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HomeMy WebLinkAbout11-28-12 (2) ~ r-~e ~ ~ rn co rn~ ANNUAL REPORT OF rn ~ ~' ~ ~ GUARDIAN OF THE PERSON ~ ~' ~ ~~ `" "' ~ ~ b r.:7 d ~ ~ ~ 'Tl '"~`7 .. ti ~ ~ ~ ~ COURT OF COMMON PLEAS OF Cy C._ ~ ~~ h. ~~ --~ :7 ~- "`~ CUMBERLAND COUNTY, PENNSYLVANIA v ~? cJ-i ~'' ° ~ ORPHANS' COURT DIVISION Estate of Al HUA CHEN 11-1184 an Incapacitated Person I. INTRODUCTION KONG JI CHEN was appointed m Plenary ®Limited Guardian of the Person by Decree of Hon. Albert H. Masland, ~ dated November 28, 2011 A. This is the Annual Report for the period from November 28 2011 to November 27 ~ 2012 (the "Report Period"); or B. This is the Final Report for the period from to (the "Report Period"), and is tiled 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 C-03 rev. 10.73.06 Page 1 of 4 ~~' Estate of AI HUA CHF,N [I. PERSONAL DATA Age of the Incapacitated Person: 59 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: Select Specialty Hospital 503 North 21st Street Camp Hill, PA (7011 an Incapacitated Person Date of Birth: 08/03/1953 B. The Incapacitated Person's residence is: ®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: C. The Incapacitated Person has been in the present residence since on or about December ] 0, 201 1 [f the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Prior to moving to his present location, he had resided at Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033. Form C-03 rev. 10.13.06 Page 2 Of 4 Estate of AI HUA CIIEN an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: Kong Ji Chen, the Guardian, residing at 7 Hedge Row Lane, Carlisle, PA 17015. Actual day to day care is provided by the staff at Select Specialty Hospital, where the Incapacitated Person resides. IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: He remains essentially comatose from traumatic brain injuries suffered in a fall from a ladder at his place of employment. Although there has been very slow minimal improvement since the date of the adjudication on November 28, 2011, he is still unable to move or communicate. B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: His care and treatment are directed by the staff at Select Specialty Hospital where he resides, and he receives full-time nursing care 24 hours a day, 7 days a week. V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: ®continue be modified ~ be terminated Farm c-o3 rev. 10.73.06 Page 3 of 4 Estate of AI HUA CHEN The reasons for the foregoing opinion are: an Incapacitated Person The fact that the Incapacitated Person is confined to a nursing hospital facility, cannot move or communicate, and is in essentially the same comatose state that he was in when the Guardian was appointed in 2011. B. During the past year, the Guardian of the Person has visited the Incapacitated Person 200 times with the average visit lasting 4 hours, minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Pennon for the period covered by this Report may be attached to supplement this Report. [ 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. November 12, 2012 Dafe .SiR urc ~jG ardian of the Person Kong Ji Chen Nome of Gasardian of the Person (type or print) 7 Hedge Row Lane Address Carlisle, PA 17015 city. state. zip (717) 218-8989 Telephone Farm~~-ni rec. to.ls.n6 Page 4 of4