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HomeMy WebLinkAboutAgenda - 03-19-2013-11f1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: March 19, 2013 Action Agenda Item No. 11 -f 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 first full term for Ms. Vicki Barringer. Ms. Barringer's one year training term will expire 03/31/2013. If appointed, Ms. Barringer will be serving a first full term expiring 03/31/2016. Position Number Special Representation Expiration Date 6 Ms. Vicki Barringer Nursing Home Administration 1 03/31/2016 FINANCIAL IMPACT: None RECOMMENDATION(S): Consider making an appointment to the Orange County Nursing Home Community Advisory Committee. 2 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1 st Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes connnunity involvement and provides public education on long -term care issues. The regional ombudsman with Triangle J Council of Governments provides specialized training and support. U Dr. Tracey Yap 834 Providence Glen Drive Chapel Hill NC 27514 Mr Elijah (Ed) Flowers, III 2 Chair 2813 Beckett's Ridge Drive Hillsborough NC 27278 Day Phone: 502.686.0016 Sex: Female First Appointed: 12/13/2011 Evening Phone: 919.240.4793 Race: Caucasian Current Appointment: 02/19/2013 FAX: Township: Chapel Hill Expiration: 01/30/2016 E -mail: tracey.yap @duke.edu Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Day Phone: 919- 357 -9256 Sex: Male First Appointed: 03/06/2008 Evening Phone: 919 - 357 -9256 Race: Caucasian Current Appointment: 02/21/2012 FAX: Township: Hillsborough Expiration: 03/31/2015 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 Evening Phone: Same Race: Caucasian Current Appointment: 02/21/2012 3 329 West King Street FAX: N/A Township: Hillsborough Expiration: 03/31/2015 Hillsborough NC 27278 E -mail: prevelsOOI@nc.ir.com Resid /Spec Req: At -Large Number of Terms: 2 Special Repr: At -Large Ms. Sharon Karnash Day Phone: 919 - 479 -5661 Sex: Female First Appointed: 06/12/2007 4 Evening Phone: same Race: Caucasian Current Appointment: 04/19/2011 5513 Quail Hollow Drive FAX: Township: Little River Expiration: 06/30/2014 Hillsborough NC 27278 E -mail: Sharon.karnash @gmail.com Resid /Spec Req: At -Large Number of Terms: 2 Special Repr: At -Large 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, March 06, 2013 Page 1 3 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1 st Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes connnunity involvement and provides public education on long -term care issues. The regional ombudsman with Triangle J Council of Governments provides specialized training and support. 6 7 8 9 IKE Ms. Vicki Barringer Day Phone: 919 - 971 -9333 Evening Phone: 919- 971 -9333 3612 Old Vine Trail FAX: Hillsborough NC 27278 E -mail: vbarringer @gmail.com VACANT Day Phone: Evening Phone: FAX: E -mail: Dr. Mario Battigelli Day Phone: 919 - 942 -5756 Evening Phone: 1307 Wildwood Drive FAX: Chapel Hill NC 27514 E -mail: mcbattigelli @gmail.com Ms. Susan Deter 5512 Quail Hollow Drive Hillsborough NC 27278 Dr Mary Ann Peter 118 W. Tryon St. Hillsborough NC 27278 Day Phone: 919 -682 -4124 Evening Phone: 919 - 479 -0574 FAX: 919- 956 -7703 E -mail: susiedeter @yahoo.com Day Phone: 919 - 732 -6073 Evening Phone: FAX: E -mail: maryannpeter @earthlink.net Sex: Female First Appointed: 03/22/2012 Race: Caucasian Current Appointment: 03/22/2012 Township: Eno Expiration: 03/31/2013 Resid /Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Sex: First Appointed: Race: Current Appointment: Township: Expiration: 06/01/2014 Resid /Spec Req: At -Large Number of Terms: Special Repr: At -Large Sex: Male First Appointed: 03/16/2010 Race: Caucasian Current Appointment: 04/19/2011 Township: Chapel Hill Expiration: 03/16/2014 Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Sex: Female First Appointed: 04/19/2011 Race: Caucasian Current Appointment: 03/22/2012 Township: Little River Expiration: 04/19/2015 Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Sex: Female First Appointed: 01/24/2012 Race: Caucasian Current Appointment: 01/24/2012 Township: Hillsborough Expiration: 06/30/2013 Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Wednesday, March 06, 2013 Page 2 0 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1 st Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes connnunity involvement and provides public education on long -term care issues. The regional ombudsman with Triangle J Council of Governments provides specialized 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 VACANT Day Phone: Sex: First Appointed: 12 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 Wednesday, March 06, 2013 Page 3 Jeanette Jones From: Charlotte Terwilliger <cterwilliger @tjcog.org> Sent: Friday, February 22, 2013 3:26 PM To: Jeanette Jones Subject: Two Recommendations for Reappointments Dear Jeanette, The Nursing Nome Community Advisory Committee would like to recommend Ms. Vicki Barringer for a first full term. Her current one year training term will be expiring 3/31/13. During the past year, Ms. Barringer attended 100% of the committee's business meetings and actively participated in all of her assigned quarterly facility visits. Ms. Barringer has a strong interest in improving the quality of life for Orange County residents living in long term care facilities and she is a strong advocate. The Adult Care Home Community Advisory Committee would like to recommend Ms. T L Crews for a first full term. Her current one year appointment will be expiring on 3/31/13. During the past year Ms. Crews attended 5 out of 6 business meetings and has actively participated in all of her assigned quarterly facility visits. Ms. Crews has a passion and love for seniors living in long term care facilities and her input on this committee has been invaluable. Please let me know if you need additional information to move these recommendations 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 @tico8.om / www.tocog.org Street Address: 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 Page 1 of 2 Vicki Barringer Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ms. Vicki Barringer 3612 Old Vine Trail Hillsborough NC 27278 919- 971 -9333 919- 971 -9333 vbarringer @gmail.com N/A 2000 Eno Female Ethnic Background: Caucasian Boards /Commissions applied for: Animal Services Advisory Board Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Work Experience: 1983 - 1984: Business and Finance Intern. 1984 - 1986: Assistant to University controller, Duke Departments. 1987 - 1991: Finance Manager, Division of Family Medicine, Duke -Watts Residency Training Program and Durham Health Care, Inc. 1991 - 1994: Administrator, Division of Family Medicine, Duke University. 1994 - 2005 Director of Finance, The Forest at Duke, Inc., 2005 - 2008: Chief Compliance Officer, Kuhn & Carson, Inc., Durham, NC. 2008: Director of Finance, Duke University: the Fuqua School of Business. 2009 - 2011: Director of Finance and Chief Financial Officer, Galloway Ridge, Inc., Pittsboro, NC Volunteer Experience: Pet Pals, Member (Pet Assisted Therapy & Activities in Orange County Schools). Finance Committee, First Baptist Church of Hillsborough, NC Association of Non - Profit Homes for the Aging, Treasurer (1999 - 2001); NC Association of Non - Profit Homes for the Aging, Board Member (2001 - 2003); Volunteer pet therapy in assisted living and skilled nursing facilities. Education: BA Accounting - NC State University (1983); Master of Business Administration - Duke: the Fuqua School of Business (1990). Other Comments: 7 Page 2 of 2 Vicki Barringer 1) 1 have both a passion for senior living as well as genuine love and respect for older adults. 2) 1 love animals and want our county to allocate appropriate resources to animal services for the protection of animals and citizens and humane treatment of the animals. STAFF COMMENTS: Applied 01/27/2012 for Nursing Home Community Advisory Committee and Animal Services Advisory Board. ADDRESS VERIFICATION: Old Vine Trail is Orange County Jurisdiction, Orange Fire Tax, and Eno Township. This application was current on: 1/27/2012 Date Printed: 3/4/2013 Applicant Interest Listing Nursing Home Community Advisory Committee Ms. T. L. Crews 4921 Guess Rd Rougmeont NC 27572 Skills: School Principal Skills: Tutor Dr. Beverly Foster 2454 Springview Trail Chapel Hill NC 27514 Skills: Nursing Management Education Ms Joyce Jefferies 4820 NC Hwy 54 West Chapel Hill NC 27516 Skills: Administrative Assistant Ms. Sandra Jones 600 West Poplar Ave., Apt. 239 Carrboro NC 27510 Skills: Skills: Geriatric Care Skills: Nurse Ms. Sandra Lemons 1321 Brookhollow Road Efland NC 27243 Skills: Administrative Assistant by Board Name and by Applicant Name Contact Person: Charlotte Terwilliger, MSW Contact Phone: 919 -558 -9401 Day Phone: 919 732 -6974 Sex: Female Evening Phone: 919 732 -6974 Race: African American Cell Phone: Township: Little River E -mail: crewsez @aol.com Date Applied: 08/21/2011 Also Serves On: Adult Care Home Community Advisory Committee Date Applied: Day Phone: 919 966 -4995 Evening Phone: 919 967 -2930 Cell Phone: E -mail: Bev_Foster @unc.edu Also Serves On: Sex: Female Race: Caucasian Township: Chapel Hill Date Applied: 02/10/2011 Day Phone: (919)425 -3597 Sex: Female Evening Phone: (919)720 -6115 Race: African American Cell Phone: Township: Chapel Hill E -mail: joyce ,Jefferies @dentistry.unc.edu Date Applied: 11/03/2010 Also Serves On: Day Phone: 828- 668 -9628 Sex: Female Evening Phone: Race: Caucasian Cell Phone: 828- 712 -2362 Township: Chapel Hill E -mail: None Date Applied: 01/22/2013 Also Serves On: Also Serves On: Also Serves On: Day Phone: 9199718385 Sex: Female Evening Phone: 9199718385 Race: Caucasian Cell Phone: Township: Cheeks E -mail: SandraL @umrh.org Date Applied: 02/11/2011 Also Serves On: Monday, March 04, 2013 Page 1 of 2 9 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Charlotte Terwilliger, MSW Nursing Home Community A 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 Cell Phone: Township: Chapel Hill E -mail: maxomason @yahoo.com Date Applied: 01/25/2011 Skills: Long -Tenn Care Also Serves On: Adult Care Home Community Advisory Committee Skills: Public Health Mr. Charles McMullen Day Phone: 9197329083 Sex: Male 108 Jones Avenue Evening Phone: 9192603879 Race: Caucasian Hillsborough NC 27278 Cell Phone: Township: Hillsborough E -mail: cmcmullenI @nc.rr.com Date Applied: 02/10/2011 Skills: Nursing Profession Also Serves On: Ms. Vickie Webb Day Phone: 919 - 491 -1073 Sex: Female 150 Lawndale Ave Evening Phone: 919- 241 -4482 Race: African American Hillsborough NC 27278 Cell Phone: Township: Hillsborough E -mail: jb29 @nc.rr.com Date Applied: 02/10/2011 Skills: Accounting Experience Also Serves On: Ms. Tiki Wlndley Day Phone: 919 -969 -8583 Sex: Female 119 Cynthia Drive Evening Phone: 919- 942 -4392 Race: African American Chapel Hill NC 27514 Cell Phone: Township: Chapel Hill E -mail: tiki_windley @yahoo.com Date Applied: 05/27/2010 Skills: Financial Advisor Also Serves On: Monday, March 04, 2013 Page 2 of 2 10 Page 1 of 2 T. L. Crews Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. T. L. Crews 4921 Guess Rd Rougmeont NC 27572 919 732 -6974 919 732 -6974 crewsez @aol.com Retired Public School Adminstrator Senior Director Programs for Exceptional Children 1996 Little River Female African American Boards /Commissions applied for: Human Relations Commission Nursing Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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 11 Page 2 of 2 Education: M.ED in Special Education BA in history with minor in education Hold Principal Certification State Licensed in areas of LD /BED /DD T. L. Crews Other Comments: 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: 3/4/2013 12 Page 1 of 2 Beverly Foster Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Dr. Beverly Foster 2454 Springview Trail Chapel Hill NC 27514 919 966 -4995 919 967 -2930 Bev_Foster @unc.edu UNC- Chapel Hill School of Nursing Faculty and Undergraduate Program Director 1981 Chapel Hill Does not apply Female Caucasian Boards /Commissions applied for: Nursing Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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: 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 13 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: 3/4/2013 14 Page 1 of 2 Joyce Jefferies Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Ms Joyce Jefferies 4820 NC Hwy 54 West Chapel Hill NC 27516 (919)425 -3597 (919)720 -6115 joyce_jefferies@dentistry.unc.edu UNC School of Dentistry Administrative Assistant Year of OC Residence: 1962 Township of Residence: Chapel Hill Zone of Residence: Does not apply Sex: Female Ethnic Background: African American Boards /Commissions applied for: Adult Care Home Community Advisory Committee Nursing Home Community Advisory Committee Advisory Board on Aging Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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. 15 Page 2 of 2 Joyce Jefferies 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. Other Comments: 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 am volunteering in. I get a joy in being able to be a contributor and not just an on- looking in seeing what needs to be done or what can be done but never makein an effort to try and make a difference. I enjoy working with others in like causes and like minds, even though having differenc appreaches but seeking to reach the same goal. STAFF COMMENTS: Originally applied 11/03/2010 for Adult Care Home community Advisory Committee, Nursing Home Communtiy Advisory Colmmittee, and Advisory Board on Aging. ADDRESS VERIFICATION: 4820 NC Hwy 54 West is in Bingham Township and Orange County Jurisdiction. This application was current on: 11/3/2010 2:36:29 PM Date Printed: 3/4/2013 16 Page 1 of 2 Sandra Jones Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Sandra Jones 600 West Poplar Ave., Apt. 239 Carrboro NC 27510 828 - 668 -9628 828 - 712 -2362 None Retired RN, Teacher 2012 Chapel Hill Carrboro City Limits Female Caucasian Boards /Commissions applied for: Nursing Home Community Advisory Committee I have been an RN for 50 years with my specialty being geriatrics. I have been in many positons in Nursing Homes from charge nurse, to supervisory, inservice director, Director of Nursing and I was licensed in Michigan as a Nursing Home Administrator. I also have degree in Education (Allied Health). Advisory Board on Aging I am aged - recently became 70 - and I am slightly handicapped and live in a senior independent apartment complex where I see the reality of aging at every level - economically, socially, healthwise, mentally, emotionally. With my background in geriatrics I can be very discerning as to the blessings and problems of aging. Community Activities /Organizational Memberships: Volunteer at McDougle Elementary School - 2nd Grade Reading and Writing Volunteer Leukemia & Lymphoma Society Volunteer Ronald McDonald House (UNC Childrens Hospital) Volunteer Literacy Council- Tutoring in Reading & Math for a 70 year old illiterate lady. Active in my church. Active in my Church Past Service on Orange County Advisory Boards: None 17 Page 2 of 2 Sandra Jones Other Comments: STAFF COMMENTS: Originally applied for Nursing Home Committee and Advisory Board on Aging 01/24/2013. ADDRESS VERIFICATION: 600 West Poplar Avenue, Apt. 239, is Carrboro Jurisdiction, Carrboro City Limits, Chapel Hill Township. This application was current on: 1/22/2013 Date Printed: 3/4/2013 W Page 1 of 1 Sandra Lemons Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Sandra Lemons 1321 Brookhollow Road Efland NC 27243 9199718385 9199718385 SandraL @umrh.org Croasdaile Village Administrative Assistant Plant Operations 1955 Cheeks Female Caucasian Boards /Commissions applied for: Nursing Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Work Experience: UNC -CH 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, 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: 3/4/2013 19 Page 1 of 2 Max Mason Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Mr. Max Mason 821 Tinkerbell Rd. Chapel Hill NC 27517 9196497937 maxomason @yahoo.com Principle Long Term Care, Inc. Development Coordinator 1978 Chapel Hill Does not apply Male Caucasian Boards /Commissions applied for: Nursing Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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, believe I would be a valuable addition to this committee. STAFF COMMENTS: 20 Page 2 of 2 Max Mason Originally applied (1/24/2011) for Nursing Home Community Advisory Committee. ADDRESS VERIFICATION: 821 Tinkerbell Road is in Chapel Hill Township. This application was current on: 1/25/2011 9:11:51 AM Date Printed: 3/4/2013 21 Page 1 of 1 Charles McMullen Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Mr. Charles McMullen 108 Jones Avenue Hillsborough NC 27278 9197329083 9192603879 cmcmullenl @nc.rr.com retired Year of OC Residence: 1993 Township of Residence: Hillsborough Zone of Residence: Does not apply Sex: Male Ethnic Background: Caucasian Boards /Commissions applied for: Nursing Home Community Advisory Committee Board of Health Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Work Experience: Almost 50 yrs in various fields of nsg. 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: 3/4/2013 22 Page 1 of 2 Vickie Webb Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Vickie Webb 150 Lawndale Ave Hillsborough NC 27278 919- 491 -1073 919- 241 -4482 jb29 @nc.rr.com City of Durham Billing Specialist 1989 Hillsborough Does not apply Female African American Boards /Commissions applied for: Nursing Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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: 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 well 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 in Hillsborough Jurisdiction, Hillsborough Township. Vickie Webb This application was current on: 2/10/2011 10:20:40 PM Date Printed: 3/4/2013 24 Page 1 of 2 Tiki Windley Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ms. Tiki Windley 119 Cynthia Drive Chapel Hill NC 27514 919- 969 -8583 919- 942 -4392 tiki_windley @yahoo.com MDC, inc. Program Manager 2007 Chapel Hill Female Ethnic Background: African American Boards /Commissions applied for: Board of Social Services Nursing Home Community Advisory Committee Adult Care Home Community Advisory Committee Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: 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: 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. Applied 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: 3/4/2013