HomeMy WebLinkAboutAgenda - 06-13-2006-9e2ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 13, 2006
Action Agenda
Item No. 9- e-
SUBJECT: Nursing Home Community Advisory Committee- New Appointments
DEPARTMENT: Board of Commissioners
PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): Under Separate Cover
Membership Roster
Letter of Recommendation
Application(s)/Resume(s) of Person(s)
Recommended
Interest List
Application(s)/Resume(s) of Person(s) on the
Interest List
INFORMATION CONTACT:
Clerk's Office, 245-2130
PURP05E: To consider making appointments to the Nursing Home Community Advisory Committee.
BACKGROUND: The Clerk's Office has received a recommendation from the Nursing Home
Community Advisory Committee to appoint Katina Nichols and Patricia Koch to their board.
FINANCIAL IMPACT: None.
RECOMMENDATION(S): Consider making new appointments to the Nursing Home Community
Advisory Committee.
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5
Mary Ann Peter
118 W. Tryon Street
Hillsborough, NC 27278
May 9, 2006
Orange County Board of Commissioners
Hillsborough, NC 2728
To the Commissioners:
I would like to recommend appointment of the following people to the Orange
County Nursing Home Community Advisory Committee. Both people have
attended a meeting of the Committee, have applications on file, and are well
qualified to be members.
Ms. Katina Nichols, RN
5656 Preston Loop
Mebane, NC 27302
Ms. Nichols is African American
Ms. Patricia Koch, retired teacher
1540 Ferrell Road
Chapel Hill, NC 27517
Sincerely,
Mary Ann Peter
Chair, Orange County Nursing Home Advisory Committee
Page 1 of 1
Katina Nichols
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ms. Katina Nichols
5656 Preston Loop
Mebane NC 27302
919-563-4373
336-266-9993
919-563-9881
nichols@mebtel.net
Touching Lives Everyday Home Care, INC
Agency Director/Owner
Cheeks
At-Large
Female
Ethnic Background: African American
Date of Birth: 2/23/1971
Boards/Commissions applied for:
Advisory Board on Aging
Nursing Home Community Advisory Committee
Human Relations Commission
Work Experience:
Presently owner, Director of Nursing and Agency Direcotr of home care agency, RN for 9
years with experience in renal and nephrology, home care, case management, MDS
coordinator at Nursing Home facility, worked as weekend RN supervisor at skilled
nursing home facility and RN team leader at Rehabiliation facility.
Volunteer Experience:
School system and soon the daycare that my baby attends.
Education:
A.D.N.
Other Comments:
I am looking forward to giving in the community and helping others. I am a stay-at-home
mom/wife who is running a business and wanting to make a difference for our youth and
other people. I want better standards for our elderly in long term care facilities. STAFF
COMMENTS: Originally applied for Adv. bd an Aging, NHCAC, HRC 7/18/2005,
ADDRESS VERIFICATION: 5656 Preston Loop is in Orange County in Cheeks township.
This application was current on: 7/18/2005 Date Printed: 5/30/2006
I
Page 1 of 1
Patricia Koch
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms, Patricia Koch
Pat
1540 Ferrell Rd
Chapel Hill NC 27517
942-6637
same
pkoch@mindspring.cam
retired
Teacher
Chapel Hill
C.H, City Limits
Female
Caucasian
12/4/1930
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Nursing Home Community Advisory Committee
Work Experience:
Taught school far 41 years
Volunteer Experience:
Volunteer at Carrboro Elementary School and Britthaven Nursing Home
Education:
B.A, and M.A,
Other Comments:
I spent over 10 years visiting my aunt in CarDl Woods, She was in assisted living for the
last 10 years of her life. I also understand that John Vogt is no longer an the board and
there is an opening, STAFF COMMENTS: Originally applied for Adult Care Home CAC
and Nursign Home CAC 7/1212005, 1540 Ferrell Rd is in Chapel Hill township in the
Chapel Hill City limits.
This application was current on: 7/12/2005 Date Printed: 5/30/2006
Applicant Interest Fisting
by Boazd Name and by Applicant Name
Contact Person:
Nursing HomeCmnn:unity AdvisoryComutittee Contact Phone: Vibeke Talley, OTR/L
919-968-2085
Ms. Jeanette Clark Day Phone: 919-620-8662 Sex; Female
221 Rencher St Apt 3 Evening Phone: 732-7656 Race: African American
Hillsborough NC 27278 FAX: 6208662 Township: Hillsborough
E-mail: Date Applied: 02/23/2005
Skills: Nursing Home Experience Also Serves On: Adult Care Home Community Advisory Committee
MS. Peggy COhll Day Phone: 979-469-6624 Sex: Female
10 Bayswater Place Evening Phone: same Race: Caucasian
Chapel Hill NC 27517 FAX: Township: Chapel Hill
E-mail: peggycohnl@earthlink net Date Applied: IO/10/2005
Skills: Geriatric Care Also Serves On: Adult Cure Home Community Advisory Committee
MS. ELIZABETH CRONER
7605 N GREENIIOROUGH ROAD
CARRIIORO NC 27510
Skills: Retired
Ms. Patricia Koch
1540 Ferrell Rd
Chapel Hill NC 27517
Skills: Retired
Skills: School Volunteer
Skins: Teacher
Mr..Ionghoon Lee
1 I 1 Howell St Apt II
Chapel Hill NC 27514
Skills: Habitat for Humanity
Day Phone: 919.933 862
Evening Phone:
FAX:
E-mail:
Also Serves On:
Day Phone: 942-6637
Evening Phone: same
FAX:
E-mail: pkoch@mindspring com
Also Serves On:
Also Serves On:
Also Serves On:
Day Phone: 919-360-1422
Evening Phone:
FAX:
E-mail: j1ee5@email unc edu
Also Serves On:
Sex: Female
Race: African American
Township: Chapel Hill
Date Applied: 11/05/2005
Sex: Female
Race: Caucasian
Township: Chapel Hill
Date Applied: 07/12/2005
Sex: Mate
Race: Asian American
Township: Chapel Hill
Date Applied: 12/27/2003
Ma Katina Nichols
5656 Preston Loop
Mebane NC 27302
Skills: Non-Proti[ Agency
Day Phone: 919-563-0373
Evening Phone: 336-266-9993
FAX: 919-563-9881
E-mail: nichols@mebtel net
Also Serves On:
Sex: Female
Race: African American
Township: Cheeks
Date Applied: 07/18/2005
Tuesday, May 30, 2006 Page 1 oC2
Applicant Interest Listing
Nursing Horne Cornnrunity Advisory Cmrrmitfee
by Board Name and by Applicant Name
Contact Person: Vibeke Talley, OT'R/L
Contact Phone: 919-968-2085
Stcills: Registered Nurse Atso Scrves On:
Ms. Jane Powell
65G Craige Dorm
IJNC Chapel Hill
Chapel liillNC 27514
Skills: Cashier
Skills: Community Service Volunteer
Skins: Customer Service
Day Phone: 970-474-9083
Evening Phone: 9]9-914-4924
FAX:
E-mail: japo@email uncedu
Alsc Serves On:
Also Serves On:
Also Serves On:
SeX: Female
Race: African American
Township: Chapel Hill
Date Applied: 09/30/2004
MS. T2TTITTlY Th3CkCT' Day Phone: 638-4387 Sex: Female
517 N. Hill So-eet Evening Phone: Race: African American
Hillsborough NC 27278 FAX: Township: Hillsborough
E-mail: gr8tpay@yahoo com Date Applied: 02/I4/2006
Skills: Certified Nurses Aide Also Serves On:
Tuesday, May 30, 2006 Page 2 ot2
!0
Page 1 of 1
Jeanette Clark
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms, Jeanette Clark
221 Rencher St Apt 3
Hillsborough NC 27278
919-620-8662
732-7856
6208662
Central Family Care
Supervisor in Charge
Hillsborough
Hillsborough ETJ
Female
African American
7/8/1955
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Joint Orange Chatham Community Action Agency
Work Experience:
I have been in the medical experience for about 12 yrs, I am a certified nurse assistant,
and a certified medical technician. I have nursing home and adult care home
experience. I supervise a group home now for mental residents
Volunteer Experience:
I have no volunteer experience but I have done outreach before and 1 have a certificate
for a class I took as an outreach worker.
Education:
GED
Other Comments:
STAFF COMMENTS: Originally applied for Nursing Home CAC and Adult Care Home
Community Advisory Committee and JOCCA, ADDRESS VERIFICATION: 211 Rencher
St is in Orange County in Hillsborough Township in Hillsborough ETJ.
This application was current on: 2/23/2005 Date Printed: 5/30/2006
Page 1 of 1
Peggy Cahn
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Peggy Cohn
Peggy
10 Bayswater Place
Chapel Hill NC 27517
919-489-6624
same
peggycahn1 @earthlink.net
retired
Geriatric Care Manager
Township of Residence: Chapel Hill
Zone of Residence: C,H, City Limits
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 8/28/1938
BoardslCommissions applied for:
Nursing Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
Community Health Nursing educator UNC and Penn State University
Director of Family Ties, Geriatric Care Management, State College PA
Volunteer Experience:
Nursing Hame visitation
Nan profit Boards in PA
Education:
BA, Wellesley
BSN, Columbia University
MPH, UNC
PhD, Penn State University College of Health and Human Developmenet
Other Comments:
STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory
Committee and NHCAC and Adv. Board on Aging 10/10/2005, ADDRESS
VERIFICATION: Mailing address listed above. Residence is 233 McCauley Street in
Chapel Hill city limits,
This application was current on: 10/10/2005 11:34:21 AM Date Printed: 5/30/2006
is
Page 1 of 1
ELIZABETH CRONER
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
MS. ELIZABETH CRONER
1605 N. GREENBOROUGH ROAD
CARRBORO NC 27510
919.933.862
RETIRED
Township of Residence: Chapel Hill
Zone of Residence: Carrboro City Limits
Sex:
Ethnic Background:
Date of Birth:
Female
African American
5/14!1934
Boards/Commissions applied for:
Advisory Board on Aging
Nursing Home Community Advisory Committee
Board of Social Services
Work Experience:
RETIRED FROM STATE OF OHIO, CLEVELAND DEVELOPMENTAL CENTER; STAFF
SUPV.
Volunteer Experience:
CURRENTLY ASSISTING ABUNDANT LIFE CHURCH PANTRY
Education:
HIGH SCHOOL; CONTINUED EDUCATION;
Other Comments:
STAFF COMMENTS: Originally applied for Adv. Bcard on Aging, Nursing Home CAC,
and Board of Social Services 11/8/2005. ADDRESS VERIFICATION: 1605 N.
Greensboro St is in Carrboro City Limits in Orange County in the Chapel Hill Township.
This application was current on: 11/5/2005 11:28:47 AM Date Printed: 5/30/2006
Page 1 of 1
Jonghoon Lee
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Mr..Jonghoon Lee
111 Howell St, Apt B
Chapel Hill NC 27514
919-360-1422
jlee5@email.unc,edu
Place of Employment:
Job Title:
Township of Residence: Chapel Hill
Zone of Residence: C.H. City Limits
Sex: Male
Ethnic Background: Asian American
Date of Birth: 7/28/1977
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Board of Health
Nursing Home Community Advisory Committee
Work Experience:
Hardee's Restaurant
UNGCH Libraries
Pantry
Dental Research Center
Volunteer Experience:
Dental Research Center
Orange County Habitat for Humanity
Education:
Sanderson High School-Raleigh, NC
UNC-CH; Chemistry Major, Math Minor
Other Comments:
STAFF COMMENTS: Original) applied for Adult Care Home Comm. Adv. Committee;
Board of Health; and Nursing Home Comm. Adv. Committee. ADDRESS
VERIFICATION: 111 Howell St Apt B is in the Chapel Hill township in the Chapel Hill
City Limits.
This application was current on: 12/27/2003 2:27:55 PM Date Printed: 5/30/2006
Page 1 of 1
Jane Powell
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Jane Powell
656 Craige Dorm
UNC Chapel Hill
Chapel Hill NC 27514
910-474-9083
919-914-4924
japo@emaihunc.edu
Wynnsong 15 Theatre
Cashier
Township of Residence: Chapel Hill
Zone of Residence: Chapel Hill Township within C,H. city limits
Sex: Female
Ethnic Background: African American
Date of Birth: 10/18/1983
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Affordable Housing Advisory Board
Work Experience:
Ocean Beach Club: waitress and secretary, Dairy Queen: cashier, Wynnsong 15: cashier
Volunteer Experience:
Volunteer with Public Service Scholars, Volunteer at Dobbins Hill apartments on
Mondays, Volunteer at UNC Hospital an Mondys, DO other volunteering when needed.
Education:
High School-Lumberton Senior High School, attending UNC Chapel, BS Nursing
Other Comments:
STAFF COMMENTS: Originally applied for Nursing Home Community Advisory
Committee, Affordable Housing Advisory Board, and Animal Shelter Operations Task
Force. ADDRESS VERIFICATION: 656 Craige Dorm is on the campus of UNC-Chapel
Hill and is located off of Manning Drive in Orange County, in the Chapel Hill Township in
the City Limits,
This application was current on: 9/30/2004 Date Printed: 5/30/2006
Page 1 of 1
Tammy Thacker
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Tammy Thacker
517 N. Hill Street
Hillsborough NC 27278
638-4387
gr8tpay@yahoo,com
Aryzen Health and Wellness
President and CAN II
Township of Residence: Hillsborough
Zone of Residence: Hillsborough Town Limits
Sex: Female
Ethnic Background: African American
Date of Birth: 5/31/1968
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Nursing Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
I have been in Health Care for over 15 years and I have a good knowledge base about
the elderly. I understand people need and what it takes to live in a safe environment.
Volunteer Experience:
I have volunteered in the classrooms of my children.
Education:
Certified CNA I and II, Certified EKG technician and Certified Medication Technician.
Other Comments:
STAFF COMMENTS: Originally applied for Adult Care Home and Nursing Home Care
Advisory Boards and Advisory Board an Aging 2/14/2006, ADDRESS VERIFICATION:
517 Hill Street is in the Town of Hillsborough in Orange County.
This application was current on: 2/14/2006 Date Printed: 5/30!2006