HomeMy WebLinkAbout02-20-15 ANNUAL REPORT OF
GUARDIAN OF THE PERSON
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COURT OF COMMON PLEAS OF -< <- r� , ' ,
CUMBERLAND COUNTY, PBNNSYLVANIA �� G' ' '
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Es[a[e of MILDRED M. SITLINGER ,an Incapacitated Person
No. ��-0976
I. INTRODUCTION
Janell R. House ,was appointed
�Plenary�Limiced Guardian of the Person by Decree of Honorable M.L Ebert, Jr. J
da[ed December2,2011
0 A. This is[he Annual Repurt for the period from December 1 2013
to oe�emne�si,zo+a , (the `Report Period");or
❑ R. This is the Fioal Report for the period frum ,
tu , (the"Report Pcriod"),and is filed
for thc following reason:
I. The death of the [ncapacitated Person. Date of death:
2. The Gua�dianship was tertninatcd by the Court by Decree of
J., dated
For a Fina!Report, omit Sections I/through!Y.
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a
Estate of Mildred M. Sitlinger ,an Incapacitatcd Pcrson
II. PERSONAL DATA
Age of the Incapacitated Person:85 Date of Birth: October 8th, 1929
❑L LIVINGARRANGEMENTS
A. Current address of the IncapacitateA Person:
413 Park View Drive
Hamsburg, PA 17110
B. �fhe Incapacitated Persods residence is:
❑own hume/apartment
❑nursing home
❑boarding home/personal care hume
�Guardinn's home/apartment
❑hospital or medical facility
�rclativc's home(name, rela[ionship and address)
Mary J.Anthony, Daughter
30601 Dagsboro Roatl; Salisbury, MD 21804-2178
❑othe[
C. The Incapaci[ated Person has been in[he present residence since �une 27, 2012
. If[he Incapacilated Person has moved within the
past yeac, state prior residence and reason(s) for move:
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Estate of Mildred M. Sitlinger , an Incapacita[ed Person
D. Name and address of the Incapacitated Persods primary caregiver:
Mary J.Anthony
30601 Dagsbom Road
Salisbury,MD 21804
N. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
See attached copies(rom pnmary care Doctor
B. Specify what, if any, social, medical, psychological and support scrviccs the
Incapaci[atcd Pcrson is receiving:
See attachetl copies from pnmary care doctorr
V. GUARDIAN'S OPINION
A. Ilisthc opinion of[he Guardian ofthc Person tha[the guardianship should:
0 continue
❑be modificd
❑be[erminatcd
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Esta[e of Mild�ed M. Sitlinge� ,an Incapaci[a[ed Person
The reasons for[he foregoing opinion arr.
B. During the past year, the Guardian of the Person has visited the lncapacitated Person
5 times with the average visit lasting 8 hours, minutes.
The repar(ofa socia(service organization emplayed by[he Cuardian [o aversee and
roordinate �he care of the Incapacilated PersanJ'or(he period cnvered by this Repor!may fie
altached!o s-upplement this Repor[.
I verify tha[the foregoing information is correct[o[he best of my knowledge,
infortnation and belieF, and that this Ve�ifcation is subject to thc penalties of 18 Pa. C.S.A. § 4904
relative[o unswom falsification to authorities.
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Janell R. House
,vome Icva.era�jme ve.ron�nve o.v.�n9
413 Park View Drive
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Harzisburg, PA 17110
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re�enn�,�e
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�'� ���an!aiic�z�-�P.ei.ala, �. �., ��.
MEGHAN EAST, PA-G
AMANDA O'LEARY, PA-C
1905 SOUTH DIVISION STREET
SALISBl1RY, MARVLHND 21804
PHONE�. i4�01 546-21IS
FAX_ f4101 546-2362
Regarding:
MILDRED SITLINGER
30601 DAGSBORO ROAD
SALISBURY MD 21804
DOB: 10/08/29
02/O6/15
To Whom it May Concern:
Above-referenced patient has been diagnosed with the following:
.DX: Dementia
And she is both mentally and physically handicapped, cannot feed herself and
unable to take care of herself and needs assistance with activities of daily living.
Sincerely,
C, �I-=
Joy Madara -Lewis, MD