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Com unity Advisory Committee Quarterly/Annual Visitation Report County: Facility Type: Facility Name/Address: Orange ❑Family Care Home ❑Nursing Home Graceful Living 624 Jones Ferry Road Carrboro, N ❑✓ Adult Care Home ❑ Visit Date: 1;/19 /24 Time spent in facility: hr 40 min Arrival time: 3 :45 ❑ am ❑✓ pm Name of person exit interview was held with: Interview was held: ❑✓ in Person ❑ Phone ❑Admin. 21 SIC(Supervisor in Charge) ❑ Other Staff Rep. Name/Title Kuburat Ganiyu Committee Members Present: Report Completed by: Stephanie Boswell, Marylou Gelblum Marylou Gelblum Number of Residents who received personal visits from committee members: 10 Resident Rights Information is clearly visible: 0 Yes ❑✓ No Ombudsman Contact Info is correct and clearly posted: 0 Yes ❑ No The most recent survey was readily accessible: ❑Yes❑✓ No Staffing information clearly posted: ❑Yes ❑ No (Required for Nursing Homes Only) Resident Profile I Comments/Other Observations 1. Do the residents appear neat, clean and odor free? N/A When we arrived at 3:45 the halls and 2. Did residents say they receive assistance with personal care front waiting rooms were full of activities?Ex. brushing their teeth, combing their hair, inserting N/A residents. No residents were dentures or cleaning their eyeglasses? restrained but many in the hallways 3. Did you see or hear residents being encouraged to participate in N/A appeared disheveled, unkempt. Most their care by staff members? residents we spoke with were 4. Were residents interacting with staff, other residents&visitors. Yes O forthcoming, and several explained 5. Did staff respond to or interact with residents who had difficulty communicating or making their needs known verbally? N/A they were sitting in the front area due 6. Did you observe restraints in use? No O to floor work. 7. If so, did you ask staff about the facility's restraintpolicies? N/A Resident Living Accommodations Yes/No/NA Comments/Other Observations 8. Did residents describe their living environment as homelike? Yes O The familiar strong odor continues to 9. Did you notice unpleasant odors in commonly used areas? Yes O permeate. Ms. Ganiyu attributed it to 10. Did you see items that could cause harm or be hazardous? Yes O men refusing to shower. The front hall 11. Did residents feel their living areas were too noisy? No O was full of artificial plants, boxes, 12. Does the facility accommodate smokers? Yes O swept piles of trash and people due to Where? 0 Outside only❑ Inside only❑ Both Inside/Outside the change in personnel and cleaning 13. Were residents able to reach their call bells with ease? N/A O efforts of floors that da 14. Did staff answer call bells in a timely&courteous manner? N/A O y If no, did you share this with the administrative staff? Resident '/NA Comments/Other Observations 15. Were residents asked their preferences or opinions about the N/A O The new administration is working activities planned for them at the facility? hard to clean the building. We were 16. Do residents have the opportunity to purchase personal items of told that staff is in place and their choice using their monthly needs funds? Yes community involvement will be Can residents access their monthly needs funds at their encouraged. We will follow up and ask convenience? 17. Are residents asked their preferences about meal/snack choices? about a Resident's Council, food Are the given a choice about where the refer to dine? N/A O choices, and privacy of phone calls. 18. Do residents have privacy in making and receiving phone calls? N/A o Several people did mention the food is 19. Is there evidence of community involvement from other civic, good and there is enough of it, volunteer or religious groups? N/A O although one man complained he gets 20. Does the facility have a Resident's Council? hungry in the night. FamilyCouncil? N/A O Areas of • • /NA Exit Summary 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 We are hopeful of finding big changes in the appearance, organization and cleanliness of the building and clients on our next visit. Because they are in the midst of a large scale transition, some disarray can be expected. We will followup with questions about whether water fountains are installed and working, the men's side has a phone, there is an active Resident's Council and if there has been an increase in community involvement. This Document is PUBLIC RECORD.Do not identify any Resident(s)by name or inference on this form. Top Copy is for the Regional Ombudsman's Record.Bottom Copy is for the CAC's Records. Revised 1/21/2020