<p> The 1818 Society Questionnaire for CCRCs</p><p>PART I: Organization Name: Kensington Park Retirement Community Name of 1818 member: Charlotte Jones Carroll (daughter of resident) (* Who will also act as the CCRC contact for communication with interested 1818 members.)</p><p>If you wish, please write a short paragraph describing the setting of your facility (urban, rural, water) and what you see as the attractions of the Community for 1818 Society Members. </p><p>Kensington Park Retirement Community, located in Kensington Maryland, provides Independent Living, Assisted Living, and Specialized Alzheimer’s/ Dementia Care.</p><p>Located on 8 picturesque acres, Kensington Park offers a park-like setting backdrop to its three Victorian-style residences. </p><p>.</p><p>1 PART II *Organization Name: Kensington Park Retirement Community *Point of Contact/Sales Representative: Randy East, Director of Sales and Marketing *Address: 3620 Littledale Road, Kensington, Maryland 20895 *Phone: 301-946-7700 Fax: 301-929-4030 *E-Mail: [email protected] Web site: www.kensingtonretirement.com *Facility Operator/Parent Organization: CRSA, Inc *Setting: 8 acres in Kensington Maryland *Number of Years fully operational: 14 *Assessment/Accreditations- N/A CAPACITY Number of Waiting list Number of Total Number of Units (in years) Residents* Units* Available Independent Living 60 0 N/A 64 Apartment - Studio 15 0 0.5 16 Apartment - lBDRM 14 0 0.5 15 Apartment - 2BDRM 31 0 1 33 Cottage/house N/A N/A N/A N/A Assisted Living 140 1 N/A 150 Skilled Nursing N/A N/A N/A N/A</p><p>*Male/Female ratio: EHO Prohibited</p><p>*Type of Ownership: Not for Profit For Profit Registered as: Insurance Co. Health provider Other</p><p>*CCAC Accredited: Yes No</p><p>*Form of Contract: Life Care Fee for Service Continuing Care Assign Assets Equity Entry Fee Rental </p><p>*Refund Provisions: 90% 75% 50% Prorated Other Options: N/A Conditions: Entrance fee consists only of community fee equal to 45 days rent </p><p>*Range of Entrance fees in 2008: $2430- $8700</p><p>*Range of Monthly fees in 2008: $1620- $5800</p><p>*Typical extra costs on a monthly bill: Level of Care: $600-$1600</p><p>2 *Sign Up Policy (Deposit required?)$500 refundable Wait List Deposit.</p><p>*Types of Medical Insurance required: N/A *Type of Health Care Benefits included: Assisted Living and Dementia Care *Medicare Certified: Yes No *Medicaid Certified: Yes No</p><p>*Entry Requirements (Minimum Age): 55 Years Old *Average age on entry: EHO Prohibited *Average Time on Waiting List: 1 month- 2 years *Average No. of years in facility: 24 Months</p><p>Religious Affiliation of Facility: None</p><p>*Type of Facility: Multi-story Single Story Both</p><p>Miles to Shopping: 1 Mile *Miles to Hospital: 2 Miles Access to Public Transportation: Yes No Distance? Entrance of Property</p><p>*Return Home Policy After Acute Leave: N/A</p><p>*Coordination/connection of Assisted Living with Independent Living facilities: Independent Living, Assisted Living, and Alzheimer’s/ Dementia Services provided at Community; priority in AL/Alz access given to IL residents. </p><p>*Please advise us of any issues that have been registered with the CCAC, BBB or local health authorities in the past 5 years and how these were resolved: none</p><p>Please summarize below any other information you consider relevant:………………. ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… ………………………………………………………………………………………………</p><p>3 FACILITIES AND SERVICES Avail- Included Costs Comments able in Fee ($) I. FACILITIES Bank Beauty/Barber Shop X Varies Billiard Room Bowling Green Card Rooms X Various religious services Chapel/Denomination conducted in community room Coffee Shop $4-$7 guest Dining Room – Guest policy X meal Dining Room– Seating No Seating Policy X policy Private Dining Room X IL- 1 Meal included. AL: 3 Type of Meal Plan? X Meals Included. Number of meals a day See Above. X Required? Alcohol in restaurant? Convenience store X Shuttle Offered. Courses/lectures X Craft Rooms X Dry cleaning/laundry X Exercise Facility/Spa Parking - Indoor Parking - Outdoor X Golf Course Access Internet Access/Computer X Facilities Library X Daily Newspapers X Pets X $25/Mo. Putting Green Storage Bins X</p><p>4 Avail- Included Costs Comments able in Fee ($) Swimming Pool - Indoor Swimming Pool – Outdoor Tennis Courts; how many? X 1 Court Workshop Other (eg. Marina) II. SERVICES 7/24 Emergency Response X Medication Management X Assisted Living Only Wellness Clinic X Activities Program X Assistance w/taxes/bills All Utilities except phone X Cable not included. Apartment maintenance X Basic Cable X Varies Housekeeping, times per Once per week. X month Linens provided X AL Only Linens Laundered X AL Only Personal Nursing/home care X AL Only Special Diets Available X Tipping policy X No Tipping Transportation – personal X Varies Transportation - scheduled X Individual gardens On-site Travel Agent X Varies Wi-fi </p><p>*Authorized Signature ………………………………………………… Date ………... </p><p>*Name Randy Allen East *Position Director, Sales and Marketing</p><p>Thank you!</p><p>5</p>