 <br /> Visit Date: 07/10/2024 Time spent in facility: hr 45 min Arrival time: 1:30 ❑ am X pm <br /> Name of person exit interview was held with: Derrick Hammon Interview was held: X in Person ❑ Phone <br /> Admin. SIC(Supervisor in Charge) ❑ Other Staff Rep. Name& Title <br /> Committee Members Present: Kelly Kester Carol Kelly Report Completed by: Carol Kelly <br /> Number of Residents who received personal visits from committee members: 7 <br /> Resident Rights Information is clearly visible:X Yes ❑ No Ombudsman Contact Info is correct and clear) posted: X Yes ❑ No <br /> The most recent survey was readily accessible: X Yes ❑ No Staffing information clearly posted: X Yes ❑ No <br /> Re uired for Nursing Homes Onl <br /> Resident Profile ' Comments/Other <br /> 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 by Y <br /> 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 <br /> If so, did you ask staff about the facility's restraintpolicies? N/A <br /> Resident Living Accommodations Yes/No/NA Comments/Other <br /> Observations <br /> 1. Did residents describe their living environment as homelike? Y <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? N <br /> Where? ❑ Outside only❑ Inside only❑ Both Inside/Outside <br /> 6. Were residents able to reach their call bells with ease? Y <br /> 7. Did staff answer call bells in a timely&courteous manner? Y <br /> If no, did you share this with the administrative staff? N/A <br /> Resident ' Comments/Other <br /> Observations <br /> 8. Were residents asked their preferences or opinions about the Y Residents consistently noted the strength of <br /> activities planned for them at the facility? the activities program. <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? Y <br /> 11. Do residents have privacy in making and receiving hone calls? Y <br /> 12. Is there evidence of community involvement from other civic, Y <br /> volunteer or religious groups? <br /> 13. Does the facility have a Resident's Council? Y <br /> Family Council? N <br /> Areas of Concern • <br />