HomeMy WebLinkAbout12-17-08 (2)ANNUAL REPORT OF GUARDIAN
OF THE PERSON
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COURT OF COMMON PLEAS OF ~??
CUMBERLAND COUNTY, PENNSYLVANIA ~?
ORPHANS' COURT DIVISION --
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Estate of Virginia M. Taylor , an Incapacitated Person-
No. 21-06-043
I. INTRODUCTION
Keystone Guardianship Services was appointed
:Plenary ~ Limited Guardian of the Person by Decree of M.L. Ebert, Jr.
dated 10/9/07.
~Th1S is the Annual Report for the period from October 10 , 2007
to October 31 2008 ,the "Report Period"); or
B. This is the Final Report for the period from
to , (the "Report Period"), and is filed
for the for the following reason:
1. The death of the Incapacitated Person. Date of death:
2. The Guardianship was terminated by the Court by Decree of
J., dated
For a Final Report, omit Sections II through IV.
Form G-03 rev. 10.13.06
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Page 1 of 4
Estate of Virginia M., Taylor , an Incapacitated Person
IL. PERSONAL DATA
Age of the Incapacitated Person: 78 Date of Birth: 7/10/1930
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
Masonic Village
600 Freemason Drive
Elizabethtown, PA 17022
B. The Incapacitated Person's residence is:
own home /apartment
f~nursing home
^ boarding home /personal care home
Guardian's home /apartment
^ hospital or medical facility
^ relative's home (name, relationship and address)
;other:
C. The Incapacitated Person has been in the present residence since 9/13/07 .
If the Incapacitated Person has moved within the past year, state prior
residence and reason(s) for move:
~-urm c-o3 rev. irz ls. oh Page 2 0£ 4
Estate of Virginia M. Taylor , an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Dr. Glenda J Cook
600 Freemason Drive
Elizabethtown, PA 17022
I`V. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person areas follows:
Virginia suffers from Alzheimer's disease, dementia and anxiety.
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Virginia receives routine visits with the social worker at the Masonic Home.
'V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
!~' continue
h be modified
^ be terminated
Poxm G-03 rev. 10.13.06
Page 3 of 4
Estate of Virginia M. Taylor , an Incapacitated Person
The reasons for the foregoing opinion are:
It is my opinion that Virginia would not be able to exist in any other type of
environment, as she lacks the mental and physical ability to care for herself.
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
20 times with the average visit lasting 30 minutes to an hour
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.
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Date St nature of Guardian of the Estate
Constance E. Stoneroad
Name of Guardian of the Estate (type or print)
512. Market Street
Address
Millersburg Pa 17061
City, State, 'Lip
717-692-2345 OR 717-692-1320
Telephone
Form G-03 rev. 10.13.06 Page 4 of 4