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Care Plan Activity Report

Kings Harbor Multicare Center

Resident: Barksdale, Clydia
DOB: 6/15/1928 (96 y)
Unit-Room-Bed: M1 - 114 - A
System/Facility ID: 19302 / 041353

Selection:
Scheduled Date: 3/11/2025
With Corrections: From 3/5/2025


Intervention Disciplines Status / Date
Critical supplies for resident are:
- [ ] Oxygen tank
- [x] Medications
- [ ] Wound Care Supplies
- [ ] Tube feeding formula
- [ ] Ostomy Care Supplies
- [ ] Peritoneal dialysis supplies
- [ ] Trach care supplies
- [ ] Others (Specify): __________
Nursing, Social Services Active
Entered On: 1/23/2022
Entered By: Morton, Toni
POC in place for the resident will be safely transferred to an alternate area with necessary critical supplies in the event of an evacuation within the allotted time. Created On: 12/08/2021
Entered On: 12/08/2021
Entered By: Morton, Toni
Inclusive of ARD 1/15, POC in place for the resident will be safely transferred to an alternate area with necessary critical supplies in the event of an evacuation within the allotted time. Created On: 1/23/2022
Entered On: 1/23/2022
Entered By: Morton, Toni
Plans remain in place for resident to be safely transferred to an alternate area with necessary critical supplies in the event of an evacuation. Created On: 4/05/2022
Entered On: 4/05/2022
Entered By: CUMMINGS, ROBERT, RN
Resident will be safely transferred to an alternate area with necessary critical supplies in the event of an evacuation including medications within the allotted time. Limited assist/HHA off unit, continue with POC. Created On: 6/23/2022
Entered On: 6/23/2022
Entered By: BAILEY, DEBBIEANN
Inclusive of ARD 9/16 and its lookback period, plan remained in place to safely evacuate within the allotted time. Created On: 9/22/2022
Entered On: 9/22/2022
Entered By: MORALES, BLANCA
Evacuation plan remained in place to safely evacuate within the allotted time. Created On: 12/20/2022
Entered On: 12/20/2022
Entered By: Forbes, Denise

⬜ = Historical Item

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