HomeMy WebLinkAboutFC-LiveWell @ Birchwood Lake Estates 2025-09-26 Com unity Advisory Committee Quarter) /Annual Visitation Report
County: Orange Facility Type: Facility Name/Address:
Livewell Assisted Living
Family Care 6720 Pauline Drive, Chapel Hill, NC 27514
Report Completed by Time spent in facility: 15 minutes Arrival time: 9:00 AM
Visit Date: 9/26/2025
Name of person exit interview was held with: Monique Shevon, Supervisor in Charge
Interview was held: In Person
Committee Members Present: Jackie Podger and Prakash Sista Report prepared by Prakash Sista
Number of Residents who received personal visits from committee members:6
Resident Rights Information is clearly visible:Yes Ombudsman Contact Info is correct and clear) posted:Yes
The most recent survey was readily accessible: Staffing information clearly posted: N/A
Required for Nursing Homes Only)
Resident •file Comments/Other Observations
1. Do the residents appear neat, clean and odor free? Yes
2. Did residents say they receive assistance with personal care Residents were dressed and ready for the day.
activities? Ex. brushing their teeth, combing their hair, inserting Breakfast was ongoing or just finished and 5 of 6
dentures or cleaning their eyeglasses? residents were sitting around the breakfast table.
Yes The 61h resident who was in hospice care was in
her room and being fed by an aide. She was
alert and cheerful and was very engaging and
responsive to others.
3. Did you see or hear residents being encouraged to participate in Yes
their care by staff members?
4. Were residents interacting with staff, other residents&visitors? Yes
5. Did staff respond to or interact with residents who had difficulty Yes
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 restraintpolicies? N/A
Resident Living Accommodations Comments/Other Observations
8. Did residents describe their living environment as homelike? Yes
9. Did you notice unpleasant odors in commonly used areas? No Yes, the residents were complimentary about
the living environment which appeared neat,well
kept/clean.
10. Did you see items that could cause harm or be hazardous? No
11. Did residents feel their living areas were too noisy? No This is a very quiet facility. No one raises their
voice or has a TV or audio device turned to a
high volume.
12. Does the facility accommodate smokers? N/A
Where?Outside only
13. Were residents able to reach their call bells with ease? Unknown Residents were not in their rooms so hard to
assess as it is a very small facility with only 6
residents,we expect this should not be a major
issue.
14. Did staff answer call bells in a timely&courteous manner?
If no, did Vou share this with the administrative staff? Unknown Did not observe it
Resident • • Observations
15. Were residents asked their preferences or opinions about the Yes Did not observe during visit, but it seemed like a
activities planned for them at the facility? well-organized residential facility with caring
staff.Also the 5 residents we observed at
breakfast were non-communicative and we saw
no evidence of planned activities.
16. Do residents have the opportunity to purchase personal items of Yes
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 choices? Yes Assisted Living residents all eat in the dining
Are they given a choice about where they prefer to dine? Yes rooms, except the one who was in hospice and
confined to her room..
18. Do residents have privacy in making and receiving hone calls? Yes
19. Is there evidence of community involvement from other civic, Yes This is a relatively remote place and we did not
volunteer or religious groups? observe any family or community members
during our visit
20. Does the facility have a Resident's Council? Not sure
Family Council?
Areas of •
Are there resident issues or topics that need follow-up or review at a later No Administrator was available on site and no
time or during the next visit? issues needed to be addressed,we spoke with
Monique Shevon, SIC.
We did give the staff the new ombudsmen's
name and telephone number to post on the
Resident Rights poster
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.