HomeMy WebLinkAboutBrookshire 2017-05-16
Community Advisory Committee
Quarterly/Annual Visitation Report
County Orange Facility Type Family
Care Home
Adult Care Home
X Nursing Home
Facility Name:
68/80
Census – current/licensed:
Visit Date and day of the week
Tues., May 16, 2017
Time spent in facility 1 hr. 15
min.
Arrival time 10:30 am
Name of person(s) with whom exit interview was held
Josh Stevens, Administrator
Interview was held Yes
Committee members present:
Teri Driscoll, Jerry Schreiber and Jerry Gregory
Number of residents who received personal visits from committee members 6 Report completed by: Teri Driscoll
Resident Rights information is clearly posted? Yes Ombudsman contact information is correct and clearly posted:
Yes
The most recent survey was readily accessible Yes
(Required for NHs only – record date of most recent sur-
vey posted) : Oct. 2016
Staffing information clearly posted? Yes
Resident Profile Yes
No
N/A
Comments/Other Observations (please num-
ber comments)
1. Do the residents appear neat, clean and odor free? Yes
2.Did residents say they receive assistance with personal care ac-
tivities? (i.e. brushing their teeth, combing their hair, inserting
dentures or cleaning their eyeglasses)
Yes
3. Did you see or hear residents being encouraged to par-
ticipate
in their care by staff members?
Yes
4.Were residents interacting with staff, other residents & visitors? Yes
5.Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally? N/A
6. Did you observe restraints in use? No
7. If so, did you ask staff about the facility’s restraint poli-
cies?
Note: Do not ask about confidential information without
consent
N/A
Resident Living Accommodations Yes
No
N/A
Comments/Other Observations (please num-
ber comments)
8. Did residents describe their living environment as homelike? Yes *14.Residents did say that sometimes it took a while to
answer call bells, especially on weekends when there
was less staff.
9. Did you notice unpleasant odors? No
10. Did you see items that could cause harm or be hazardous? No
10a. Were unattended med carts locked? Yes
10b. Were bathrooms clean, odor-free and free from hazards? yes
10c. Were rooms containing hazardous materials locked? Yes
11. Did residents feel their living areas were kept at a reasonable
noise level?
Yes
12. Does the facility accommodate smokers?
Note: By regulation smoking is only permitted outside of the
Building
No
13. Were residents able to reach their call bells with ease? Yes
14. Did staff answer call bells in a timely & courteous manner? Yes*
14a If no, did you share this with the administrative staff?
*** N/A equals not applicable, not asked, not observed
Facility / Date: Brookshire-5/16/2017
Resident Services Yes
No
N/A
Comments/Other Observations (please
number comments)
15. Were residents asked their preferences or opinions
about the activities planned for them at the facility?
N/A
15a. Was a current activity calendar posted in the facility? Yes
15b. Were activities scheduled to occur at the time of
your
visit actually occurring?
Yes
16. Do residents have the opportunity to purchase personal
items of their choice using their monthly needs funds?
16a.Can residents access their monthly needs funds at
their
convenience?
17. Are residents asked their preferences about meal &
snack choices?
Yes
17a. Are they given a choice about where they prefer to dine? Yes
17b. Did residents express positive opinions regarding
their
dining experience?
Yes
17c. Is fresh ice water available and provided to residents? Yes
18. Do residents have privacy in making and receiving
phone calls?
Yes
19. Is there evidence of community involvement from other
Civic, volunteer or religious groups?
Yes
20. Does the facility have a functioning: Resident’s
Council?
Family
Council?
Yes
Areas of Concern Exit Summary
Are there resident issues or topics that need follow-up or
review at a later time or during the next visit?
Response to call bells – will follow up.
Discuss items from “Areas of Concern” Section as well as
any changes observed during the visit. Give summary of
visit with Administrator or SIC. Does the facility have
needs that the committee or community could help address?
We had a very good exit interview with the Administrator.
He has a relatively new Activity Director and is very proud
of her. They have 6 residents that are 100 yrs. Old or older.
They were having a party soon to celebrate. The Adminis-
trator also commented on how he now is getting family
members of former residents to come there when they need
a nursing home or rehab.
1/2015