HomeMy WebLinkAboutCedar Grove 2019-08-17Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange Facility Type:
X Family Care Home Nursing Home
Adult Care Home
Facility Name/Address: Cedar Grove Family Care Home
403 Saw Mill Rd Cedar Grove NC 27231
Visit Date: 8 / 17 / 19 Time spent in facility: hr. 45 min Arrival time: 1:45 am X pm
Name of person exit interview was held with: Betsy Collins, Co-owner Interview was held: X in Person Phone
Admin. SIC (Supervisor in Charge) Other Staff Rep. Sister Anna
Committee Members Present: Gloria Brown and Joan Rehm
Report Completed by: Gloria Brown
Number of Residents who received personal visits from committee members: 10
Resident Rights Information is clearly visible: Yes No Ombudsman Contact Info is correct and clearly posted: Yes No
The most recent survey was readily accessible: NA Yes No
(Required for Nursing Homes Only)
Staffing information clearly posted: No Yes Emergency Information is
clearly posted
Resident Profile Yes/No/NA Comments/Other
Observations
1. Do the residents appear neat, clean and odor free?
Yes
1) Some were sitting on the front porch,
1 kitchen eating, some in their rooms
watching their TVs.
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? Yes
4. Were residents interacting with staff, other residents & visitors?
Yes
4) On my visits I have observed that the
residents are respectful of others space and
like interacting with visitors.
5. Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally? Yes
5) On our way out one resident was wanting
a soda. Betsy hear her and replied I will see
what I can do.
6. Did you observe restraints in use? No
7. If so, did you ask staff about the facility’s restraint policies? NA
Resident Living Accommodations Yes/No/NA Comments/Other
Observations
8. Did residents describe their living environment as homelike? Yes 8. Each has their own beg and some of their
personal belongings.
9. Did you notice unpleasant odors in commonly used areas? No
10. Did you see items that could cause harm or be hazardous? No
11. Did residents feel their living areas were too noisy? No 11) There are many space for a change of
environment is desired.
12. Does the facility accommodate smokers?
Where? Outside only Inside only Both Inside/Outside
No
13. Were residents able to reach their call bells with ease? NA
14. 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
15. Were residents asked their preferences or opinions about the
activities planned for them at the facility?
Yes 15. They discuss where they would like to go to
shop, eat out or attend comm. Events in area.
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
17. Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
No
No
17. Snack gets a choice sometimes.
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 19. Area churches come by on Sunday to take
the residents to services and events. More come
by during holidays.
20. Does the facility have a Resident’s Council?
Family Council?
NA
NA
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?
Present Areas of Concern:
• Again the team members observed that the hallways are
quite dark and that could be a safety hazard.
• We previously suggested a light was needed in the second
house by the kitchen entry where there is a tripping hazard.
There is no natural light in these areas.
• Again the dark hallway especially in the second building.
This was discussed with Betsy and she acknowledged it was
dark but no complaints by residents I guess they get
accustomed to the darkness.
Yes Discuss items from “Areas of Concern”
Section as well as any changes observed
during the visit
Dark hallways could be hazardous for falls.
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.