HomeMy WebLinkAboutSignature 2023-08-16 Community Advisory Committee Quarterly/Annual Visitation Report
County:Orange Facility Type: Facility Name/Address: Signature Healthcare, 1602 E Franklin St,
❑Family Care Home X Nursing Home Chapel Hill, NC 27514
❑Adult Care Home ❑Combination Home
Visit Date 08/16/2023 Time spent in facility: 1hr 15 min Arrival time: 1 pm
Name of person exit interview was held with: Moses Muhairwe, Administrator Interview was held: X in Person
Committee Members Present: Shade Little, Jackie Podger, Vibeke Talley Report Completed by: Vibeke Talley
Number of Residents who received personal visits from committee members: 10
Resident Rights Information is clearly visible: Yes Ombudsman Contact Info is correct and clearly posted:Yes
The most recent survey was readily accessible: Yes Staffing information clearly posted: Yes
(Required for Nursing Homes Only)
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, Yes
inserting dentures or cleaning their eyeglasses?
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3. Did you see or hear residents being encouraged to NA
participate in their care by staff members?
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4. Were residents interacting with staff, other residents & Yes
visitors?
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5. Did staff respond to or interact with residents who had
difficulty communicating or making their needs known Yes
verbally?
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6. Did you observe restraints in use? No
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7. If so, did you ask staff about the facility's restraint
policies?
Resident Living Accommodations Yes/No/N Comments/Other Observations
8. Did residents describe their living environment as Yes
homelike?
9. Did you notice unpleasant odors in commonly used areas? No No odors noted but one resident stated that
she would like her room to be cleaner. The
resident didn't think it looked clean even
after it had just been cleaned.
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? Yes* 12: Smokers,who are deemed safe to smoke
Where?X Outside only ❑ Inside only ❑ Both independently,may go outside and smoke
Inside/Outside any time they want. Smokers who need
supervision have certain smoking times
where staff go outside with them.
13. Were residents able to reach their call bells with ease? Yes
14. Did staff answer call bells in a timely&courteous manner? Yes
If no, did you share this with the administrative staff?
Residenti Observations
15. Were residents asked their preferences or opinions about Yes* 15: One resident stated that there did not
the activities planned for them at the facility? seem to be many activities scheduled.
16. Do residents have the opportunity to purchase personal Yes* 16: During Business Office hours only.
items of their choice using their monthly needs funds?
Can residents access their monthly needs funds at their
convenience?
17. Are residents asked their preferences about meal/snack Yes
choices? Yes
Are they given a choice about where they prefer to dine?
18. Do residents have privacy in making and receiving phone Yes
calls?
19. Is there evidence of community involvement from other Yes
civic,volunteer or religious groups?
20. Does the facility have a Resident's Council? Yes
Family Council? No
Areas of Concern Yes/No/N Exit Summary
Are there resident issues or topics that need follow-up or review at Yes Exit interview with the Administrator. He
a later time or during the next visit? stated that he had been working with
housekeeping on improving the cleanliness
of the facility. Regarding the offering of
activities the Administrator stated that the
number of trips to shops and other
community events has increased with the
new Activities Director who has now been
at the facility for—6 months. He also stated
that he hears from many residents who
enjoy the activities.
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.