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Co munity Advisory Committee Quarterly/Annual Visitation Report County: ORANGE Facility Type: Facility Name/Address: ❑Family Care Home ❑Nursing Home The Stratford ®Adult Care Home 405 Smith Level Road, Chapel Hill, NC 27516 Visit Date: 12/09/2025 Timespent in facility: 60 min Arrival time: 2:20 ❑ am ® pm Name of person exit interview was held with: Davita Thompson Interview was held: ® in Person ❑ Phone ❑Admin. ® SIC (Supervisor in Charge) ❑ Other Staff Rep. Committee Members Present: Alicia Reid, Shade Little Report Completed by: Shade Little Number of Residents who received personal visits from committee members: 10, 6 more in Memory Unit Resident Rights Information is clearly visible: ®Yes❑ No Ombudsman Contact Info is correct and clear) posted: ® Yes❑ No The most recent survey was readily accessible: ❑ Yes ❑ No Staffing information clearly posted: ® Yes ❑ No (Required for Nursing Homes Onl Resident Profile Yes/No/NA Comments/Other Observations 1. Do the residents appear neat, clean and odor free? Y Staff responsive to residents' needs, helping to walk 2. Did residents say they receive assistance with personal care when needed. 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 restraint policies? NA Resident Living Accommodations Yes/No/NA Comments/Other Observations 1. Did residents describe their living environment as homelike? N All walls have been painted. New baseboards 2. Did you notice unpleasant odors in commonly used areas? N throughout. All the hall floors are new, the residents' 3. Did you see items that could cause harm or be hazardous? N rooms are next. 4. Did residents feel their living areas were too noisy? N The Memory Care Area has recently undergone new 5. Does the facility accommodate smokers? Y paint,flooring, baseboard, and other cosmetic Where?® Outside only❑ Inside only❑ Both Inside/Outside updates. 6. Were residents able to reach their call bells with ease? NA The Dining Room is brighter: lights,walls,floor. And 7. Did staff answer call bells in a timely&courteous manner? NA food still gets good reviews. 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 Along with the walls and floors, the library has new activities planned for them at the facility? chairs. 2. Do residents have the opportunity to purchase personal items of Y All residents of the Memory Unit in the common their choice using their monthly needs funds? room interacting with the staff. Can residents access their monthly needs funds at their Y The activity board has been kept up to date, changes convenience? made as needed. 3. Are residents asked their preferences about meal/snack choices? N Are they given a choice about where they prefer to dine? N 4. Do residents have privacy in making and receiving hone calls? Y 5. Is there evidence of community involvement from other civic, N volunteer or religious groups? 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 Met with Davita Thompson. No issues escalated. 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 Copy is for the Regional Ombudsman's Record.Bottom Copy is for the CAC's Records.