HomeMy WebLinkAboutAgenda - 06-07-2005-9d1ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 7, 2005
Action Agenda
Item No. 9- ~ -1
SUBJECT: Adult Care Home Community Advisory Committee- One New Appointment
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
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 new appointments to the Adult Care Home Community
Advisory Committee.
BACKGROUND: There are two At-Large positions on the Adult Care Home Community
Advisory Committee. The Committee is recommending Judith Mitchell to fill one of these At-
Large positions on their board.,
Position Number S ecial Re resentation Ex iration Date
5 At-Lar e 6/30/2006
6 At-Lar e 6/30/2006
FINANCIAL IMPACT: None.
RECOMMENDATION(S): Consider making one new appointment to the Adult Care Home
Community Advisory Committee, as the Board may desire.
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I Monica Evans -Orange Adult Care Home CAC business Paga 1
~_)
From: <JMPASSMORE@aol.com>
To: <mevans@co.orange na,us>
Date: 4/19/2005 6:43:41 PM
Subject: Orange Adult Care Home CAC business
Hi, Monica,
I hope that you are well! I am writing to share to business items related
to
the Orange Adult Care Home Community Advisory Committee,
i. The Orange County Adult Care Home Advisory Committee would like to
nominate.ludith Mitchell
for a vacant position on their board.
Charron Andrews, Chair, writes:
"With the agreement of the committee, I would like to nominate Judith
Mitchell
to the Oran~c e County Adult Care Home Community Advisory CorrLmittee Board.
Ms~Mitchellhas experiences both in herprofessional and persopal life that
make
her an excellent candidate for this position. A lonq time Orange County
resident,
she cared for her disabled son for many years, From her application, you will
see that Pry
settingwhE
children.
2. Ann Chamberlin, a current Adult Care Home Advisory Committee member, who
is in good standing and
has attended over 75% of the business meetings and has attended 100% of her
scheduled facility visits,
wishes to be reappointed to another term. (Current appointment expires in
June,)
3. Once we hear from Laurin Easthom, who is also up for reappointment, I
will contact you.
(Current appointment expires in June.)
Should you need further information, please do not hesitate to contact me.
Jmpassmore@aol,com_ (mailto:jmpassmore@aol.com)
or cell phone: 423..1444.
Many thanks, Monica,
Jill
Jill V. Passmore
Region J Lead LTC Ombudsman
Triangle J Area Agency on Aging
Triangle J Council of Governments
PO Box 12276
(a
Page 1 of 1
Judith Mitchell
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. Judith Mitchell
3620 Dairyland Road
Hillsborough NC 27278
(919)933-8381
919-933-1851
919-933-6623
jmitchell58@earthlink.net
Retired
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 for 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 far 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: 11/15/20D3 Date Printed: 5/23/2005
Applicant Interest Listing
Adaelt CareFlonie Conavzu~iityAdvisoiy Committee
by Board Name and by Applicant Name
Contact Person: Katherine Leith
Contact Phone: 919-968-2082
Rev Gwendolyn G. Jordan
2314 Miller Rd
Hillsborough NC 27278
Skills:
Skills: Minority Community
Skills: Political Volunteer
Ms. Jeanette Clark
221 Rencher St Apt3
Hillsborough NC 27278
Day Phone: 643-2207
Evening Phone:
FAX:
E-mail:
Also Serves On:
Also Serves On:
Also Serves On;
Skills: Nursing Home Experience
Day Phone: 919-620-8662
Evening Phone: 732-7856
FAX: 6208662
E-mail:
Also Serves On:
Sea: Female
Race: African American
Township: Eno
Date Applied: 04/I2/2005
Sex: Female
Race: Afican American
Township: Hillsborough
Date Applied: 02/23/2005
Ms Capria Harris
327 Forrest Street
Hillsbourgh NC 27278
Skins: First Pood Service
Day Phone: 919-732-7483
Evening Phone: 919-923-6318
FAX:
E-mail: Rorograndbabyl7@aoI com
Also Serves On:
Sex: Female
Race: African American
Township: Hillsborough
Date Applied: 09/09/2004
Ms Johanna Jensen
2201 Baycourt Tmil
Hillsborough NC 27276
Skills: Medical Technologist
Mr, Jonghoon Lee
I 1 I Howell St Apt B
Chapel Hitt NC 27514
Shills: Habitat for Humanity
Day Phone: 225-1925
Evening Phone: 245-1637
FAX:
E-mail: jjensenj@mindspringcom
Also Serves On:
Day Phone: 9I9-360-1422
Evening Phone:
FAX:
E-mail: jlee5@email unc edu
Also Serves On:
Sex: Fcmate
Race: Caucasian
Township: Hillsborough
Date Applied: 11/09/2003
Sex: Mate
Race: Asian American
Township: Chapel Hilt
Date Applied: 12/27/2003
Monday, May 23, 2005 Page t of 2
Applicant Interest Listing
Adult Care Horne Conunurrita7 Advisory Cornrnittee
by Board Name and by Applicant Name
Contact Person: Katherine Leith
Contact Phone: 919-968-2082
MS. Judlth MItChCll Day Phone: (919)933-8381 Sex: Female
3620 Dairyland Road Evening Phone: 919-933-1851 Race: Caucasian
Hillsborough NC 27276 FAX: 919-933-6623 Township: Bingham
E-mail: jmitche1158@earthtink net Date Applied: 11/15/2003
Skills: Community Service Volunteer Also Serves On:
Skills: EMi Also Serves On:
Skills: Receptionist Also Serves On:
Ms. Rupa Shulda
601 Tones Ferry RD A-5
Carrboro NC 27510
Skills: Coach
Skins: Sales
Skills: Special Olympics - N C
Day Phone: 962-2143
Evening Phone: 270-3707
FAX:
E-mail: shukla@emailunc edu
Also Serves On:
Also Serves On:
Also Serves On:
Sex: Female
Race: Asian American
Township: Chapel Hill
Date Applied: 09/28/2004
Monday, May 23, 2005 Page 2 of 2
Page 1 of 2
Gwendolyn G, Jordan
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:
Rev. Gwendolyn G, Jordan
2314 Miller Rd
Hillsborough NC 27278
643-2207
retired
Eno
Eno Twnsp
Female
African American
9/25/1948
Boards/Commissions applied for:
Board of Social Services
Advisory Board on Aging
Adult Care Home Community Advisory Committee
Historic Preservation Commission
Human Services Advisory Commission
Commission for Women
Work Experience:
Worked as an income Maintence Specialist far 25 years in New Jersey. Middlesex
County Welfare, Board of Social Services, Medicaid, Food Stamps, Work First,
Licensed Minister-Associate Minister of Jones Grove Missionary Baptist Church
Hillsborough
Volunteer Experience:
NAACP, Democratic Party, Worked the palls Election Day 11/2004. African American
Democratic Caucus,
Education:
Middlesex County College Credits, New Jersey State/County Training on Welfare- Work
first programs, Master's Degree in Religious Education ,
Other Comments:
STAFF COMMENTS: Originally applied for Board of Social Services, Advisory Board on
Aging, Adult Care Home Community Adv, Committee, HSAC, Commission for Women,
Historic Preservation, ADDRESS VERIFICATION: 2314 Miller Rd is in the Eno township
Page 2 of 2
/o
Gwendolyn G. Jordan
in Qrange County.
This application was current on: 4/12/2005
Date Printed: 5/23/2005
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
Adult Care Home Community Advisory Committee
Joint Orange Chatham Community Action Agency
Work Experience:
I have been in the medical experience far 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 I 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 JOGCA. ADDRESS VERIFICATION: 211 Rencher
5t is in Orange County in Hillsborough Township in Hillsborough ETJ.
Thls application was current on: 2/23/2005 Date Printed: 5/23/2005
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
Hillsbourgh NC 27278
919-732-7483
919-923-6318
Rorograndbabyl7@aDl,cam
Township of Residence: Hillsborough
Zone of Residence: Hillsborough Town Limits
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 Tom
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 far you 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: 327 Forrest Street is in Hillsborough City Limits,
This application was current on: 9/9/2004 3:25:52 PM Date Printed: 5/23/2005
Page 1 of 1
Johanna Jensen ~-3
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 Johanna Jensen
2201 Baycourt Trail
Hillsborough NC 27278
225-1925
245-1637
jjensenj@mindspring.com
Medical Technologist
Township of Residence: Hillsborough
Zone of Residence: -
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 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 College 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 City Limits,
In Hillsborough Township. MOAD/ncg ,
This application was current on: 11/9/2003 pate Printed: 5/23/2005
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: Does 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
UNG-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: 5/23/2005
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 RDA-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 Carolina 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
~S
Other Comments:
I have helped out in my mother's adult day care center far 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 for 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
Page 2 of 2 Rupa Shukla ~ ~
Committee! Thanks! STAFF COMMENTS: Originally applied for Adult Gare Hame
Community Advisory Committee, Carrboro Planning Board and Southern Orange Senior
Center Desaign Committee. ADDRESS VERIFICATION: 601 Jones Ferry Rd is in
Chapel Hill Township, in the Carrboro City Limits.
Thls application was current on: 9/28/2D04 10:11:58 AM Date Printed: 5/23/2005