HomeMy WebLinkAboutAgenda - 01-24-2012-12d 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
� ACTION AGENDA ITEM ABSTRACT
Meeting Date: January 24, 2012
Action Agenda
Item No. �°�y ,
SUBJECT: Orange County Nursing Home Community Advisory Committee—Appointment
DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): Under Separate Cover INFORMATION CONTACT:
Membership Roster Clerk's Office, 245-2130
Letter Of Recommendation
Application(s)/Resume(s) of Person(s) for
consideration
Applicant Interest List
Application(s)/Resume(s) of Person(s) on
the Interest List
PURPOSE: To consider making an appointment to the Orange County Nursing Home
Community Advisory Committee.
BACKGROUND: The following appointment is for Board consideration:
• Appointment to a one year training term for Dr. Mary Ann Peter. If appointed Dr. Peter
will be serving a one-year training term expiring 06/30//2013.
Position Number S ecial Re resentation Ex iration Date
10 Dr. Ma Ann Peter At-Lar e 06/30/2013
FINANCIAL IMPACT: None
RECOMMENDATION(S): Consider making an appointment to the Orange County Nursing
Home Community Advisory Committee.
Board and Commission Members
And Vacant Positions
Nursing Home Community Advisory Committee
Meeting Times: 5:30 p.m.Every other ist Monday starting withJan. Terms: 2 Contact Person: Chariotte Terwilliger,MSW
Meeting Place: Seymour Center Positions: 12 Length:3 years Contact Phone: 919-558-9401
Description: All appointments aze made by the Boazd of Comm'ssioners.This committee helps to maintain the intent of the Residents'Bill of Rights,promotes community involvement and
provides public education on long-[erm caze issues The regional ombudsman with Trian�e J Council of Governments provides specialized training and support.
Dr. Tracey Yap Day Phone: 502.686.0016 Sex: Female First Appointed: 12/13/2011
1 Evening Phone:919.240.4793 Race:Caucasian Cunent Appointment: 12/13l2011
834 Providence Glen Drive FAX: Township: Chapel Hill Expiration: O1/30/2013
Chapel Hill NC 27514 E-mail:tracey.yap@duke.edu Resid/Spec Req:At-Lazge Number of Terms:
Special Repr: At-Large
Mr Elij ah(Ed)Flowers, III Day Phone:919-357-9256 Sex: Male First Appointed: 03/06/2008
2 Ch21r Evening Phone:919-357-9256 Race:Caucasian Current Appoinhnent: 03/17/2009
2813 Beckett's Ridge Drive FAX: Township: Hillsborough Expiration: 03/31/2012
Hilisborough NC 27278 E-mail:ED_FLOWERS@YAHOO.COM Resid/Spec Req:At-Large Number of Terms: 2
Special Repr: At-Large
Mrs. Patricia Revels Day Phone:(919)241-4071 Sex:Female First Appointed: 03/06/2008
3 Evening Phone:Same Race:Caucasian Current Appointment: 03/17/2009
329 West King Street FAX:N/A Township: Hillsborough Expiration: 03/31/2012
Hillsborough NC 27278 E-mail:preve1s001@nc.rr.com Resid/Spec Req:At-Lazge Number of Terms: 1
Special Repr: At-Lazge
_
Ms. Sharon Karnash Day Phone:919-479-5661 Sex:Female First Appointed: 06/12/2007
4 Evening Phone:sazne Race:Caucasian Current Appointment: 04/19/2011
5513 Quail Hollow Drive FAX: Township: Little River Expiration: 06/30/2014
Hillsborough NC 27278 E-mail: Shazon.karnash@gmail.com Resid/Spec Req:At-Large Number of Terms: 2
Special Repr:At-Lazge
VACANT Day Phone: Sex: First Appointed:
5 Evening Phone: Race: Current Appointment:
FAX: Township: Expiration: 06/30/2008
E-mail: Resid/Spec Req: At-Large Number of Terms:
Special Repr:Nursing Home Administration
Wednesday,Ja�ivary 11,2012 Page 1 N
Board and Commission Members
And Vacant Positions
Nursing Home Community Advisory Committee
Meeting Times: 5:30 p.m.Every other lst Monday starting withJan. Terms: 2 Contact Person: Chazlotte Terwilliger,M3W
Meeting Place: Seymour Center Positions: 12 Length:3 years Contact Phone: 919-558-9401
Description: All appointments are made by the Boazd of Commssioners.This committee helps to mainhain the intent of the Residents'Bill of Rights,promotes community involvement and
provides public education on long-term care issues The regional ombudsman with Trian�e J Council of Govemmenu provides sp�ialized training and support.
Ms Verna Dunn Day Phone:281-855-8551 Sex: Female First Appointed: 10/18/2011
6 Evening Phone:281-855-8551 Race:Caucasian Current Appointment: 10/18/2011
503 Cazl Drive F�� Township: Chapel Hill Expication: 09/30/2012
Chapel Hill NC 27516 E-mail:springfinal@gmaii.com Resid/Spec Req: At-Large Number of Terms:
Special Repr:Nursing Home Administration
Ms Sarah Lowman Day Phone:919-259-0053 Sex: Female First Appointed: 06/O1/2010
� Evening Phone:same Race:Caucasian Current Appointment: 04/19/2011
316 Standish Drive FAX: Township: Chapel Hill Expiration: 06/Ol/2014
Chapel Hill NC 27517 E-mail:sazah_Iowman@med.unc.edu Resid/Spec Req:At-Lazge Number of Terms: 1
Special Repr:At-Large
Dr. Mario Battigelli Day Phone:919-942-5756 Sex: Male First Appointed: 03/16/2010
8 Evening Phone: Race:Caucasian Current Appointment: 04/19/2011
1307 Wildwood Drive F�� Township: Chapel Hiil Expiration: 03/16/2014
Chapel Hill NC 27514 E-mail:mcbattigelli@gmai(.com Resid/Spec Req:At-Lazge Number of Terms: 1
Special Repr: At-Large
Ms. Susan Deter Day Phone:919-682-4124 Sex:Female First Appointed: 04/19/2011
9 Evening Phone:919-479-0574 Race:Caucasian Current Appointment: 04/19/2011
5512 Quail Hollow Drive FAX: 919-956-7703 Township: Little River Expiration: 04/19/2012
Hillsborough NC 27278 E-mail: susiedeter�yahoo.com Resid/Spec Req:At-Lazge Number of Terms:
Special Repr: At-Lazge
�IACAN'j' Day Phone: Sex: First Appointed:
10 Evening Phone: Race: Current Appointment:
FAX: Township: Expiration: 06/30/2013
' E-mail: Resid/Spec Req:At-Large Number of Terms:
Special Repr: At-Large
Wednesday,January 11,2012 Pa e 2
g w
Board and Commission Members
And Vacant Positions
Nursing Home Community Advisory Committee
Meeting Times: 5:30 p.m.Every other lst Monday starting withJan. Terms: 2 Contact Person: Charloue Terwilliger,MSW
Meeting Place: Seymour Center Positions: 12 Length:3 years Contact Phone: 919-558-9401
Description: All appointments are made by the Boazd of Comm'ssioners.This committee helps to maintain the intent of the Residents'Bill of Rights,promotes community involvement and
provides public education on long-term care issues The regional ombudsman with Trian�e J Council of Govemments provides sp�ialized training and support.
VACANT Day Phone: Sex: First Appointed:
11 Evening Phone: Race: Current Appointment:
FAX: Township: Expiration: 12/31/2010
E-mail: Resid/Spec Req:At-Large Number of Terms:
Special Repr:Nursing Home Administration
`IAC�'j' Day Phone: Sex: First Appointed:
12 Evening Phone: Race: Cunent Appointment:
FAX: Township: Expiration: 12/31/2010
E-mail: Resid/Spec Req:At-Lazge Number of Terms:
Special Repr:Nutsing Home Administration
Wednesday,January 11,2012 Page 3 �
5
Jeanette Jones
From: Charlotte Terwilliger <cterwilliger@tjcog.org>
Sent: Thursday,January 12,2012 7:07 AM
To: leanette Jones
Subject: Nursing Home Community Advisory Appointment
Jeanette,
I am sending this email to recommend the appointment Dr MaryAnn Peter to serve a one year training term on the
Orange County Nursing Home Community Advisory Committee. Dr Peter has extensive administrative experience,with
13 of those years as Director of Nursing at Duke University Medical Center. She previously served on this committee,
was an active member, and has a sincere desire to advocate for Orange County residents who live in long term care
facilities. In addition, her professional experience would be invaluable.
Please let me know if there is anything else you need from me to move this recommendation forward.
Thank you.
Sincerely,
Charlotte
Charlotte Terwilliger
Ombudsman—Orange and Chatham Counties
Area Agency on Aging
Triangle J Council of Governments
PO Box 12276/RTP, NC 27709
(o) 919-558-9401/(f)919-998-8101
cterwilliger@tico�.or�/www.tico�.or�
Street Addresss
4307 Emperor Blvd.,Suite 110, Durham, NC 27703
E-Mail correspondence to and from this address is subject to the North Carolina Public Records Act and may
be disclosed to third parties unless made confidential under applicable law.
1
6
Page 1 of 2 Mary Ann Peter
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr Mary Ann Peter
Name Called:
Home Address: 118 W. Tryon St.
Hillsborough NC 27278
Phone: (Day) 919-732-6073
Phone: (Evening)
Fax:
Email: maryannpeter@earthlink.net
Place of Employment: Retired nurse educator and administrator
Job Title:
Year of OC Residence: 2000
Township of Residence: Hillsborough
Zone of Residence: Hillsborough Twnshp - In City Limits
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 7/17/1940
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
My qualifications include the 20 years I have served on the Board of Trustees of DTCC
and in a leadership capacity as vice chair or chair for 17 of those years. I have taught at
UNC-Chapel Hill for 10 years. I have 24 years of administrative experience, with 13 of
those years as Director of Nursing at Duke University Medical Center during which time I
also taught in the Duke School of Nursing. I have previously served on the Nursing
Home Community Advisory Committee. I have previously served on this committee. I
have a nursing background.
Volunteer Experience:
OC Nursing Home Community Advisory Committee, Durham Technical Community
College Board of Trustees, Orange County Advisory Board on Aging. Senion Care of
Orange County Board. Historical Foundation of Hillsborough and Orange County.
Education:
I have a BS and a MS degree from Duke University and a PhD degree from UNC-Chapel
Hill in Education
Other Comments:
I am submitting my name for consideration by the BOCC for appointment to the Durham
Technical Community College Board of Trustees, and am fully supported and
encouraged by Dr. William Ingram, president of DTCC, to do so. I have been a member
of the DTCC Board of Trustees since 1987 and was elected vice-chair in 1991 and then
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Page 2 of 2 Mary Ann Peter
elected chain I 2004. My initial appointment and reappointments were by the Durhan
County Board of Education when I lived in Durham County.My husband and I have had
property in Orange County since 1971, and have lived in Hillsborough since 2000.
Since my residency has changed, so does my need to be reappointed by another official
body. My current appointment expires in July, 2008. I realize that the BOCC needs to
have close contact with the Durham Tech Board of Trustees and I pledge to fulfill that
promise if appointed. My heart and many hours of volunteer work on Orange County
boards and committees serve as testimony to my sincere desire to work dilgently on your
behalf. As Durham Technical Community College moves into the future with a new
president and a new campus in Orange County, I would like to provide leadership in
making an excellent transition in the service of Orange County, its Commissioners and
the Orange County Campus of Durham Technical Community College.Originally Applied
01/30/03 for Adult Care Home Community Advisory Committee. STAFF COMMENTS:
Originally applied for Durham Technical Community College 2/14/2008, Applied for
Nursing Home Community Advisory Committee 1/9/2012. ADDRESS VERIFICATION:
118 W.Tryon Street, Hillsborough is in Hillsborough Township in city limits.
This application was current on: 1/9/2012 Date Printed: 1/11/2012
8
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: Charlotte Terwilliger,MSW
Nursing Home Community Advisory Committee Contact Phone: 919-558-9401
Mr. Jack S. Chestnut Day Phone: 919-732-1242 Sex: Male
4303 Hope Valley Drive Evening Phone: 919-732-1242 Race: Caucasian
Hillsborough NC 27278 FAX: Township: Hilisborough
E-mail: jackchestnut@!aol.com Date Applied: OS/24/2010
Skills: .C.H.SENIOR CNTR.PROGR.PART Also Serves On:
Skills: Cazol Woods Retirement Center Also Serves On:
Skills: HUD202 Housing for Elderly Boazd M Also Serves On:
Ms. T. L. Crews Day Phone: 919 732-6974 Sex: Female
4921 Guess Rd Evening Phone: 919 732-6974 Race: �ican American
Rougmeont NC 27572 FAX: Township: Little River
E-mail: crewsez@aol.com Date Applied: 08/21/2011
Skills: School Principal Also Serves On:
Skitls: Tutor Also Serves On:
Dr. Beverly Foster Day Phone: 919 966-4995 Sex: Female
2454 Springview Trail Evening Phone: 919 967-2930 Race: Caucasian
Chapel Hill NC 27514 FAX: 919 843-6212 Township: Chapel Hill
E-mail: Bev_Foster@unc.edu Date Applied: 02/10/2011
Skills: Nursing Management Education Also Serves On:
Ms Joyce Jefferies Day Phone: (919)425-3597 Sex: Female
4820 NC Hwy 54 West Evening Phone: (919)720-6115 Race: African American
Chapel Hill NC 27516 FAX: (919)425-3529 Township: Chapel Hill
E-mail: joyceJefferies@dentistry.unc.edu Date Applied: 11/03/2010
Skills: Administrative Assistant Also Serves On:
Ms. Sandra Lemons Day Phone: 9199718385 Sex: Female
1321 Brookhollow Road Evening Phone: 9199718385 Race: Caucasian
Efland NC 27243 FAX: Township: Cheeks
E-mail: SandraL@umrh.org Date Applied: 02/1 1120 1 1
Skills: Administrative Assistant Also Serves On:
Wednesday,January 11,2012 Page 1 of 2
9
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: Charlotte Terwilliger,MSW
Nursing Home Community Advisory Committee Contact Phone: 919-558-9401 �
Mr. Max Mason Day Phone: 9196497937 Sex: Male
821 Tinkerbell Rd. Evening Phone: Race: Caucasian
Chapel Hill NC 27517 FAX: Township: Chapel Hill
E-mail: maxomason@yahoo.com Date Applied: O1/25/2011
Skills: Long-Term Caze Also Serves On: Adult Care Home Community Advisory Committee
Skills: Public Health
Mr'. CI13TIeS MCMu110ri Day Phone: 9197329083 Sex: Male
108 Jones Avenue Evening Phone: 9192603879 Race: Caucasian
Hillsborough NC 27278 FAX: Township: Hillsborough
E-mail: cmcmullenl@nc.rr.com Date Applied: 02/10/2011
Skills: Nursing Profession Also Serves On: Adult Care Home Community Advisory Committee
Dr Mary A.nn Peter Day Phone: 919-732-6073 Sex: Female
118 W.Tryon St. Evening Phone: Race: Caucasian
Hillsborough NC 27278 FAX: Township: Hillsborough
E-mail: maryannpeter@earthlink.net Date Applied: O1/09/2012
Skilis: Durham Technical Community College Also Serves On:
Skills: Professor Also Serves On:
Skills: Registered Nurse Also Serves On:
Ms. Vickie Webb Day Phone: 919-491-1073 Sex: Female
150 Lawndale Ave Evening Phone: 919-241-4482 Race: �can American
Hillsborough NC 27278 FAX: 919-560-1107 Township: Hillsborough
E-mail: jb29@nc.rr.com Date Applied: 02/10/2011
Skills: Accounting Experience Also Serves On:
Ms. Tiki Windley Day Phone: 919-969-8583 Sex: Female
119 Cynthia Drive Evening Phone: 919-942-4392 Race: .�ican American
Chapel Hill NC 27514 FAX: Township: Chapel Hill
E-mail: tiki_windley@yahoo.com Date Applied: OS/27/2010
Skills: Also Serves On:
Wednesday,January 11,2012 Page 2 of 2
10
Page 1 of 2 Jack S. Chestnut
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Mr. Jack S. Chestnut ;
Name Called:
Home Address: 4303 Hope Valley Drive
Hillsborough NC 27278
Phone: (Day) 919-732-1242
Phone: (Evening) 919-732-1242
Fax:
Email: jackchestnut@!aol.com
Place of Employment: Retired
Job Title:
Year of OC Residence:
Township of Residence: Hillsborough
Zone of Residence: . . .
Sex: Male
Ethnic Background: Caucasian
Date of Birth: 12/6/1944
Boards/Commissions applied for:
Nursing Home Communiry Advisory Committee
Work Experience:
Director, Community Contact/Special Project, Carol Woods Retirement Center. 21 years
at Carol Woods Retirement Community as Director of Residential services. Responsible
for housing issues- maintenance, remodeling, etc.l worked for Carol Woods Retirement
Center for 30 years. The first 20years I was the Director of Facility Services . The last 10
years I was the Director of Community Contacts and Special Projects.
Volunteer Experience:
Chair of the Advisory Board on Aging; OC Affordable Hosing Board; Chapel Hill Friends
Board. (Current 1/13/04) ; Board Member-Adailade Walters Housing (HUD 202) - 8
years; Rotarian- 9 years- volunteer repair of low income elderly homes; Friends of the
Chapel Hill Senior Center-board, Chapel Hill/Carrboro Sunrise Rotary Board Member,
Orange County Capital Needs Task Force Member, New Hope springs Homeowners
Association Board Member, North Carolina Independent Housing with services advisory
committee.Attended Yuba City College, Have had many training work shops. 30 years of
experience working with Seniors.Attended Yuba City College, Have had many training
work shops. 30 years of experience working with Seniors.Attended Yuba City College,
Have had many training work shops. 30 years of experience working with Seniors. have
served on the Advisory Board on Aging, Both Senior Center Boards, Senior Care of
Orange County Adult Day Health Program and other boards.
Education:
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Page 2 of 2 Jack S. Chestnut
High School - Diploma - Kansas City, KS Yuba City College- graduate study; American
Association of Homes and Services for the Aging - certification for Retirement Housing
Professionals Attended Yuba City College, Have had many training work shops. 30 years
of experience working with Seniors.
Other Comments:
Awarded title of Retirement Housing Professional by the American Association of Homes
and Services to the Aging Awarded Environmental Services Award in 1997 by the North
Carolina Association of Non-Profit Homes for the Aging Awarded Rotarian of the Year in �
1998 for the Chapel Hill/Carrboro Sunrise Rotary. STAFF NOTES: Renewed application
1/12/04 for Southern Orange Senior Center (New) Design Committee. Renewed 5/24/01
for AHAB. Renewed application 12/14/2000 for Advisory Board on Aging. Renewed
application 08/16/00 for Commissioners Affordable Housing Task Force. Applied
09/30/1999 for Master Aging Plan Task Force. Applied for Nursing Home Community
Advisory Committee 5/24/2010. ADDRESS VERIFICATION: 4203 Hope Valley Drive,
Hillsborough is in Chapel Hill Township and Orange County Jurisdiction.
This application was current on: 5/24/2010 Date Printed: 1/11/2012
12
Page 1 of 2 T. L. Crews
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. T. L. Crews
Name Called:
Home Address: 4921 Guess Rd
Rougmeont NC 27572
Phone: (Day) 919 732-6974
Phone: (Evening) 919 732-6974
Fax:
Email: crewsez@aol.com
Place of Employment: Retired Public School Adminstrator
Job Title: Senior Director Programs for Exceptional Children
Year of OC Residence: 1996
Township of Residence: Little River
Zone of Residence: -
Sex: Female
Ethnic Background: African American
Date of Birth:
Boards/Commissions applied for:
Human Relations Commission
Adult Care Home Community Advisory Committee
Nursing Home Community Advisory Committee
Work Experience:
Currently serving as Executive Director for the Little River Community Complex
Durham Public Schools worked in adminstrative leadership in the Exceptional Children's
Program. Retired in 2005 as Director of the system's Exceptional Children's Program; at
the request of the superintendent I returned to provide training and assistance to the new
Director when appointed.
Volunteer Experience:
Worked with children in placement through Durham Social Services and court system. I
reviewed files and collected relevant data for attorneys to use in court custody and
placement hearings
Tutored young adults and children
Volunteered in a university sponsored child development center
Currently Executive Director of Little River Community Complex
Education:
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Page 2 of 2 T. L. Crews
M.ED in Special Education
BA in history with minor in education
Hold Principal Certification
State Licensed in areas of LD/BED/DD
Other Comments:
I have spent most of my life working to better provide assistance to infants, children,
young adults, those at risk, and senior citizens. As a result of spending days and nights
in several nursing homes sitting with elderly parents and relatives, I've gained a deeper
understanding and compassion for elderly residents and workers in nursing facilities.
STAFF COMMENTS: 08/23/2011 Applied to serve on Human Relations Commission,
Adult Care Home Community Advisory Committee, and Nursing Home Community
Advisory Committee. ADDRESS VERIFICATION: 4921 Guess Road is in Little River
Township, Orange County Jurisdiction.
This application was current on: 8/21/2011 11:48:53 AM Date Printed: 1/11/2012
14
Page 1 of 2 Beverly Foster
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Beverly Foster
Name Called:
Home Address: 2454 Springview Trail
Chapel Hill NC 27514
Phone: (Day) 919 966-4995
Phone: (Evening) 919 967-2930
Fax: 919 843-6212
Email: Bev_Foster@unc.edu
Place of Employment: UNC-Chapel Hill School of Nursing
Job Title: Faculty and Undergraduate Program Director
Year of OC Residence: 1981
Township of Residence: Chapel Hill �
Zone of Residence: Does not apply
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 1/13/1943
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
Preparation of undergraduate baccalaureate students for nursing licensure and practice;
program administration and teaching. Direct patient care in the areas of adult acute care
and maternal child.
Volunteer Experience:
Orange County Board of Health, member and chair.
Senior Center Wellness Advisory Board, member and chair.
North Carolina Board of Nursing, member and chair.
Governor's Task Force for Healthy Carolinians (current).
Foundation for Nursing Excellence, member and chair (current)
Program accreditor for nursing (CCNE) (current)
Education:
BSN (1964), Syracuse University
MSN (1976), UCLA
MPH,(1981), University of Hawaii
PhD,(1993), UNC-Chapel Hill
Other Comments:
I have not recently been involved in local community service and wish to again become
active locally. My mother was rather briefly in two skilled nursing facilities in Orange
County prior to her death a few years ago, and I became aware of the needs for
15
Page 2 of 2 Beverly Foster
monitoring and service improvement in this area. At my age I realize I may be a user of
these services myself! I believe my background in nursing education, accreditation and
regulation may be of use to the committee. STAFF COMMENTS: Originally applied for
Nursing Home Community Advisory Committee 2-10-2011. ADDRESS JURISDICTION:
2454 Springview Trail, CH, is in CH Township and CH Jurisdiction.
This application was current on: 2/10/2011 7:20:17 AM Date Printed: 1/11/2012
16
Page 1 of 2 Joyce Jefferies
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms Joyce Jefferies
Name Called:
Home Address: 4820 NC Hwy 54 West
Chapel Hill NC 27516
Phone: (Day) (919)425-3597 �
Phone: (Evening) (919)720-6115
Fax: (919)425-3529
EmaiL• joyceJefferies@dentistry.unc.edu
Place of Employment: UNC School of Dentistry
Job Title: Administrative Assistant
Year of OC Residence:
Township of Residence: Chapel Hill
Zone of Residence: Does not apply
Sex: Female
Ethnic Background: African American
Date of Birth: 7/23/1955
Boards/Commissions applied for:
Work Experience:
Employed by UNC Hospitals and UNC-Chapel Hill since 1973 first as a dietary assistant
now an Administrative Assistant in Dentistry where I perform a variety of functions
including accounting, billing, preparing check requests to pay bills, arranging travel,
coordinating meetings, preparing meeting agendas, ordering supplies, budgeting,
preparing reports, drafting letters, etc. I would like to serve on the Advisory Boards
because I am experiencing first-hand, in regards to my elderly mother, in trying to find an
affordable assisted-living facility in good standard that really uphold the care and the
best interest of their residents. Also the assurance of knowing that these facilities are
being governed by guidelines, rules and regulations that they have to adhere to and that
there are committees to visit these faciliteis to ensure that these guidelines are being
carry out. It is difficult enough to have to place our elderly family members in a facility
but having the reassurance in knowing that they are being well taken care of makes this
transition a lot more bearable.
Volunteer Experience:
I volunteer at my church, Hospitality- serving guests of the Pastor and greeting members
as they enter the church, Sisters of Jubilee-visiting the Women prisons in Raleigh,
organizing birthday parties, prayer and fellowship, visiting the sick and shut in.
Education:
I received my GED from Durham Technical Institute and enrolled in the Business
Administration Associate Degree Program, also at Durham Tech.
17
Page 2 of 2 Joyce Jefferies
Other Comments:
I feel that I am at the place in my life mentally, physically and spiritually where I have a lot
to offer in reaching out and assisting others through community involvement, etc. I look
at volunteering as a personal committment just as rewarding to me as to the area that I
am volunteering in. I get a joy in being able to be a contributor and not just to try and
make a difference. I enjoy working with others in like causes and like minds, even
though having different approaches but seeking to reach the same goat. STAFF
COMMENTS: Originally applied 11-3-2010 for Adult Care Home Community Advisory
Committee, Nursing Home Community Advisory Committee, Advisory Board on Aging.
ADDRESS VERIFICATION: 4820 NC Highway 54 West is in Bingham Township and
Orange County Jurisdiction.
This application was current on: 11/3/2010 2:36:29 PM Date Printed: 1/11/2012
18
Page 1 of 1 Sandra Lemons
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Sandra Lemons
Name Called:
Home Address: 1321 Brookhollow Road
Efland NC 27243
Phone: (Day) 9199718385
Phone: (Evening) 9199718385
Fax:
Email: SandraL@umrh.org
Place of Employment: Croasdaile Village
Job Title: Administrative Assistant Plant Operations
Year of OC Residence: 1955
Township of Residence: Cheeks
Zone of Residence: -
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 10/6/1955
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
UNGCH Medical School Admissions Office 16 yrs; Orange County Schools 7 yrs;
Croasdaile Village 3 yrs
Volunteer Experience:
School and Church
Education:
Chapel Hill High School; King's College, Charlotte NC; King's College, Raleigh NC
Other Comments:
Working for a large retirement center with several levels of care including skilled nursing,
I know the importance of quality care for residents. I am required to complete online staff
development on Resident Rights, Preventing Resident Abuse, Sexual Harassment,
HIPPA, Corporate Compliance; Alzheimer's; Slips, Trips and Falls to name a few. I feel
that I could serve Orange County with this knowledge to make sure that the facilities in
our county give the best quality care and safest living environment to residents. STAFF
COMMENTS: Originally applied for Nursing Home Community Advisory Committee
02/11/2011. ADDRESS VERIFICATION: 1321 Brookhollow Road, Efland, NC is in
Orange County Jurisdiction, Cheeks Township.
This application was current on: 2/11/2011 8:48:46 AM Date Printed: 1/11/2012
19
Page 1 of 2 Max Mason
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Mr. Max Mason
Name Called:
Home Address: 821 Tinkerbell Rd.
Chapel Hill NC 27517
Phone: (Day) 9196497937
Phone: (Evening)
Fax:
Email: maxomason@yahoo.com �
Place of Employment: Principle Long Term Care, Inc.
Job Title: Development Coordinator
Year of OC Residence: 1978
Township of Residence: Chapel Hill
Zone of Residence: Does not apply
Sex: Male
Ethnic Background: Caucasian
Date of Birth: 7/27/1977
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
Development Coordinator for one of NC's largest long term care providers. Plan for
development of nursing facilities, hospices, and home health agency. Administrator for
residential recovery facility for pregnant women who struggled with substance abuse.
Volunteer Experience:
Serve on the Community Grantmaking Committee at the Triangle Community Foundation.
Board Member, Chrysalis Foundation for Mental Health
Member of APPLES Service Learning program at UNC-Chapel Hill as undergraduate.
Education:
BA, History, UNC-Chapel Hill
MA, Slavic Languages & Literatures, UNC-Chapel Hill
Current student (part-time): Masters of Healthcare Administration, UNC-Chapel Hill
Gillings School of Public Health
Other Comments:
As noted, I am presently a student in public health and currently work in the field of long
term care; thus, I have a great interest in the issues affecting nursing facility residents.
Given my experience and familiarity with this segment of the health care system, I
believe I would be a valuable addition to this committee. STAFF COMMENTS:
Originally applied (1/24/2011) for Nursing Home Community Advisory Committee.
ADDRESS VERIFICATION: 821 Tinkerbell Road is in Chapel Hill Township.
20
Page 2 of 2 Max Mason
This application was current on: 1/25/2011 9:11:51 AM Date Printed: 1/11/2012
21
Page 1 of 1 Charles McMullen
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Mr. Charles McMullen
Name Called:
Home Address: 108 Jones Avenue
Hilisborough NC 27278
Phone: (Day) 9197329083
Phone: (Evening) 9192603879
Fax:
EmaiL• cmcmullen1 @nc.rr.com
Place of Employment: retired
Job Title:
Year of OC Residence: 1993
Township of Residence: Hillsborough
Zone of Residence: Does not apply
Sex: Male
Ethnic Background: Caucasian
Date of Birth: 8/22/1946
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Board of Health
Work Experience:
Almost 50 yrs in various fields of nsg.
Volunteer Experience:
Education:
Other Comments:
STAFF COMMENTS: Originally applied for Nursing Home Community Advisory
Committee, Adult Care Home Community Advisory Committee, and Board of Health
02/10/2011. ADDRESS VERIFICATION: 108 Jones Avenue is in Hillsborough
Jurisdiction, Hillsborough Township.
This application was current on: 2/10/2011 10:59:02 AM Date Printed: 1/11/2012
22
Page 1 of 2 Vickie Webb
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Vickie Webb
Name Called:
Home Address: 150 Lawndale Ave
Hillsborough NC 27278
Phone: (Day) 919-491-1073
Phone: (Evening) 919-241-4482 �
Fax: 919-560-1107
Email: jb29@nc.rr.com
Place of Employment: City of Durham
Job Title: Billing Specialist
Year of OC Residence: 1989
Township of Residence: Hillsborough
Zone of Residence: Does not apply
Sex: Female
Ethnic Background: African American
Date of Birth: 9/28/1956
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
My work experience is limited to providing in home care to the elderly who wish to remain
in their homes as long as possible. I provided basic daily assistance with medication, and
personal hygiene, as well as food preparation.
Volunteer Experience:
My volunteer experience is limited to the time I spent in a nursing facility in which my
mother was a resident, and I would go in a help with feedings and companionship of
some selected residents
Education:
I have a high school diploma, and am currently enrolled in an online course to obtain an
Associates degree in Arts with a foundation in business, and am due to graduate in
September 2011.
Other Comments:
I am interested in serving on this committee because I care about people. I especially
care about the people who can not longer care, or speak for themselves. During my
mothers stay at a local nursing home, I was an advocate for her as well as other
residents who either had no family or distant family. I got along well with the staff of the
facility and was very much respected as welC as showing respect for the jobs they
performed. STAFF COMMENTS: Originally applied for Nursing Home Community
Advisory Committee 02/10/2011. ADDRESS VERIFICATION: 150 Lawndale Avenue is
23
Page 2 of 2 Vickie Webb
in Hillsborough Jurisdiction, Hillsborough Township.
This application was current on: 2/10/2011 10:20:40 PM Date Printed: 1/11/2012
24
Page 1 of 2 Tiki Windley
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Tiki Windley
Name Called:
Home Address: 119 Cynthia Drive
Chapel Hill NC 27514
Phone: (Day) 919-969-8583
Phone: (Evening) 919-942-4392
Fax:
Email: tiki windley@yahoo.com
Place of Employment: MDC, inc.
Job Title: Program Manager
Year of OC Residence: 2007
Township of Residence: Chapel Hill
Zone of Residence: . . .
Sex: Female
Ethnic Background: African American
Date of Birth: 11/6/1971
Boards/Commissions applied for:
Board of Social Services
Nursing Home Community Advisory Committee
Adult Care Home Community Advisory Committee
Human Relations Commission
Work Experience:
MDC, Inc. 2006 to Present Program Manager whose duties include meeting facilitation,
training, free tax preparation, asset-building and making presentations. Prior experience
includes teaching financial literacy to high school students and their families, housing
counseling, working with ex-offenders and community engagement and organization.
Current experience includes meeting facilitation, training, oral presentations, community
engagement and organization.
Prior experience includes teaching financial literacy to high school students, asset
education, free tax preparation an housing counseling.
Volunteer Experience:
Meeting facilitation, event planning, volunteer supervision Site coordinator for free tax
preparation site
Escort for Project Homeless Connect (Orange County)
smith Middle School School Improvement Team
Triangle United Way Orange Accountability Committee
Triangle United Way Regional Initiative Task Force
25
Page 2 of 2 Tiki Windley
NC Indian Economic Development Initiative Project G-7
Steering Committee
Assets Educator: Community Success Initiative
NC Second Chance Alliance Escort, Project Homeless Connect (Orange County) 2009
Chairman, Guest Outreach, Project Homeless Connect, 2010
Triangle United Way Orange Accountability Committee
Triangle United Way Regional Task Force Initiative
Assets educator, Community Success Initiative
Project G-7 Steering Committee, NC Indian Economic Development
NC Second Chance Alliance
NC Assets Alliance Escort, Project Homeless Connect (Orange County) 2009 ,
Chairman, Guest Outreach, Project Homeless Connect, 2010
Triangle United Way Orange Accountability Committee
Triangle United Way Regional Task Force Initiative
Assets educator, Community Success Initiative
Project G-7 Steering Committee, NC Indian Economic Development
NC Second Chance Alliance
NC Assets Alliance
Escort, Project Homeless Connect (Orange County) 2009
Chairman, Guest Outreach, Project Homeless Connect, 2010
Triangle United Way Orange Accountability Committee
Triangle United Way Regional Task Force Initiative
Assets educator, Community Success Initiative
Project G-7 Steering Committee, NC Indian Economic Development
NC Second Chance Alliance
NC Assets Alliance
Education:
Bachelor of Science, Elizabeth City State University 1997
Master of Public Administration, NC Central University, 2010
Elizabeth City State University, 1997
Master in Public Administration
NC Central University, December 2010
Other Comments:
I would like to provide a voice for those citizens who feel they are unheard in our
community. STAFF COMMENTS: Originally applied for Commission for Women, Board
of Social Services &Adult Care Home Community Advisory Committee 10/6/09.
Aopplied for Human Relations Commission, Board of Social Services, & Nursing Home
Community Advisory Committee 05/27/2010. ADDRESS VERIFICATION: 119 Cynthia
Drive, Chapel Hill is Chapel Hill township, CH jurisdiction.
This application was current on: 5/27/2010 Date Printed: 1/11/2012