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HomeMy WebLinkAbout07-13-12 (2)r . Reset For_m~l ANNUAL REPORT OF GUARDIAN OF THE PERSON ~ t._ ~ ~a ~ ~ ~ C. ; _;t.7 COURT OF COMMON PLEAS OF ~~.. ~ r ~U~ ° `~ ca f't_'1 t.. -r_-. CUMBERLAND COUNTY PENNSYLVANIA o~ ~ y ` , ORPHANS' COURT DIVISION ~; N ~ © f `'~ n, Estate of BRITTANY NICOLE PALMER , an Incapacitated Person No. 21-11-0157 I. INTRODUCTION DENISE E. PALMER was appointed ®Plenary Limited Guardian of the Person by Decree of EDWARD E. GUIDO _ J. dated MARCH 23, 2011 ~,~] A. This is the Annual Report for the period from March 23 2011 to December 31 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: 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, orreit Sections II through IV. Form G-03 rev. 10.13.06 Page 1 of 4 f Estate of BRITTANY NICOLE PALMER , an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: 24 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: 1218 Biddle Drive Carlisle, PA 17013 B. The Incapacitated Person's residence is: Date of Birth: 05/27/1988 own home /apartment nursing home Q boarding home /personal care home Guardian's home /apartment ® hospital or medical facility ®relative's home (name, relationship and address) other: Group Home C. The Incapacitated Person has been in the present residence since January 6, 2012 . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: 1089 W. Trindle Road, Mechanicsburg, PA 17055; move made to allow the IP to live more independently, learn self help skills and have a better quality of life. Form c-o3 rev. ~n.r3.o6 Page 2 of 4 Estate of BRITTANY NICOLE PALMER , an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Denise E. Palmer (the Guardian of the Person and Estate) 1089 W. Trindle Road Mechanicsburg, PA 17055 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Spastic cerebral palsy; mild retardation; non-verbal. B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: The IP is residing in a Group home with other residents of similar age. She receives assistance with all activities of daily living there as well as group and independent social activities. The Guardian ensures that the IP's medical, dental and psychological care needs are being met. 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. !0./3.06 Pa4;e 3 of 4 Estate of BRITTANY NICOLE PALMER an Incapacitated Person The reasons for the foregoing opinion are: The IP has permanent medical and mental conditions which prevent her from. snaking and/or communicating responsible personal and financial decisions; as well as requesting B. During the past year, the Guardian of the Person has visited the Incapacitated Person 20 times with the average visit lasting 4 hours, minutes. The report of a social service organization employed by the Guardian to oversee arZd coordinate the care of the Incapacitated Person for the period covered by this Report mc7y 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. ///^\\\ r, June 15, 2012 ~~_ ~" -' ~'l~~~ Date Signature of Guardian of the Person Denise E. Palmer Name of Guardian of the Person (type or print) 1089 W. Trindle Road Address Mechanicbsurg, PA 17055 City, State, Zip 717- ~] (-p (o - ~' 7 ~? O Telephone Form G-03 rev. ln.ls.n~ F'age 4 of 4