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IN REI
DOROTHY Kf.I NE
:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
-I
1
1 NO.' 21-94-56
1
RULE
WE COMMAND, you that layIng aside all business and excuses
Whatsoever, you be and appear in your proper person before the
Honorable JUdges of the Common Pleas Court, Orphans' Court
Divisi~n at a session of the said Court there to be held, for
the County of Cumberland to show (')auee why Dorothy KlJ. ne should
not be judged an inoapa(')itated person and ElaIne Frost be
appointed as her guardian. Rule returnable the 7th day of
February at 3:00 P.M. 1994 at. a hearing in front of the undersi9lleld
in Courtroom No.2, Cumberland County, Courthouse, CarliSle,
Pennsylvania.
Witness my hand and,offi(')ial seal of offi(')e at CarliSle,
Pennsylvania, this 26th day of January, 1994.
. ) \)
ct'~L C, ~LL'<.. ^,k~ f~. r"J-d
Mary .Lew s (
Clerk of Orphans' Court
Cumberland County
Carlisle,Pa.
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IN REI
DOROTHY KLINE
. IN 'I'HE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-94-56
ORPHANS I COURT DIVISION
QMM
On this . 1 ~day of February 1994, the hearing that was
scheduled on Monday, February 7,1994 at 3100 p.rn, has been
continued generally.
BY
. BAYLEY
.'
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SAlOIS, GUmo
" MASI,ANU
~6 W. Hlsh Street
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N REI
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO, 21-94-56
OROTHY KLINE
ORPHANS' COURT DIVISION
~R
. AND NOW, this 23rd day of May, 1994, after hearing on the
etition fOl" Incapacitation and Appointment of a Guardian for
orothy Kline, IT IS
HEREBY ORDERED AND DIRECTED that Dorothy Kline is adjudged
n incapacitated person and that Elaine ~'rost is appointed
uardian of her person and estate.
k
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BY THE COURT I
HONORABLE HAROLD E '. SHEELY, P. J,
"
SAIDIS, GUIDO
'" MASLAND
2109 MOlk.1 51".1
Camp Hili, PA
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11 CLHN'J'
Ilf;'j't:llIilNA'I'lUN Hl,I'UHT
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Nl\lIb: )C ro~"" ~ ,~ \~e
::::: \ ~6- Y C" \ ~ ~'t:3
City/Town: \-J tM:j\l\\ \e...
p~ Zip: \~~ I
Statel
.
(client or guardian)
This is to certify that the above-~red individual was assessed through the
program onl DI\TElc:9 - \ ~ -q.,
OPTION3-Level XI
-.' ~ of this Assessment was to determine the most appropriate and least restrictive
level'of care necessary to preserve the individuals's welfare and safety. As a result of
the assessment, the most appropriate level of care was detemined to bel
1\. ~ursing facility
o Short-Term
(6 mths. or less)
End date
~ng-Term
{more than 6 mths,)
B.lJ Domiciliary Care
C. 1=.1. Personal Care Boarding Home
D. n COlllD1Unity Services (Specify)
,OPTIONS LEVEL II ASSESSMENT UNIT
lWm: Diane Gourlev. CUmberland County Office of Aqinq
ADDRESS: RoolIl 111. East Winq, Cumberland County Courthouse
(street)
PA
(State)
717 24 -6110
(Tele Number)
Carlisle
City
17013
(Zip)
_ DATE~- \ &...~~
This Assessment Report deals solely with the preli level of care determination made
by the OPTIONS Level II Assessment Unit. Upon receipt of your completed Common Application
Form (PA 600P) the Dep~ent of Publio Welfare, through the County Assistance Office, will
detemine your finanoial eligibility for lIedical Assistance. That Office will notifY you
of their deoision via a Notice to Applicant Form (PA-162). An appeal process will be
available for both the final level of care determination and the finanoial eligibility
deoision. Details of the appeal process will be outlined in the PA-162 Notification.
If you disagree with either the level of care determination or the decision made regarding
your eligibility for II.A., you may file an appeal subsequent to receipt of notification
from the ('.AO (via PI\-162 Form). In all cases to assess UlO formal appeals process for
level of care or financial eligibility, the County Assistance Office must be contacted and
the Common IIpplication Form (PA6001>) must be completed and returned to the ClIO.
e-.Co. ~ o.."",~ V\ ~
. \\1(;, \ td '1,/1-( 1M ~
. ASSESSMENT SUMMARY .
(0
(Ie)
"
RATING SCALE
Summarlzo your conclusions In each soctlon, locuolng on unmot noods, Score
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IN RE I
IN 'l'HE COl/R'JI OIr COMMON PLEAS OF
CUMllERl,ANO COUN"JIY, PENNSYLVANIA
NO. 21-94-56
ORPHANS' COURT DIVISION
DOROTHY KLINE
Q8W
AND NOW/ this I~day of May/ 1994, the hearing that was
originally scheduled for February 7, 1994 at 3100
been rescheduled to the .B A(l day of \.,/l'nt\'<-j
Courtroom No.2, Cumberland County Courthouse,
p.m., has now
<<.:t 1:30",.
, 1994'11 in
Carlisle,
pennsy 1 vania.
.,;
I;,.'
SAIDIS. Gumo
'" MASLANn
26 W. High SIrCCI
CRllIsl., PA
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N RE:
OROTHY KLINE
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 21-94-56
ORPHANS' COURT DIVISION
ORDER
AND NOW, this 23rd day of May, 1994, after hearing on the
et.ition .for Inc,apaci tat ion and Appointment of a Guardian for
orothy Kline, IT IS
HEREBY ORDERED AND DIRECTED that Dorothy Kline is adjudged
n incapacitated person and that Elaine Frost is appointed
uardian of her person and estate.
BY THE COURT:
CL<-~.. .r==. ...
HON RABLE HAROLD E.
./
P.J.
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. SAlOIS, GUIDO ,
&. MASLAND
2109 Mark'l Sir",
Camr Hili, PA
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IN RE I
IN THE COURT OFCO~~ON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. ~/-9~ -.f'6~
DOROTliY KLINE
ORPHANS' COURT DIVISION
RULE TO SHOW CAUSE
AND NOW, this J.1tJ. day of ~(t/l\'/)"(\.'<1r , 1994, in
consideration of the attached Petition, a Rule is dirE:lcted to any
interested parties to show cause why Dorothy Kline should not be
judged an incapacitated person and Flaine Frost be appointed as
her guardian. Rule returnable the rJd- day of .J ~_tl,.w.~,d :;t If'"
1994 at II hearing in front of the undersigned in Courtroom No.
~ , Cumberland County Courthouse, Car~i8le,
J.
SAIDIS. GUIIlO
" MASI.ANO
26 W. Hlsh Slre't
C.rlill..I'A
,I"
IN Rill:
IN TilE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
DORO'rHY K.LINE
NO.
1991
ORPHANS' COURT DIVISION
PETITION OF INCAPACITATION_AND
AN APPOINTMENT OF A GUARDIAN
AND NOW, comes your Petitioner Elaine Frost by and through
its attorneys Saidis, Guido & Masland and respectfully avers the
following in support or her Petition:
1. Your Petitioner is Elaine Frost, an adult individual
residing at One Point Road, Newville, Cumberland County,
Pennsylvania 17241, hereinafter Petitioner.
2. The alleged incapacitated person is Dorothy Kline, age
86, an adult individual residing at One Point Road, Newville,
Cumberland County, Pennsylvania 17241, and she is a widow.
3. The PeU tioner is the daughter of the alleged
incapacitated person.
4. 'rhe alleged incapacitated person suffers from senile
dementia as well as possible depression.
She is markedly
disoriented, and has no orientation as to person, place or time.
SAlIlIS, GUIIlO
& MASI.ANIl
26 W. High Sire"
C.rlillc. PA
At the present time, she is incapable of making any decisions for
herself or to take of her own physical needs.
5.
Before said condition of dementia and the result in
incapacity is expected to be of unlimited duration.
6. The alleged incapacitated person has been seen by Dr.
Joseph A. Pion, who had examined her on November 4, 1993; a copy
.
of his finding is attached hereto and made a part hereof marked
dS Exhibit "A".
7. The gross value of the alleged incapacitated person is
nominal, ae she has been staying with the Petitioner and has had
all of her needs attended to by the petitioner.
8. The Petitioner would be the proposed guardian, who at
thi& time has no interest adverse to the alleged incapacitated
person; the proposed guardian's written consent to her
appointment is attached hereto and made a part hereof marked as
Exhibit "B".
9. No guardian has ever been appointed for the alleged
incapacitated person.
10. The purpose for the filing of this Petition is so that
the alleged incapacitated person can be placed in a nursing home
in Newville, specifically The Swaim Health Center at 210 Big
Spring Road, Newville, Pennsylvania 17241.
Further, the
Petitioner has been attending to all of the needs of the alleged
incapacitated person, and is no longer in a position to do so, as
she is herself wheelchair bound and it is getting more and more
difficult for her to take care of the alleged incapacitated
person.
SAmIS. (;umo
" MASI,ANU
26 W. High Su",
Carlisle, PA
11. There is no other next of kin to contact in these
matters, as the Petitioner is the only child of the alleged
incapacitated person.
WHEREFORE, your Petitioner respectfully requests Your
Honorable Court to enter an Order adjudicating Dorothy Kline to
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