HomeMy WebLinkAboutCedar Grove 2018-09-27Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange
12 residents/12 licensed
Facility Type:
X Family Care Home Nursing Home
Adult Care Home
Facility Name/Address:
Cedar Grove Family Care Homes
403 Saw Mill Road
Cedar Grove, NC 27231
Visit Date: 09 /27 / 2018 Time spent in facility: 0 hr 45min Arrival time: 3:10 am X pm
Name of person exit interview was held with: Sister of Betsy Collins Interview was held: X in Person Phone
Admin. SIC (Supervisor in Charge) X Other Staff Rep. (Name & Title)
Committee Members Present: Gloria Brown, Will Lang
Report Completed by: Will Lang
Number of Residents who received personal visits from committee members : 6
Resident Rights Information is clearly visable: X Yes No Ombudsman Contact Info is correct and clearly posted: Yes X No
The most recent survey was readily accessible: Yes No
(Required for Nursing Homes Only)
Staffing information clearly posted: Yes No
Resident Profile Yes/No/NA Comments/Other Observations
Do the residents appear neat, clean and odor free? Yes
Did residents say they receive assistance with personal care activities? Ex.
brushing their teeth, combing their hair, inserting dentures or cleaning their
eyeglasses?
Yes
One resident was fresh from being shaved by
staff.
Did you see or hear residents being encouraged to participate in their care
by staff members? Yes
Were residents interacting with staff, other residents & visitors? Yes
Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally? Yes
Did you observe restraints in use? No
If so, did you ask staff about the facility’s restraint policies? No
Resident Living Accommodations Yes/No/NA Comments/Other Observations
Did residents describe their living environment as homelike? Yes
Did you notice unpleasant odors in commonly used areas? No
Did you see items that could cause harm or be hazardous? No
Did residents feel their living areas were too noisy? No Most residents appear to have a TV in their room,
yet many were sitting around the TV in the living
room.
Does the facility accommodate smokers?
Where? Outside only Inside only X Both Inside/Outside
Yes
Were residents able to reach their call bells with ease? NA The facility is very small so staff are easily
accessible to residents.
Did staff answer call bells in a timely & courteous manner?
If no, did you share this with the administrative staff?
NA
NA
Resident Services Yes/No/NA Comments/Other Observations
Were residents asked their preferences or opinions about the activities
planned for them at the facility?
NA
Do residents have the opportunity to purchase personal items of their choice
using their monthly needs funds?
Can residents access their monthly needs funds at their convenience?
Yes
Yes
Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
No
All meals are provided at a family dining table
where all residents eat together. They are able to
eat in their rooms if preferred.
Do residents have privacy in making and receiving phone calls? Yes
Is there evidence of community involvement from other civic, volunteer or
religious groups?
No
Does the facility have a Resident’s Council?
Family Council?
No
This is a very small facility so resident input is
regularly sought and considered.
Areas of Concern Yes/No/NA Exit Summary
Are there resident issues or topics that need follow-up or review at a later
time or during the next visit?
During our last visit one house seemed dark, especially in the hall. This has
been corrected and the hall appeared brighter.
No Discuss items from “Areas of Concern” Section
as well as any changes observed during the visit
No areas of concern were identified during this
visit.
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.