HomeMy WebLinkAboutCarol Woods 2019-08-13Community Advisory Committee
Quarterly/Annual Visitation Report
County: Orange Facility Type: Family Care Home
Nursing Home xAdult Care Home
Facility Name/Address: Carol Woods, 750 Weaver Dairy Road,
Chapel Hill, NC 27514
Visit Date: 08/13/2019 Time spent in facility: 1 hr min Arrival time: 1:40 am x pm
Name of person exit interview was held with:
Interview was held: x in Person Phone
Admin. SIC (Supervisor in Charge) Other Staff Rep.
Bethany XXXXX
(Name & Title)
Committee Members Present: MaryLou Gelblum, Shade Little, Karen Green-McElveen Report Completed by: Shade Little
Number of Residents who received personal visits from committee
members: 6
Resident Rights Information is clearly visible:x Yes No Ombudsman Contact Info is correct and clearly posted: Yes XNo
The most recent survey was readily accessible: Yes No
(Required for Nursing Homes Only)
Staffing information clearly posted: x Yes No
Resident Profile Yes/No/NA Comments/Other Observations
Do the residents appear neat, clean and odor free? Y
Did residents say they receive assistance with personal care activities? Ex.
brushing their teeth, combing their hair, inserting dentures or cleaning
their eyeglasses?
Y
Did you see or hear residents being encouraged to participate in their care
by staff members?N
Were residents interacting with staff, other residents & visitors?Y
Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally?Y
Did you observe restraints in use?N/A
If so, did you ask staff about the facility’s restraint policies? N/A
Resident Living Accommodations Yes/No/NA Comments/Other Observations
1.Did residents describe their living environment as homelike?Y Resident pleased to have P/T available in room
when needed.
2.Did you notice unpleasant odors in commonly used areas?N
3.Did you see items that could cause harm or be hazardous?N
4.Did residents feel their living areas were too noisy?N
5.Does the facility accommodate smokers?
Where? X Outside only Inside only Both Inside/Outside
Y
6.Were residents able to reach their call bells with ease?N/A
7.Did staff answer call bells in a timely & courteous manner?
If no, did you share this with the administrative staff?
N/A
Resident Services Yes/No/NA Comments/Other Observations
8.Were residents asked their preferences or opinions about the
activities planned for them at the facility?
Y
9.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?
Y
10.Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
Y They can also store personal food items in a
pantry area.
11.Do residents have privacy in making and receiving phone calls?Y
12.Is there evidence of community involvement from other civic,
volunteer or religious groups?
Y A wide of community groups (religious, musical,
civic) visits the facility.
13.Does the facility have a Resident’s Council?
Family Council?
Y
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?
N Discuss items from “Areas of Concern” Section as
well as any changes observed during the visit
The Ombudsman’s name was STILL incorrect in
Building 6 (telephone of 919-558-9401 is correct).
WE need to get one out there.
Again we note: Carol Woods provides excellent
services to its residents. The facility is very well
maintained. Residents have a wide range of
activities available.
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.