HomeMy WebLinkAboutAgenda - 11-16-2004-5b1ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: November 16, 2004
Action Agenda
Item No. ,Gjj - b -~
SUBJECT: Adult Care Home Community Advisory Committee (ACHCAC)-One Reappointment
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) Being
Recommended for Reappointment
Interest List
Application(s)/Resume(s) of Person(s) on the
Interest List
INFORMATION CONTACT:
Clerk's Office, ext. 2130, 2125, 2126, 2129
TELEPHONE NUMBERS:
Hillsborough 245-2130
Chapel Hill 968-4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To consider making one reappointment to the Adult Care Home Community
Advisory Committee.
BACKGROUND: The term of Ms. Emily Gordon expires on Dec 31, 2004. She wishes to be
reappointed and is eligible,. If reappointed, Ms. Gordon will be serving her fist full term, ending
Dec 31, 2007.
FINANCIAL IMPACT: None.
RECOMMENDATION(S): Consider making one reappointment to the Adult Care Home Community
Advisory Committee as the Board may desire.
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Monica Evans -Emily, Gordon--reappointment--OACCAC _ Page ' ,
~,
From: <JMPASSMORE@aol.com>
To: <mevans@co orange.naus>
Date: 10/6/2Q04 8:22:25 PM
Subject: Emily Gordon--reappointment--OACCAC
Hi, Monica,
Emily Gordon, Orange Adult Care CAC member, is up for reappointment in
December. She is currently a member in good standing, having regularly attended
business meetings and facility visits. She is an asset to this committee and
wishes to be reappointed for another term.
Should you need further information, please do not hesitate to contact me.
Sincerely,
Jill
Jill V. Passmore
Region J Lead LTC Ombudsman
Triangle J Area Agency on Aging
Triangle J Council of Governments
PO Box 12276
RTP, NC 277Q9
Cell: 423.1444
jmpassmore@aol com & jpassmore@tjcog.org
CC: <cfandrew@emaihunc edu>, <Ideloye@hotmaiLcom>, <justkidseg@earthlink,net>,
<ptillet@co.orange nc,us>, <kleith@co orange nc us>
`(~
Page 1 of 1
Emily M. Gordon
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. Emily M. Gordon
P.Q. Box 1352
Carrbara NC 27510
919-928-9751
919-928-9751
n/a
justkidseg@earthlink.net
PrideNC
Mentor
Chapel Hill
Chapel Hill Township within C.H. city limits
Female
Caucasian
Boards/Commissions applied for:
Work Experience:
Caring Community -NYC HA/ NYC DOH; Just Kinds Foundation: NASW: Pride, NC.;
UNC: Care as Needed: Consultant -See resume for details, not shown, Adult Homes
and N.H. Experience.
Volunteer Experience:
Orange House, CHSL; Community Church Project
Education:
MSW - l.)niverisity of Michigan
Other Comments:
Since arriving in the Orange County area I have worked privately as a Geriatrics
consultant and I am CNAT. Address verification: 800 Pritchard Ave Ext. is within Chapel
Hill City Limits, MOAD/ncg
This application was current on: 7/3/2003 Date Printed: 11/1/2004
~~
Applicant Interest Listing
Adult Ctzz•e Hozzze Conznuuzity Advisory Con:rnittee
Ms Cap7ia Harris
327 P'arrest Street
I-lillsbourgh NC 27278
Shills: Past Pond Service
by Board Name and by Applicant Name
Contact Person:
Contact Pbone:
Day Phone: 919-732-7483
Evening Phone: 919-92.3-6318
FAX:
E-mail: Rorograndbabyl7~aol com
Nso Scrvcs On:
Pam 7illett
919-968-2084
--~~ ~~
Sex: Female
Race: African American
Township: Flillsborough
Date Applied: 09/09/2004
Ms .Johanna.Jensen
2201 aaycourt Trait
Hillsborough NC 27278
Skills: Medical Technologist
Mr..Tonghoon Lee
111 liowctl St Apt 6
Chapel Bill NC 27514
Skirts: Habitat (br Humanity
Ms Judith Mitchell
3620 Dairyland Road
Iiittsborough NC 27278
Skills: Community Service Volunteer
Skills: L--MT
Skills: Receptionist
Ms. Rupa Slutkla
GOI tones Fcrty RD A-5
Canboro NC 27510
Skills: Coach
$k1115: $elCS
Skirls: Special Olympics - N C
Day Phone: 225-1925 Sex: Female
Evening Phone: 245-1637 Race: Caucasian
FAX: Township: Flillsborough
E-mail: jjensenjcu mindspring cam Date Applied: 11/09/2003
Also Serves On:
Day Phonr 919-360-1422 Sex: Male
Evening Phone: Race: Asian American
FAX: Township: Chapel l-till
E-mail: jleeS~Jemail unc edu Da[c Applied: 12/27/2003
Nso Scrvcs On:
Day Phone: (919)933-8381 Sox: Pcmale
Evening Phone: ')19-933-1851 Race: Caucasian
FAX: 919-933-6623 Township: Dingham
E-(pail: jmitche1158 rr earthlink net Date Applied: 11/I S/2003
Also Serves On:
Also Serves On:
Nso Serves On:
Day Phone: 962-2143 Sex: Female
Evening Phone: 270- 3707 Race: Asian American
FAX: Township: Chapel HiII
E-mail: shukla rremail unc edu Date Applied: 09/28/2004
Also Serves On:
Also Serves On:
ALSO Serve$ Oo:
Monday, November Ot, 2004 Page I of I
Page 1 of 1
Capria Harris
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 Capria Harris
327 Forrest Street
Hillsbaurgh NC 27278
919-732-7483
919-923-6318
Rorograndbabyl7@aol.com
Township of Residence: Hillsborough
Zone of Residence: Does not apply
Sex:
Ethnic Background:
Date of Birth:
Female
African American
8/31 / 1986
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Hillsborough Planning Board
Board of Social Services
Human Relations Commission
Work Experience:
I have worked at the Holiday Inn, the KFC and Hardees.
Volunteer Experience:
I have volunteerd at the Center for Volunteer Caregiving and at the Sportsplex and Tam
Thumb Daycare Center in Salemburg When I was attending school I also volunteerd at
two Nursing Homes in Salemburg.) also have 150 hours in community service from
school,
Education:
I attended Tarheel Challenge in Salemburg where I received my GED, June,11,2004
Other Comments:
I grew up here then I went to school in Salemburg, I am back home now looking for a job
or a place to volunteer, I hope that you will give me a call and let me voluteer for yota or
offer me a job thank you, STAFF COMMENTS: Originally applied for Adult Care Home
Ocmmunity Advisory Committee, Hillsborough Planning Board and Board of Social
Services. ADDRESS VERIFICATION:
This application was current on: 9/9/2004 3:25:52 PM Date Printed: t 1/1/2004
C~
Page 1 of 1
Johanna Jensen
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 Johanna Jensen
2201 Baycourt Trail
Hillsborough NC 27278
225-1925
245-1637
jjensenj@mindspring.com
Medical Technologist
Hillsborough
Female
Caucasian
9/19/1963
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Duke University Hospital, Medical Technologist, .5/1990- present
Volunteer Experience:
Education:
BS in Medical Technology, Medical CDllege of Virginia
Other Comments:
STAFF NOTES: 10/03 Original appl. For CFW; ACHCAC. ADDRESS VERIFICATION:
2201 Baycourt Trail, Hillsborough is in Beckett's Ridge Subd, in Hillsborough Gity Limits,
In Hillsborough Township. MOAD/ncg .
This application was current on: 11/9/2003 Date Printed: 11/1/2004
IV
Page 1 of 1
,longhoon 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@emaihunc,edu
Place of Employment:
Job Title:
Township of Residence: Chapel Hill
Zone of Residence: Daes not apply
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
UNC-CH 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 Hame Camm, 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: 11/1/2004
Page 1 of 1
Judith Mitchell
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Ms. Judith Mitchell
3620 Dairyland Road
Hillsborough NC 27278
(919)933-8381
919-933-1851
919-933-6623
Email: jmitchell58@earthlink.net
Place of Employment: Retired
Job Title:
Township of Residence: Bingham
Zone of Residence:
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 6/20/1940
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Currently (11/03) I am working far Home Health Solution. Was retired from as
receptionist for Carrboro Peds. And Internal Medicine. Prior to that I worked as UNC
Student Health as a receptionist in Women's Health.
Volunteer Experience:
Department of Social Service; Orange County Fire Department -EMT -First Responder,
Education:
High School; Few courses at Community College, 18 credit hours; Adult Education
Courses.
Other Comments:
STAFF NOTES: Renewed app. 11/15/03 for A.C.H.CAC, Applied 1/16/2001 for Adult
Care Home Community Advisory Committee, OTHER COMMENTS: Very interested
in helping the adult mentally alert but physcially challenged live on their own, There is
nothing for them in this county. I also beleive that Senior Citizens should have better care
both physically and mentally. There are a lot of lonely seniors in just this county alone,.
You may check with Chris Nutter or Heather Barrow for references, Or with any of the
Doctors at Carrboro Peds. And Internal Medicine,
This application was current on: 11/15/2003 Date Printed: 11/1/2004
I',~
Page 1 of 2
Rupa Shukla
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. Rupa Shukla
601 Jones Ferry RD A-5
Carrboro NC 27510
962-2143
270- 3707
shukla@email.unc.edu
UNC- CH Lineberger Comprehensive Cancer Cent
Research Technician/ Lab Manager
Chapel Hill
Carrboro City Limits
Female
Asian American
4/11/1981
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Carrboro Planning Board
Southern Orange Senior Center (New) -Design Co
Work Experience:
University of North Catalina at Chapel Hill-- Lineberger Cancer Center
Ann Taylor Loft, Sales Associate
Volunteer Experience:
Orange County Special Olympics-- Swim Coach
Trinity Adult Day Care Center (Tullahoma, TN)
Relay- for- Life
Education:
BA History and BA Chemistry from UNC- Chapel Hill
Other Comments:
I have helped out in my mother's adult day care center for the past 10 years, The center
specialized in Alzheimer's care, but also allows patrons with other physical ailments to
participate, The Trinity Adult Care Center is a great place far caregivers to comfortably
leave their loved ones while they are at work, The center provides meals, physical
exercises, as well as games that strengthen the participants' minds-- working on their
recall skills and helping to sharpen their minds. The knowledge I have gained through
this experience would definitely help me to serve on either the Adult Care Home
Community Adivsory Committeee or the Southern Orange Senior Center Design
~3
Page 2 of 2
Rupa Shukla
Committee! Thanks! STAFF COMMENTS: Originally applied for Adult Gare Home
Community Advisory Committee, Carrboro Planning Board and Southern Orange Senior
Center Desaign Committee. ADDRESS VERIFICATION: 6Q1 Jones Ferry Rd is in
Chapel Hill Township, in the Carrboro City Limits.
This application was current on: 9/28/2004 10:11:58 AM Date Printed: 11/1/2004