HomeMy WebLinkAboutStratford 2023-04-04 Community Advisory Committee Quarterly/Annual Visitation Report
County: ORANGE Facility Type: Facility Name/Address:
❑Family Care Home ❑Nursing Home The Stratford
®Adult Care Home 405 Smith Level Road, Chapel Hill, NC 27516
Visit Date: 4/4/2023 Timespent in facility: 1 hour Arrival time: 1:???? ❑ am ® pm
Name of person exit interview was held with: Interview was held: ® in Person ❑ Phone
❑Admin. ® SIC Supervisor in Charge) ❑ Other Staff Rep. Crystal Tinnen
Committee Members Present: Karen??GreenMcElveen???? Shade Little Report Completed by: Shade??Little
Number of Residents who received personal visits from committee members: 7
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: ❑Yes ❑ No Staffing information clearly posted: ® Yes❑ No
(Required for Nursing Homes Only)
Resident Profile Yes/No/NA Comments/Other Observations
1. Do the residents appear neat,clean and odor free? Y
2. Did residents say they receive assistance with personal care
activities? Ex. brushing their teeth, combing their hair, inserting NA
dentures or cleaning their eyeglasses?
3. Did you see or hear residents being encouraged to participate in N
their care by staff members?
4. Were residents interacting with staff, other residents&visitors? Y
5. Did staff respond to or interact with residents who had difficulty NA
communicating or making their needs known verbally?
6. Did you observe restraints in use? N
7. If so, did you ask staff about the facility's restraintpolicies? NA
Resident Living Accommodations Yes/No/NA Comments/Other Observations
1. Did residents describe their living environment as homelike? N Still NO meal choices. Staff reported many NOT
2. Did you notice unpleasant odors in commonly used areas? N eating the vegetables.
3. Did you see items that could cause harm or be hazardous? N The Memory Care unit Is doing a great job while still
4. Did residents feel their living areas were too noisy? N short on staff.
5. Does the facility accommodate smokers? Y
Where? ® Outside only❑ Inside only❑ Both Inside/Outside
6. Were residents able to reach their call bells with ease? NA
7. Did staff answer call bells in a timely&courteous manner? NA
If no, did you share this with the administrative staff?
• - • • • • •
1. Were residents asked their preferences or opinions about the NA Four in TV room watching news.
activities planned for them at the facility? Doctor from Durham visits every Wednesday(other
2. Do residents have the opportunity to purchase personal items of Y days as needed) and sees ALL patients.
their choice using their monthly needs funds?
Can residents access their monthly needs funds at their Y Some new residents are residing temporarily as
convenience? Coventry is closed for renovations.
3. Are residents asked their preferences about meal/snack choices? N
Are they given a choice about where they prefer to dine? N
4. Do residents have privacy in making and receiving hone calls? Y
5. Is there evidence of community involvement from other civic, N
volunteer or religious groups?
6. Does the facility have a Resident's Council? Y
Family Council?
Areas of • •
/NA Exit Summary
Are there resident issues or topics that need follow-up or review at a later Y
time or during the next visit?
Community Advisory Committee Quarterly/Annual Visitation Report
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.