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* 1. Which Hilltop community do you or your loved one reside in?

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* 2. What is your relationship to the community?

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* 3. The on-site amenities provided (ex: hair salon, physical therapy) are valuable to me.

  Valuable Nice to have They offer poor service I haven't used this service
Beauty Salon
Infinity Rehab
Footsies
AAA Hearing
Alpine Bank Services

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* 4. The communication I receive from The Commons or The Fountains meets my needs.

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* 5. I find the communication I receive at scheduled Cottage meetings is valuable.

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* 6. The apartment or cottage is cleaned to my satisfaction.

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* 7. The housekeeping staff are friendly.

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* 8. The common areas of the building are kept clean and tidy.

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* 9. Care staff are knowledgeable about the care they provide.

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* 10. Care staff treat me or my loved one with respect and kindness.

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* 11. I feel confident in the accuracy of medication administration for myself or my loved one.

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* 12. I understand the rules of how the care staff must administer my medications.

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* 13. I (or my loved one) would recommend the Medication Services to other residents.

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* 14. I (or my loved one) is satisfied with PharmCare Pharmacy Services.

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* 15. My (or my loved one's) care manager is:

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* 16. I understand what issues to take to my care manager.

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* 17. My care manager is approachable.

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* 18. My care manager communicates clearly with me or my loved one.

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* 19. I receive timely communication from my care manager regarding care concerns or changes.

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* 20. Monthly statements are easy to read and understand.

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* 21. I can easily get my questions answered concerning my bills.

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* 22. I believe the services and quality care I (or my loved one) receive are fairly priced.

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* 23. Medical transportation is a valuable service to me or my loved one.

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* 24. I (or my loved one) am satisfied with the medical transportation services that are provided.

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* 25. I (or my loved one) participate in the activities/outings offered.

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* 26. The offered activities/outings planned are of interest to me or my loved one.

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* 27. I (or my loved one) participate in the fitness classes.

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* 28. I (or my loved one) use the fitness equipment.

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* 29. I feel comfortable making suggestions about the activities programs.  

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* 30. I (or my loved one) am pleased with the customer service provided by the front desk.

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* 31. I (or my loved one) am pleased with the time it takes to get something fixed or repaired in my (or my loved one's) apartment or cottage.

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* 32. I (or my loved one) am pleased with my dining experience overall.

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* 33. The serving staff are professional and friendly.

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* 34. I (or my loved one) am pleased with the quality of food prepared.

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* 35. I (or my loved one) am pleased with the variety of daily specials being offered.

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* 36. I (or my loved one) can find something on the menu that sounds good to me.

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* 37. My (or my loved one's) meals in the dining room arrive at the proper temperature.

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* 38. I feel safe in my home or I feel my loved one is safe in their home.

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* 39. I (or my loved one) understand the fire safety procedures in my building.

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* 40. I would like to receive a quarterly electronic newsletter with information on current Emergency Planning drills and procedures.

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* 41. Overall, The Commons or The Fountains staff provide excellent customer service.

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* 42. Is there something we could do differently that would help to make your life better? Please list below.

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* 43. Please write in your name and phone number if you would like someone to follow up with you regarding your feedback or ideas.

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