HomeMy WebLinkAboutCrescent Green 2019-03-04Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange Facility Type:
Family Care Home Nursing Home
Adult Care Home x
Facility Name/Address: Crescent Green
624 Jones Ferry Road Carrboro NC
Visit Date: 3 / 14 / 19 Time spent in facility: 1 hr 20 min Arrival time: 6:00 pm
Name of person exit interview was held with: Juliette Nesmith Interview was held: in Person Phone
Admin. SIC (Supervisor in Charge) Other Staff Rep. (Name & Title)
Committee Members Present: Allison Brown, Tiketha Collins
Report Completed by: Tiketha
Number of Residents who received personal visits from committee members: 3
Resident Rights Information is clearly visible: Yes Ombudsman Contact Info is correct and clearly posted: Yes
The most recent survey was readily accessible: Yes No
(Required for Nursing Homes Only) n/a
Staffing information clearly posted: Yes No n/a
Resident Profile Yes/No/NA Comments/Other Observations
1. Do the residents appear neat, clean and odor free? yes
2. Did residents say they receive assistance with personal care
activities? Ex. brushing their teeth, combing their hair, inserting
dentures or cleaning their eyeglasses?
yes
3. Did you see or hear residents being encouraged to participate in
their care by staff members? n/a
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?
6. Did you observe restraints in use? no
7. If so, did you ask staff about the facility’s restraint policies?
Resident Living Accommodations Yes/No/NA Comments/Other Observations
8. Did residents describe their living environment as homelike? yes
9. Did you notice unpleasant odors in commonly used areas? yes Odor in the shower room
10. Did you see items that could cause harm or be hazardous? no
11. Did residents feel their living areas were too noisy? no
12. Does the facility accommodate smokers?
Where? Outside only Inside only Both Inside/Outside
yes Outside area with limited seating for those
ambulating
13. Were residents able to reach their call bells with ease? n/a
14. Did staff answer call bells in a timely & courteous manner?
If no, did you share this with the administrative staff?
Resident Services Yes/No/NA Comments/Other Observations
15. Were residents asked their preferences or opinions about the
activities planned for them at the facility?
yes
16. 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
Concern was expressed for one resident by
another resident that her funds were not always
available.
17. Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
no
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?
20. Does the facility have a Resident’s Council?
Family Council?
no
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?
no Discuss items from “Areas of Concern” Section as
well as any changes observed during the visit
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.