HomeMy WebLinkAboutNH-Signature HealthCARE of CH 2025-03-06 Co munity Advisory Committee Quarter/ /Annual Visitation Report
County: ORANGE Facility Type: Facility Name/Address:
❑Family Care Home ®Nursing Home Signature HealthCARE of Chapel Hill
❑Adult Care Home 1602 East Franklin Street, Chapel Hill, NC 27514
Visit Date: 03/06/2025 Timespent in facility: 95 min. Arrival time: 9:00 ® am ❑ pm
Name of person exit interview was held with: Interview was held: ® in Person ❑ Phone
❑Admin. ® SIC Supervisor in Charge) ❑ Other Staff Rep. Moses Muhairwe,Administrator
Committee Members Present: Alicia Reid, Shade Little Report Completed by: Shade Little
Number of Residents who received personal visits from committee members: 20
Resident Rights Information is clearly visible: ®Yes ❑ No Ombudsman Contact Info is correct and clear) posted: ®Yes ❑ No
The most recent survey was readily accessible: ®Yes ❑ No Staffing information clearly posted: ®Yes❑ No
Re uired for Nursinq Homes Only)
Resident • •/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 dentures or cleaning NA
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 restraint policies? NA
Resident Living Accommodations Yes/No/NA Comments/Other Observations
1. Did residents describe their living environment as homelike? Y The facility was better lit than our visit a month ago.
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? Y
Where? ® Outside only❑ Inside only❑ Both Inside/Outside
6. Were residents able to reach their call bells with ease? Y
7. Did staff answer call bells in a timely&courteous manner? NA
If no, did you share this with the administrative staff?
Resident • • Observations
1. Were residents asked their preferences or opinions about the Y A seemingly phone room had NO lighting. When
activities planned for them at the facility? reported to administration,this room is NOT a phone
2. Do residents have the opportunity to purchase personal items of Y room but is to be repurposed in the future.
their choice using their monthly needs funds?
Can residents access their monthly needs funds at their Y
convenience? They also have a food committee who met on 5
3. Are residents asked their preferences about meal/snack choices? Y March. No report yet.
Are they given a choice about where they prefer to dine? Y
4. Do residents have privacy in making and receiving hone calls? Y
5. Is there evidence of community involvement from other civic, Y
volunteer or religious groups?
6. Does the facility have a Resident's Council? Y
Family Council?
Areas of • Yes/No/NA Exit Summary
Are there resident issues or topics that need follow-up or review at a later N
time or during the next visit?
his Document is PUBLIC RECORD.Do not identify any Resident(s)by name or inference on this form.t
Bottom Copy is for the CAC's Records.