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HomeMy WebLinkAbout11-19-12 (7)ANNUAL REPORT OF GUARDIAN OF THE PERSON COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION Estate of Inez H. No. 21-07-0200 I. INTRODUCTION Gloria J. Banks -x~ n r+t. ni Z= -_j ~ ~~ U = ~ `- --- r~w ' ~ i ~~ . ~ . c J i ^~ _ ~ i ~_ CJ~I~ ' r~ v7 ~ . ~, .an Incapacitated Person ® Plenary ©Limited Guardian of the Person by Decree of Oler, J. dated 4/12/07 m A. This is the Annual Report for the period from July 12 2011 to Julyl ] 2012 (the "Report Period"); or B. This is the Final Report for the period from J., 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 1., dated For a Fina! Report, omit Sections II through IV. was appointed Fo.mc,-n3 .eT.in.is.oe Page 1 of4 Estate of Inez H. Davis an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: 8~ Date of Birth: 6/1/30 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Golden Living Center, 770 Poplar Church Road, Camp Hill, PA 17011 B. The Incapacitated Person's residence is: ~ own home /apartment m nursing home boarding home /personal care home Guardian's home /apartment ©hospital or medical facility relative's home (name, relationship and address) 0 other: C. The Incapacitated Person has been in the present residence since 12/2/06 . If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: n/a Form G-03 rev. l0./j.06 Page 2 of 4 Estate of Inez H. Davis an Incapacitated Person D. Name and address of the Incapacitated Person's primary care;;iver: Golden Living Care Center -Alzheimer's Unit 770 Poplar Church Road, Camp Hill, PA 17011 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Alzheimer's Disease B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Social, dental, nursing, ophthalmology and pharmaceutical 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 rev. /0.[3.06 Page 3 of4 Estate of Inez H. Davis an ]ncapacitated Person The reasons for the foregoing opinion are: There has been not improvement in the Incapacitated Person's condition. B• During the past year, the Guardian of the Person has visited the incapacitated Person times with the average visit lasting / -=hours, --~ minutes. 77ae report of a social servace organization employed b coordinate the care ofthe Incapacitated Person or the ppdement this Report attached to su f period covered b ~th s Report may be 1 verify that the foregoing information is correct to the best of m information and belief,• and that this Verification is subject to the relative to unsworn falsification to authorities. Y knowledge, penalties of 1 fi Pa. C.S.q. § 4904 Dare .Signanrre ofCaardian Q!/+ Person %~-~-C" Gloria J. Banks Name ofGaardian ojrhe person (type or print) ~ 5776 Catherine St Addres-~ Harrisburg, pq 17112 G%v. store. Zrp -~ l i t /) 545-4816 Telephon~~ Form G-03 rev. /p./3.06 Page 4 of 4