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i, *� *,i�,�i it T,.� 4 <br />REQUEST FOR REMOVAL OF <br />COMMUNITY ADVISORY COMMITTEE MEMBER(S) <br />TO: Clerk/County Manager <br />FROM: Debi L. Lee, Lead Regional Long Term Care Ombudsman <br />Volunteer: Shana King <br />Date: January 8, 2013 <br />County Committee Assignment _X_ Adult Care Home Nursing Home Joint <br />Date of Appointment: May 21, 2012 <br />Reason for Request <br />Volunteers are a vital part of the services that support older adults in your county. However, the volunteer <br />indicated above is not eligible for continued service for the following reason: <br />Conflict of Interest <br />1. G.S. 131 E -128 (f) Nursing Home <br />2. G.S. 131 D -31 (g) Adult Care Home <br />X Failure to complete required orientation and training <br />1. G.S. 131 E- 128 (g) Nursing Home <br />2. G.S. 131 D- 31 (h) Adult Care Home <br />3. Regional Long Term Care Ombudsman Memo dated July 17, 1998 <br />If a new member does not complete the training and in facility <br />orientation within three months from the date of appointment, the <br />County Commissioners will be asked to replace the committee <br />member. " <br />Dates offered <br />Other (documentation will be attached) <br />1. As determined by the N.C. Division of Aging State Long Term Care <br />Ombudsman Program Policies and Procedures <br />2. As determined by the N.C. Attorney General's Office <br />3. As determined by the committee by -laws. <br />4. As determined by policy set by the County Commissioners. <br />5. As determined by resignation of the member — verbal request due to <br />increased work schedules <br />This is an official request to the Board of Commissioners to have this individual removed from service <br />on the above - mentioned board. Should you have any questions, please contact Debi L. Lee, Lead <br />Regional Ombudsman, 704 - 348 -2714. Thank you in advance for your prompt attention to this matter. <br />525 North Tryon Street, Charlotte, NC 28202 <br />1- 800 -508 -5777 Fax: 704 - 347 -4710 <br />www. centralina.org <br />Attachment number 2 <br />H -1 Page 237 <br />