HomeMy WebLinkAbout12-03-08~~,
ANNUAL REPORT OF
GUARDIAN OF THE PERSON
COURT OF COMMON PLEAS OF
Cumberland COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
Estate of Yvette J. Harner
No. 21 -08-0467
I. INTRODUCTION
Nancyyvette Stewart
Plenary Limited Guardian of the Person by Decree of M . L . Ebert
dated 5-29-08
J.,
A. This is the Annual Report for the period from May 2 9 , 2 0 0 8
to November 2 9 , 2 0 0 8 (the "Report Period"); or
B. This is the Final Report for the period from
to ,
for the following reason:
(the "Report Period"), and is filed
1. The death of the Incapacitated Person. Date of death:
2. The Guardianship was terminated by the Court by Decree of
For a Final Report, omit Sections II through Ii!
J., dated
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an Incapacitated Person
was appointed
Form G-03 rev. 10.13.06 Page 1 Of 4
Estate of Yvette J. Harner
II. PERSONAL DATA
Age of the Incapacitated Person: 8 2
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
an Incapacitated Person
Date of Birth: 7/ 5/ 1 9 2 6
Claremont Nursing & Rehabilitation Center
1000 Claremont Road
Carlisle, PA 17013
B. The Incapacitated Person's residence is:
Q own home /apartment
nursing home
boarding home /personal care home
Guardian's home /apartment
hospital or medical facility
relative's home (name, relationship and address)
Q other:
C. The Incapacitated Person has been in the present residence since Apr i 1 1 , 2 0 0 8
If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
The Woods at Cedar Run - In need of higher level of care
824 Lisburn Road
Camp Hill, PA 17011
Grayson View -Moved to be closer to daughter.
150 Kempton Avenue
Harrisburg, PA Page 2 of 4
Form G-03 rev. 10.13.06
Estate of Yvette J. Harner , an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Claremont Nursing & Rehabilitation Center
1000 Claremont Road
Carlisle, PA 17013
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
High Blood Pressure, Early Stages of Dementia and
Knee pain/unable to ambulate
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
She had just completed physical therapy and
her social activities include bingo and arts and crafts.
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
continue
be modified
be terminated
Form G-03 rev. 10.13.06 Page 3 of 4
Estate of Yvette J . Harner , an Incapacitated Person
The reasons for the foregoing opinion are:
Dementia, poor memory and judgment
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
Two times with the average visit lasting 3 hours, minutes.
(Two times a month)
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the Incapacitated Person for the period covered by this Report may be
attached to supplement this Report.
I verify that the foregoing information is correct to the best of my knowledge,
information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904
relative to unsworn falsification to authorities.
It 2N d ~
Date
Signature of Gu d' n of the Person
Nancyyvette Stewart c/o
Name of Guardian of the Person (type ar print)
Hynum Law Office, 2608 N. 3rd St.
Address
Harrisburg, PA 17110
City, State, Zip
717-774-1357
Telephone
Form G-03 rev. 10.13.06 Page 4 of 4