HomeMy WebLinkAboutFC-Livewell Elliot Road 2025-12-05 Com unity Advisory Committee Quarter) /Annual Visitation Report
County: ORANGE Facility Type: Facility Name/Address:
®Family Care Home ❑Nursing Home Livewell Assisted Living
❑Adult Care Home 202 N. Elliot Rd, Chapel Hill, NC 27514
Visit Date: 12/05/2025 Time spent in facility: Arrival time: 2:30 ❑ am ® pm
hr 30 min
Name of person exit interview was held with:x Interview was held: ® in Person ❑ Phone
❑Admin. ❑ SIC(Supervisor in Charge) ® Other Staff Rep.
Committee Members Present: Shade??Little???? Alicia Reid Report Completed by: Shade Little
Number of Residents who received personal visits from committee members:4
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
(Required for Nursing Homes Only)
Resident • '/NA Comments/Other Observations
1. Do the residents appear neat,clean and odor free? Yes 2 residents watching TV when we visited. 6
2. Did residents say they receive assistance with personal care activities? female residents currently reside there.
Ex.brushing their teeth, combing their hair,inserting dentures or cleaning NA The help(two on duty)were very receptive to the
their eyeglasses? residents' requests.
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 restraint policies?
Resident Living Accommodations Yes/No/NA Comments/Other Observations
1. Did residents describe their living environment as homelike? No There has been a complete new paint job and
2. Did you notice unpleasant odors in commonly used areas? No floors completed since our last visit.
3. Did you see items that could cause harm or be hazardous? No The hall bathroom has been redone.
4. Did residents feel their living areas were too noisy? NA
5. Does the facility accommodate smokers? No
Where? ❑ Outside only❑ Inside only❑ Both Inside/Outside
6. Were residents able to reach their call bells with ease? Yes
7. Did staff answer call bells in a timely&courteous manner? NA
If no, did you share this with the administrative staff?
Resident '/NA Comments/Other Observations
1. Were residents asked their preferences or opinions about the No
activities planned for them at the facility?
2. Do residents have the opportunity to purchase personal items of NA
their choice using their monthly needs funds?
Can residents access their monthly needs funds at their NA
convenience?
3. Are residents asked their preferences about meal/snack choices? Yes
Are they given a choice about where they prefer to dine? No
4. Do residents have privacy in making and receiving phone calls? NA
5. Is there evidence of community involvement from other civic, No
volunteer or religious groups?
6. Does the facility have a Resident's Council? No
Family Council? No
Areas of •
Are there resident issues or topics that need follow-up or review at a later No
time or during the next visit?
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.