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HomeMy WebLinkAbout04-14-11ANNUAL REPORT OF GUARDIAN OF THE PERSON ~' COURT OF COMMON PLEAS OF ~1~ °J~ -~~f~~ ~ ~ ~ Cumberland COUNTY, PENNSYLVANIA ~' z ~ - r ORPHANS' COURT DIVISION ~?~~ O~ c`> n ~• n ~ ._ Estate of Elizabeth M. Gardosik an Incapacitated Person No. 21 08 0224 I. INTRODUCTION Sandra M. Gazdosik and Andrew T. Gazdosik was appointed ®Plenary Limited Guardian of the Person by Decree of J. Wesley Oler, Jr. ~ dated April 16, 2008 ~ A. This is the Annual Report for the period from Aaril 16.2010 to Aoril 16. 2011 (the "Report Period"); or © B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: I. The death of the Incapacitated Person. Date of death: 2. The Guazdianship was terminated by the Court by Decree of For a Fina! Report, omit Sections II through IV. Form a-03 rsv. 10./3.06 Page 1 of 4 Zi,~ rni .~i ~ f`~ i~ %j -T7 ;: -:~ ,. ., _. -: r.= m r::~ p ~rx ~~ 1., dated Estate of Elizabeth M. Gardosik II. PERSONAL DATA Age of the Incapacitated Person: 83 III. LMNG ARRANGEMENTS A. Current address of the Incapacitated Person: Assisted Living Facility Loyalton of Creekview 1100 Crandon Way Mechanicsburg, PA 17050 B. The Incapacitated Person's residence is: an Incapacitated Person Date of Birth: 8/27/1926 ^ 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. 1'he Incapacitated Person has been in the present residence since 5/1/2010 . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Prior residence for Elizabeth was her home at 4814 Virginia Road, Mechanicsburg PA. Elizabeth was moved to an Assisted living facility because she now neees 24 hour care. Her family members could no longer manage her earo. Form a-03 .~. ~0.~9.06 Page 2 of 4 Estate of Elizabeth M. Gardosik . an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Odyssey Hospice Healthcare Provider 4660 EastTrindle Road Camp Hill, PA 17011 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Elizabeth can no longer walk and is wheel chair bound. She can nolonger feed, cloth or clean herself and needs 24 hour assisted care. Elizabeth is in the late stages of Alzheimers disease. B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Assisted living at Loyalton of Creekview, Mechanicsburg and Hospice care. 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 .~. ro. r3.o6 Page 3 of 4 Estate of Elizabeth M. Gardosik - . an Incapacitated Person The reasons for the foregoing opinion are: Elizabeth is in the late stages of Alzheimers. B. During the past year, the Guardian of the Person has visited the Incapacitated Person 156 times with the average visit lasting 2 hours, o minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person jor 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. ~ _n. ~ I Date - Signature ojGuart6an oft)a Person ~~~~~ AN~W T G~Ar~US, l~ 88 Mw6~bvb ~ ~ cxc( Ifal;~~.x , ~/f /7a3Z 7/7 - -'~blJ'`S71G Sandra M. Gardosik Name ojGuardian of the Person (type or print) 3030 North 3rd Street ,lddress Harrisburg PA 17110 Ciry, Smte, Zip 236-2056 Telephone Form G03 ~. to.ta.o6 Page 4 of 4