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Com unity Advisory Committee Quarterly/Annual Visitation Report County: Facility Type: Facility Name/Address: Carol Woods Retirement Community, Building 5 Orange Assisted Living 750 Weaver Dairy Rd Chapel Hill, NC 27514 Visit Date: 09/24/25 Time spent in facili : 25 min. Arrival time: 9: 05 AM Name of person exit interview was held with: Jessica Fines-Crawford, administrator Interview was held: in person Committee Members Present: Kelly Kester and Karen Green-McElveen Report Completed by: Kelly Kester and Karen �Green-McElveen Number of Residents who received personal visits from committee members: 4 Resident Rights Information is clearly visible: ®Yes Ombudsman Contact Info is correct and clear) posted: ®Yes The most recent survey was readily accessible: ®Yes Staffing information clearly posted: ®Yes Re uired for NursinQ Homes Onl Resident • •/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? Several residents were eating breakfast together and Ex. brushing their teeth, combing their hair,inserting dentures or cleaning Y conversing.Multiple staff members were seen rounding on their eyeglasses? each table of residents and bringing them food or drinks. 3. Did you see or hear residents being encouraged to participate in their Y One resident shared,"I can't sayh good things." care b staff members? enough g g 4. Were residents interacting with staff,other residents&visitors? Y 5. Did staff respond to or interact with residents who had difficulty NIA communicating or making their needs known verbally? 6. Did ou observe restraints in use? N 7. If so,did you ask staff about the facility's restraint policies? NIA Resident Living Accommodations Yes/No/NA Comments/Other Observations 1. Did residents describe their living environment as homelike? Y 2. Did you notice unpleasant odors in commonly used areas? N The building is very clean and free of clutter. It is nicely 3. Did you see items that could cause harm or be hazardous? N decorated with art,some of which was created by current 4. Did residents feel their living areas were too noisy? N and previous residents. 5. Does the facility accommodate smokers? y The grounds surrounding Building 5 are well-maintained Where? ® Outside only and there are multiple areas for residents to sit outside. 6. Were residents able to reach their call bells with ease? NIA 7. Did staff answer call bells in a timely&courteous manner? NIA 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 Y activities planned for them at the facility? Residents were seen working on puzzles in the common 2. Do residents have the opportunity to purchase personal items of Y area and interacting with staff members. their choice using their monthly needs funds? One resident stated that they have multiple options for Can residents access their monthly needs funds at their Y food and there is always something she is satisfied with at convenience? each meal. 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 N time or during the next visit?