HomeMy WebLinkAbout02-24-15 (3) ANNUAL REPORT OF
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GUARDIAN OF THE PERSON �' '' � � "'
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COURT OF COMMON PLEAS OF � �"
CUMBERLAND COUNTY, PENNSYLVANIA "��
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Estate of Zachary T. Pritchett , an Incapacitated Person
No. 21-2014-0848
I. INTRODUCTION
Alissa C. Moriarty ,was appointed
�Plenary�Limited Guardian of the Person by Decree of Albert Masland � J,�
dated November 3, 2014
� A. This is the Annual Report for the period from November 3 � 2014
to December 31 , 2014 (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, orr�it Sections II through IT�
Form G-03 rev.10.13.06 Page 1 of 4 �
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Estate of Zachary T. Pritchett , an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person: 20 Date of Birth: December 8, 1994
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
507 Dakemich Court
Enola, PA 17025
B. The Incapacitated Person's residence is:
�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. The Incapacitated Person has been in the present residence since 2011
. If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Form c-o3 rev.10.13.06 Page 2 of 4
Estate of Zachary T. Pritchett , an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Dr. Brad Henken
JDC Pediatrics
2025 Technology Parkway, Suite 108
Mechanicsburg,PA 17050
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Anoxic Brain Injury.
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Through the public School system: Life Skills Class(Special Education Program);
Physical,Occupational and Speech Therapy; Sheltered Employment Opportunity:
and Adaptive Physical Education.
Through the Easter Seals: Bowling; and All Abilities Social Group.
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 Ye,�.�0.13.06 Page 3 of 4
Estate of Zachary T. Pritchett , an Incapacitated Person
The reasons for the foregoing opinion are:
There have been no improvements of Zachary's physical or mental conditions since
the date of the entry of the Order on November 3, 2014, that declared him to be an
incapacitated and appointing a permanent,plenary guardian of his person and estate.
B. During the past year,the Guardian of the Person has visited the Incapacitated Person
358 times with the average visit lasting 24 hours, minutes.
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the Incapacitated Person for 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.
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Date Signature of Guardian of the Person
Alissa C. Moriarty
Name of Guardian of the Person(rype or print)
507 Dakemich Court
Address
Enola, PA 17025
Ciry,State,Zip
(717) 497-1715
Telephone
Form c-o3 rev.10.13.06 Page 4 of 4