HomeMy WebLinkAbout11-10-10 (2)13509.1.guardian.report.person.pdf
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AL REPORT OF
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COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLV ANIA
ORPHANS' COURT DIVISION
WILLIAM HERBERT OCKER
an Incapacitated
Person
Estate of
No. 21-09-0695
I. INTRODUCTION
Kimberly Sue Ocker ,was appointed
Plenary ®Limited Guardian of the Person by Decree of Kevin A. Hess , J.,
dated 09/11/2009
09/01 2009
A. This is the Annual Report for the period from
to 08/31 201__ (the "Report Period"); or
[~ B. This is the Final Report for the period from
__ (the "Report Period"), and is filed
to
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 li through IV.
Page 1 of 4
Form G-03 rev. 10.13.06
Estate of WILLIAM HERBERT OCKER
II. PERSONAL DATA
Age of the Incapacitated Person: 51
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
730 Mountain Road
Newville, PA 17241
B. The Incapacitated Person's residence is:
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)
other:
C. The Incapacitated Person has been in the present residence since 1999
If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
an Incapacitated Person
Date of Birth: 7/7/1959
Form G-03 rev. 10.13.06 Page 2 of 4
Estate of WILLIAM HERBERT OCKER
an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Kimberly S. Ocker
730 Mountain Road
Newville, PA 17241
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Diffuse axonal injury to the brain or Traumatic Brain Injury (TBI), C6-7 transverse
process fracture and rib fractures.
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Mr. Ocker is unable to ambulate and is dependent on others for most, if not all,
activities of daily living (ADC's). These needs are met by 8 to 10 hours of care on a
daily basis by an LPN. He is also continuing to receive follow-up care by a variety
of specialists for his various medical needs.
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 WILLIAM HERBERT OCKER
an Incapacitated Person
The reasons for the foregoing opinion are:
Mr. Ocker's Physicians have indicated that this level of care for him will continue,
at least for the foreseeable future.
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
Incapacitated Person resides with Guardian of the Person.
times with the average visit lasting hours, minutes.
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 subjec o the penalties of 18 Pa. C.S.A. § 4904
relative to unsworn falsification to authorities.
//~/ b ~/ CU ~ ~`~
Date Signa ure of Guardian of he Person
Kimberly Sue'Ocker
Name of Guardian of the Person (type or print)
730 Mountain Road
Address
Newville, PA 17241
ctry, state, zlp
717-776-7469
Telephone
Form G-03 rev. 10.13.06 Page 4 of 4