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Corn unity Advisory Committee Quarterly/Annual Visitation Report <br /> County: Facility Type: Facility Name/Address: <br /> Orange ❑Family Care Home ❑✓Nursing Home Parkview Health & Rehabilitation Center 1716 Leg <br /> ❑Adult Care Home ❑ <br /> Visit Date: 03 / 27 /25 Time spent in facility: hr 40 min Arrival time: 3 : 45 ❑ am ❑✓ pm <br /> Name of person exit interview was held with: Interview was held: Win Person ❑ Phone <br /> ❑✓ Admin. ❑ SIC(Supervisor in Charge) ❑✓ Other Staff Rep. Name/Title Kayla Rudd, Unit Manager <br /> Committee Members Present: Report Completed by: <br /> Stephanie Boswell, MaryLou Gelblum Marylou Gelblum <br /> Number of Residents who received personal visits from committee members: 5 <br /> Resident Rights Information is clearly visible: ®Yes® No Ombudsman Contact Info is correct and clearly posted: ® Yes ® No <br /> The most recent survey was readily accessible: ®Yes® No Staffing information clearly posted: ❑Yes ❑ No <br /> (Required for Nursing Homes Only) <br /> Resident Profile I Comments/Other Observations <br /> 1. Do the residents appear neat, clean and odor free? Yes Many residents were observed outside <br /> 2. Did residents say they receive assistance with personal care <br /> activities?Ex. brushing their teeth, combing their hair, inserting Yes their rooms in communal spaces, <br /> dentures or cleaning their eyeglasses? some gathered watching tv, listening <br /> 3. Did you see or hear residents being encouraged to participate in N/A to music, or visiting with each other <br /> their care by staff members? and staff. One resident was receiving <br /> 4. Were residents interacting with staff, other residents&visitors? Yes a manicure. <br /> 5. Did staff respond to or interact with residents who had difficulty N/A <br /> communicating or making their needs known verbally? <br /> 6. Did you observe restraints in use? No <br /> 7. If so, did you ask staff about the facility's restraintpolicies? N/A <br /> Resident Living Accommodations Yes/No/NA Comments/Other Observations <br /> 8. Did residents describe their living environment as homelike? Yes The building though sprawling was <br /> 9. Did you notice unpleasant odors in commonly used areas? No <br /> 10. Did you see items that could cause harm or be hazardous? No clean, bright and welcoming with <br /> 11. Did residents feel their living areas were too noisy? No many windows and walls covered in <br /> 12. Does the facility accommodate smokers? No large colorful photographs.There were <br /> Where? ❑ Outside only❑ Inside only❑ Both Inside/Outside pleasant outdoor spaces available. A <br /> 13. Were residents able to reach their call bells with ease? Yes number of residents said they like <br /> 14. Did staff answer call bells in a timely&courteous manner? Yes where they lived and that call bells are <br /> If no, did you share this with the administrative staff? <br /> • • ' •M ments/Other Observations <br /> 15. Were residents asked their preferences or opinions about the Yes <br /> activities planned for them at the facility? <br /> There were daily activities and menus <br /> 16. Do residents have the opportunity to purchase personal items of listed on bulletin boards. Residents <br /> their choice using their monthly needs funds? Yes are given a choice of foods. <br /> Can residents access their monthly needs funds at their <br /> convenience? <br /> 17. Are residents asked their preferences about meal/snack choices? Yes <br /> Are they given a choice about where they prefer to dine? <br /> 18. Do residents have privacy in making and receiving phone calls? N/A <br /> 19. Is there evidence of community involvement from other civic, <br /> volunteer or religious groups? N/A <br /> 20. Does the facility have a Resident's Council? <br /> FamilyCouncil? N/A <br /> Areas of • <br /> Are there resident issues or topics that need follow-up or review at a later N Discuss items from "Areas of Concern"Section <br /> time or during the next visit? O as well as any changes observed during the visit <br /> We will inquire about community involvement and a <br /> Resident's Council at our next visit. <br /> This Document is PUBLIC RECORD.Do not identify any Resident(s)by name or inference on this form. <br /> Top Copy is for the Regional Ombudsman's Record.Bottom Copy is for the CAC's Records. <br /> Revised 1/21/2020 <br />