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� r <br />Central+'na Council of Grams <br />REQUEST FOR REMOVAL OF <br />COMMUNITY ADVISORY COMMITTEE MEMBER(S) <br />TO: Clerk/County Manager <br />FROM: Cindy Englert, Regional Long Term Care Ombudsman Program Coordinator <br />Volunteer: Tara Smith <br />Date: 8 -5 -16 <br />County Committee Assignment X_ Adult Care Home Nursing Home Joint <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 — see attached <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 <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 Cindy Englert, <br />Ombudsman Program Coordinator, 704 - 348 -2715. Thank you in advance for your prompt attention to this <br />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 \n <br />H -2 Page 209 <br />