BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA

Transcription

1 BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Petition for Early Termination of Probation of: KATHY ARREDONDO OAH No Registered Nurse License No. Petitioner. DECISION The attached Decision of the Board of Registered Nursing is hereby adopted by the Board as its Decision in the above-entitled matter. This Decision shall become effective on April, 201. IT IS SO ORDERED this th day of April 201. Board of Registered Nursing Department of Consumer Affairs State of California

2 . BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Petition for Early Termination of Probation by: OAH No KATHY ARREDONDO, Petitioner. DECISION GRANTING THE PETITION This matter was heard by a quorum of the Board of Registered Nursing (Board) on February, 201, in Ontario, California. Erlinda G. Shrenger, Administrative Law Judge, Office of Administrative Hearings, State of California, presided. Kathy Arredondo (Petitioner) was present and represented herself.. Desiree Tulleners, Deputy Attorney General, appeared on behalf of the Attorney General of the State of California pursuant to Government Code section The petition and other relevant documents were presented. Petitioner and the Deputy Attorney General made oral presentations to the Board. Petitioner responded to questions of Board members and the Deputy Attorney General. The record was closed, the Board met in executive session, and the matter was submitted on February, 201. FACTUAL FINDINGS 1. (A) The Board, by Decision and Order, effective March 2, 200, approved a stipulated settlement of the Statement of Issues in Board Case No , pursuant to which Petitioner's application for a registered nurse license was granted, registered nurse license number was issued to Petitioner on May, 200, upon her completion of all licensing requirements, the license was immediately revoked, the order of revocation stayed, and Petitioner was placed on probation for three years under various terms and conditions. (B) The stipulated settlement was based on Petitioner's admission to the truth of the charges and allegations in Statement of Issues No , and her agreement that her application for licensure was subject to denial. Petitioner had convictions in 1 for forgery and in 1 for taking a vehicle for temporary use without the owner's consent. in 1, Petitioner unlawfully obtained and possessed crack cocaine and a crack pipe. In 2002, Petitioner's vocational nurse license had been disciplined and placed on probation by the

3 California Board of Vocational Nursing and Psychiatric Technicians (LVN Board). The Board denied Petitioner 1 S application for a registered nurse license on the grounds that she had been convicted of crimes substantially related to the qualifications, functions, and duties of registered nurse; she had engaged in conduct which if done by a Board licensee would have been grounds for suspension or revocation of a license; and she had a license that was disciplined by another California health care professional licensing board. 2. (A) The Board, by Decision and Order, effective November 1, 200, approved a stipulated surrender of license and order in Board Case No (OAH No ), pursuant to which Petitioner surrendered her registered nurse license number and the Board accepted the surrender. (B) The stipulated surrender of license was based on the Second Amended Accusation and Petition to Revoke Probation in Board Case No , and Petitioner 1 s admission to the truth of the charges and allegations contained therein and her agreement that cause existed for the Board to discipline her license. Petitioner had two convictions in 200 for driving under influence of alcohol. Petitioner 1 S vocational nurse license was revoked by the L VN Board. In addition, Petitioner had violated several probation conditions previously imposed by the stipulated settlement in Board Case No (C) Petitioner has explained that her failure to comply with this previous probation, which resulted in the surrender of her license, occurred during a difficult time in her life when her husband passed away and she was left to raise three young children as a widow. The difficulty of that situation contributed to her abuse of alcohol.. The Board, by_decision, effective December 2, 2011, reinstated Petitionds registered nurse license number, immediately revoked the license, stayed the order of revocation, and placed Petitioner on probation for five years under various terms and conditions. The probation period began on January, 20, and is presently scheduled to run until January, The instant petition for early termination of probation was filed on or about April2, The probation monitor reports that Petitioner fully complied with the Board 1 S probation program and cooperated with Board representatives. She appeared for probation interviews as directed and submitted all requ-ired written reports. She completed all nursing courses required by the Board. Petitioner timely paid the full amount of the cost recovery owed to the Board of $,000.. Petitioner bas functioned as a nurse during her probation. On March 1, 201, she was approved for employment with Madera Surgery Center, and has continued in that employment up to the present time. Petitioner 1 s performance evaluations from Madera Surgery Center rate her work as exceeding or meeting the position expectations. 2

4 . The probation monitor reports that Petitioner has submitted evidence of her completion of a treatment and rehabilitation program. She has abstained from the use of psychotropic drugs. During probation, Petitioner submitted to random drug/alcohol testing as required by the Board. She did miss one call into First Lab on April 20, 201, which was Easter Sunday. Petitioner had been busy with her family members for the Easter holiday and forgot to call the lab. The next day, Monday, Petitioner realized she had forgotten to call. When she got to work, Petitioner told her manager, who instructed her to call the lab. The lab informed Petitioner she was not selected to test. Petitioner next called the probation monitor and disclosed she missed the call to the lab.. Petitioner submitted substantial documentation establishing rehabilitation and her efforts at recovery and maintaining sobriety. Petitioner acknowledges that she is an alcoholic and that addressing her alcoholism is a lifelong process. She has been sober for approximately four and one-halfyears. Her sobriety date is September 11, She continues to attend Alcoholics Anonymous (AA) and a nurse support group. She speaks at AA meetings and shares her experience, strength and hope. Petitioner has a relapse prevention plan. She has family and friends to support her in maintaining sobriety. In her letter to the Board, and in her testimony, Petitioner expressed that she has learned and implemented tools from the Board's probation program which continues to help her maintain sobriety while she continues to grow both personally and professionally. LEGAL CONCLUSIONS 1. The Petitioner has the burden of establishing by clear and convincing evidence that she is entitled to an early termination ofherprobation. (Bus. & Prof. Code, 20.1, subd. (b).) 2. Business and Professions Codesection 20.1, subdivision (a), provides that a petition may be brought for the early termination of probation. Petitioner has met her heavy burden of establishing that cause to terminate her probation: She has fully documented her rehabilitation and her commitment to recovery and maintaining sobriety. She has a relapse prevention plan in place and a strong network of family and friends to support her in maintaining sobriety. Her testimony established she has taken to heart the lessons learned in recovery. Under the circumstances, no further probation is warranted (Factual Findings 1-.) II I I II II I I II II II II

5 " ' ORDER The petition for termination of probation is granted. The probation of Registered Nursing License No., issued to Kathy Arredondo, is hereby terminated. IT IS SO ORDERED. This Decision shall be effective A()rii 1 '201. I DATED: Aor1 I Z 20! I I ichael D. Jac:Kson, Vice President, For the Board of Registered Nursing Department of Consumer Affairs

6 BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Petition for Reinstatement: KATHY ANN ARREDONDO OAH No Registered Nurse License No. Petitioner. DECISION The attached Decision of the Board of Registered Nursing is hereby adopted by the Board as its Decision in the above-entitled matter. This Decision shall become effective on December 2, IT IS SO ORDERED this ~day of November 2011.

7 BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Petition for Reinstatement of: KATHY ANN ARREDONDO, OAH No Registered Nurse License No. Petitioner. DECISION This matter was heard before a quorum ofthe Board ofregistered Nursing in Emeryville, California, on September 1, The board members present were: President Jeannine Graves, MPA, BSN, RN; Vice President Doug Hoffner; Judy Corless, BSN, RN; Dian Harrison, MSW, Erin Niemela; and, Catherine M. Todero, PhD, MSN, RN. Administrative Law Judge Steven C. Owyang, State of California, Office ofadministrative Hearings, presided. Petitioner Kathy Ann Arredondo was present and represented herself. Leslie E. Brast, Deputy Attorney General, represented the Department ofjustice, Office ofthe Attorney General. FACTUAL FINDINGS 1. The Board ofvocational Nursing and Psychiatric Technicians (VNPT board) issued a probationary L VN license to petitioner Kathy Ann Arredondo by way of stipulated settlement, effective September 2, This followed a statement of issues filed by that board based on two criminal convictions, attendant dishonesty and fraud, possession of crack cocaine and a crack pipe, and for acts that if committed by a licensee would have been grounds for suspension or revocation.. In September 1, petitioner was convicted in Santa Cruz County of having taken a vehicle for.~~mporary use (commonly known as "joyriding"). In December 1-, sh~ was convicted in Santa Cruz County of forgery. -1

8 2. Petitioner failed to meet the requirements ofher probation and the VNPT board revoked her L VN license by a default decision and order that took effect on January 1, Petitioner applied for licensure as an registered nurse in March 200, after she received her L VN license but before that license was revoked. The Board of Registered Nursing denied her application and, in December 200, filed a statement of issues based on the same convictions, dishonesty, and drug offenses as in the vnpt board's statement of issues, plus the fact of her disciplinary history with the VNPT board. In settlement of the statementof issues the board issued petitioner registered nurse license number in March 200; the registered nurse license was immediately revoked and the revocation stayed subject to a three-year term of probation that included standard conditions plus submission to mental and physical examinations, participation in a treatment or rehabilitation program for chemical dependence) abstinence and drug screening.. Petitioner failed to comply with the conditions of her probation and the board sought revocation of her license. The second amended accusation in that matter was settled, effective November 1, 200, by petitioner's stipulated surrender of her registered nurse license. She was precluded from petitioning the board for reinstatement for a year from the effective date of the board's decision. Petitioner was also required, upon any reinstatement of her license, to pay to the board its costs of investigation and enforcement, in the amount of$,000.. Petitioner's husband passed away in December 200, leaving her to raise three children as a widow. The difficulty of these circumstances contributed to her alcohol abuse... Petitioner filed a petition for reinstatement of her registered nurse license on February 2, Petitioner acknowledges that she is an alcoholic. She attends Alcoholics Anonymous meetings twice per day. She submitted records of her attendance at AA meetings from December 2, 200, through July 2, Petitioner has a September 11, 2010, date of sobriety. This followed a relapse in August Petitioner takes responsibility for her mistakes. She remains active in the recovery community. She continues to raise her children, who are now teenagers. If reinstated, she would like to pursue legal nurse consulting. She is willing to abide by all terms and conditions that may be imposed by the board.. Petitioner submitted a j~br~~ ~0, 2011, letter from her AA sponsor H.S. (sponsor's name redacted). H.S. wrote: ~. -2

9 When Kathy asked me to write this letter of support, I first insisted that she provide me with the Accusations and Revocation Petition on record with the courts. As I read through the allegations I couldn't help but think they were talking about someone else; this behavior does not seem possible for the Kathy I have come to know. The Kathy I have been working closely with over the past months is a responsible, determined and loving human being. Kathy has been working diligently on her steps and is surprisingly humble and introspective. She often talks about "seeing her part" in situations and wanting to "clean up her side of the street". [sic] Kathy and I speak almost on a daily basis and her personal growtp over this short time has been inspiring. In reading through the paperwork I can see that Kathy has been given plenty of chances. From what I have learned about Kathy and the struggles she has had to overcome, she was not in the right frame of mind to abide by the stipulations set forth in her probation. I ask that you please give her just one more opportunity to prove herself. I am confident that she will not let you down. 10. Petitioner submitted letters from the following, all of whom are affiliated with the Peoples Church, Fresno: Children's Pastor Brad Holck; Child Care Director and Minister of Family Counseling Barbara Solis; Junior High Specialist Matt Markarian; and, Stephen Minister Patricia Hedstrom, RN. They attest to petitioner's integrity, dependability, compassion, sober lifestyle, maturity, and hard work. 11. Patricia Hedstrom, RN, appeared as a witness on petitioner's behalf. Hedstrom is a registered nurse with more than 20 years of experience. She has known petitioner for more than four years, having worked with her as a lay minister at Peoples Church. Hedstrom described petitioner as a different person than she had been in the 10's, that she is a great mother and a wonderful, trustworthy, and honest friend.. Petitioner attended the Institute of Technology in Clovis, where she was on the Dean's List. Penny Dhindsa, Lead Career Services Advisor, wrote a February 1, 2011, letter in support of petitioner's reinstatement. Dhindsa noted petitioner's "superb communication skills, both written and verbal, and her excellent rapport with people of all ages." " ' '.,.. ;- : :'. ' f : "..:.. ' 1. Petitioner completed continuing education'units, including a 0-hour Cancer in Women course at the Western Schools, Clovi's. She did not take additional continuing education after 200, due to a lack of income. -

10 1. Petitioner was for the most part unemployed in 200, 200, and She had a temporary job at Precision Medical Services for about five months in Petitioner started work as an admissions clerk at Sierra Kings Hospital in Reedley in February A January 2,2011, letter from Ron Dillmore, Operations Manager, Precision Medical Services, attests to petitioner's excellent work ethic, attendance, rapport with coworkers and clients, trustworthiness, and integrity. 1. Petitioner has had a long and difficult road that included drug and alcohol abuse, criminal convictions, the death of her husband, discipline by this board and the VNPT board, raising three children as a single parent, and periods of unemployment. She has demonstrated a sincere commitment to recovery, despite a brief relapse in August Petitioner has made great strides toward rehabilitation. She has demonstrated to the satisfaction of the board that reinstatement of her license upon relevant probationary terms and conditions is warranted. LEGAL CONCLUSIONS Cause exists pursuant to Business and Profession Code section 20.1 to reinstate petitioner's registered nurse license, subject to probationary terms and conditions. ORDER The petition of Kathy Ann Arredondo for reinstatement of her registered nurse license is. granted. Registered nurse license shall be reinstated. The license shall immediately be revoked, the order of revocation stayed and petitioner placed on probation for a period of five years on the following conditions: Each condition of probation contained herein is a separate and distinct condition. If any condition of this order, or any application thereof, is declared unenforceable in whole, in part, or to any extent, the remainder of this order, and all other applications thereof, shall not be affected. Each condition of this order shall separately be valid and enforceable to the fullest extent permitted by law. (1) -:- Petitioner shall obey all federal, state and local laws. A full and detailed account of any and all violations of law shall be reported by petitioner to the board in writing within 2 hours of occurrence. To permit monitoring of compliance with this condition, petitioner shall submit completed fingerprint forms and fingerprint (e~s. within days ofthe effective date of the decision, unless previously.' uqrnitted as prut of the licensure application process..,. -

11 CRIMINAL COURT ORDERS: If petitioner is under criminal court orders, including probation or parole, and the order is violated, this shall be deemed a violation of these probation conditions, and may result in the filing ofan accusation and/or petition to revoke probation. (2) COMPLY WITH_IHE BOARD'S PROBATION PROGRAM- Petitioner shall fully comply with the conditions of the probation program established by the board and cooperate with representatives of the board in its monitoring and investigation of petitioner's compliance with the board's probation program. Petitioner shall inform the board in writing within no more than 1 days of any address change and shall at all times maintain an active, current license status with the board, including during any period of suspension. Upon successful completion of probation, petitioner's license shall be fully restored. () REPORT IN PERSON- Petitioner, during the period of probation, shall appear in person at interviews/ meetings as directed by the board or its designated representatives. () RESIDENCY. PRACTICE, OR LICENSURE OUTSIDE OF STATE Periods of residency or practice as a registered nurse outside of California shall not apply toward a reduction of this probation time period. Petitioner's probation is tolled, if and when she resides outside of California. Petitioner must provide written notice to the board within 1 days of any change of residency or practice outsid~ the state, and within 0 days prior toreestablishing residency or returning to practice in this state. Petitioner shall provide a list of all states and territories where she has ever been licensed as a registered nurse, vocational nurse, or practical nurse. Petitioner shall further provide information regarding the status of each license and any changes in such license status during the term of probation. Petitioner shall inform the board if she applies for or obtains a new nursing license during the term of probation. () SUBMIT WRITTEN REPORTS- Petitioner, during the period of probation, shall submit or cause to be submitted such written reports/declarations and verification of actions under penalty of perjury, as required by the board. These reports/declarations shall contain statements relative to petitioner's compliance witt) allth,e conditions of the board's probation program. Petitioner shall immediately ~X.'ecute all release of information forms as may be require~ by the boara bt its representatives. -

12 Petitioner shall provide a copy of this decision to the nursing regulatory agency in every state and territory in which she has a registered nurse license. () FlJNCTION AS A REGISTERED NURSE -Petitioner, during the period of probation, shall engage in the practice of registered nursing in California for a minimum of 2 hours per week for six consecutive months or as determined by the board. For purposes of compliance with the section, "engage in the practice of registered nursing" may include, when approved by the board, volunteer work as a registered nurse, or work in any non-direct patient care position 'that requires licensure as a registered nurse. The board may require that advanced practice nurses engage in advanced practice nursing for a minimum of 2 hours per week for six consecutive months or as determined by the board. Ifpetitioner has not complied with this condition during the probationary term, and petitioner has presented sufficient documentation ofher good faith efforts to comply with this condition, and if no other conditions have been violated, the board, in its discretion, may grant an extension of petitioner's probation period up to one year without further hearing in order to comply with this condition. During the one' year extension, all original conditions of probation shall apply. () EMPLOY1VIENT APPROVAL AND REPORTING REQUIREMENTS Petitioner shall obtain prior approval from the board before commencing or continuing any employment, paid or voluntary, as a registered nurse. Petitioner shall cause to be submitted to the board all performance evaluations and other employment related reports as a registered nurse upon request of the board. Petitioner shall provide a copy of this decision to her employer and immediate supervisors prior to commencement of any.nursing or other health care related employment. In addition to the above, petitioner shall notify the board in writing within 2 hours after she obtains any nursing or other health care related employment. Petitioner shall notify the board in writing within 2 hours after she is terminated or separated, regardless of cau,se,.from any nursing, or other health care related employment with a full expfaria:tion of the circumstances surrounding the termination or separation., '.. -

13 () SUPERVISION- Petitioner shall obtain prior approval from the board regarding petitioner's level of supervision and/or collaboration before commencing or continuing any employment as a registered nurse, or education and training that includes patient care. Petitioner shall practice only under the direct supervision of a registered nurse in good standing (no current discipline) with the board, unless alternative methods of supervision and/or collaboration (e.g., with an advanced practice nurse or physician) are approved. Petitioner's level of supervision and/or collaboration may include, but is not limited to the following: (a) Maximum- The individual providing supervision and/or collaboration is present in the patient care area or in any other work setting at all times. (b) Moderate - The individual providing supervision and/or collaboration is in the patient care unit or in any other work setting at least half the hours petitioner works. (c) Minimum- The individual providing supervision and/or collaboration has person-to-person communication with petitioner at least twice during each shift worked. (d) Home Health Care - If petitioner is approved to work in the home health care setting, the individual providing supervision and/or collaboration shall have person-to-person communication with petitioner as required by the board each work day. Petitioner shall maintain telephone or other telecommunication contact with the individual providing supervision and/or collaboration as required by the board during each work day. The individual providing supervision and/or collaboration shall conduct, as required by the board, periodic, on-site visits to patients' homes visited by petitioner with or without petitioner present. () EMPLOYMENT LIMITATIONS- Petitioner shall not work for a nurse's registry, in any private duty position as a registered nurse, a temporary nurse placement agency, a traveling nurse, or for an in-house nursing pool. Petitioner shall not work for a licensed horrie".health agency as a visiting nurse unless the registered nursing supervision and other protections for home visits have. been approved by the board. Petitioner shall not work in any other registered nursing occupation where home visits are reguired. -

14 . ' Petitioner shall not work in any health care setting as a supervisor of registered nurses. The board may additionally restrict petitioner from supervising licensed vocational nurses and/or unlicensed assistive personnel on a case-bycase basis. Petitioner shall not work as a faculty member in an approved school of nursing or as an instructor in a board approved continuing education program. Petitioner shall work only on a regularly assigned, identified and predetermined worksite( s) and shall not work in a float capacity. If petitioner is working or intends to work in excess of 0 hours per week, the board may request documentation to determine whether there should be restrictions on the hours of work. (1 0) COMPLETE A NURSING COURSE(S}- Petitioner, at her own expense, shall enroll and successfully complete a course(s) relevantto the practice of registered nursing no later than six months prior to the end of her probationary term. Petitioner shall obtain prior approval from the board before enrolling in the course(s). Petitioner shall submit to the board the original transcripts or certificates of completion for the above required course(s). The board shall return the original documents to petitioner after photocopying them for its r~cords. (11) COST RECOVERY - Petitioner shall pay to the board costs associated with its investigation and enforcement pursuant to Business and Professions Code section. in the amount of$,000. Petitioner shall be permitted to pay these costs in a payment plan approved by the board, with payments to be completed no later than three months prior to the end of the probation term. If petitioner has not complied with this condition during the probationary term, and petitioner has presented sufficient documentation of her good faith efforts to comply with this condition, and if no other conditions have been violated, the board, in its discretion, may grant an extension of petitioner's probation period up to one year without further hearing in order to comply with this condition. During the one year extension, all original conditions of probation will apply. () VIOLATION OF PROBATION- Ifa petitioner violates the conditions of her probation, the board after giving petitio1-er notice and an opportunity to r".. ' -

15 0 ' be heard, may set aside the stay order and impose the stayed discipline (revocation) ofpetitioner's license. If during the period of probation, an accusation or petition to revoke probation has been filed.against petitioner's license or the Attorney General's office has been requested to prepare an accusation or petition to revoke probation against petitioner's license, the probationary period shall automatically be extended and shall not expire until the accusation or petition has been acted upon by the board. (1) LICENSE SURRENDER- During petitioner's term ofprobation, if she ceases practicing due to retirement, health reasons or is otherwise unable to satisfy the conditions of probation, petitioner may surrender her license to the board. The board reserves the right to evaluate petitioner's request and to exercise its discretion whether to grant the request, or to take any other action deemed appropriate and reasonable under the circumstances, without further hearing. Upon formal acceptance of the tendered license and wall certificate, petitioner will no longer be subjectto the conditions of probation. Surrender of petitioner's license shall be considered a disciplinary action and shall become a part of petitioner's license history with the board. A registered nurse whose license has been surrendered may petition the board for reinstatement no sooner than the following minimum periods from the effective date ofthe disciplinary decision: 1) Two years for reinstatement of a license that was surrendered for any reason other than a mental or physical illness; or 2) One year for a license surrendered for a mental or physical illness. (1) PHYSICAL EXAMINATION- Within days ofthe effective date of this decision, petitioner, at her expense, shall have a licensed physician, nurse practitioner, or physician assistant, who is approved by the board before the assessment isperformed, submit an assessment of petitioner's physical condition and capability to perform the duties of a registered nurse. Such an assessment shall be submitted in a format acceptable to the board. If medic any determined, a recommended treatment program will be instituted and followed by petitioner with the physician, nurse practitioner, or physician assistant providing written reports to the board on forms provided by the board. If petitioner is determined to be unable't pra~tice safely as a registered nurse, the licensed physician, nurse practitioner, br physician assistant making this determination shall immediately notify thepoard and. petitioner by telephone, and the board shall request that the Attorney General '.s office prepare an -

16 accusation or petition to revoke probation. Petitioner shall immediately cease practice and shall not resume practice until notified by the board. During this period of suspension, petitioner shall not engage in any practice for which a license issued by the board is required until the board has notified petitioner that a medical determination permits petitioner to resume practice. This period of suspension will not apply to the reduction of this probationary time period. If petitioner fails to have the above assessment submitted to the board within the -day requirement, petitioner shall immediately cease practice and shall not resume practice until notified by the board. This period of suspension will not apply to the reduction of this probationary time period. The bard may waive or postpone this suspension only if significant, documented evidence of mitigation is provided. Such evidence must establish good faith efforts by petitioner to obtain the assessment, and a specific date for compliance must be provided. Only one such waiver or extension may be permitted. (IS) PARTICIPATE IN TREATMENT/REHABILITATION PROGRAM ~~~~~~~~~~~~~-Petitioner, at her expense, shall successfully complete during the probationary period or shall have successfully completed prior to commencement of probation a board-approved treatment/rehabilitation program of at least six months duration. As required, reports shall be submitted by the program on forms provided by the board. If petitioner has not completed a board-approved treatment/rehabilitation program prior to commencement of probation, petitioner, within days from the effective date of the decision, shall be enrolled in a program. If a program is not successfully completed within the first nine months of probation, the board shall consider petitioner in violation of probation. Based on board recommendation, each week petitioner shall be required to attend at least one, but no more than five -step recovery meetings or equivalent (e.g., Narcotics Anonymous, Alcoholics Anonymous, etc.) and a nurse support group as approved and directed by the board. If a nurse support group is not available, an additional -step meeting or equivalent shall be added. Petitioner shall submit dated and signed documentation confirming such attendance to the board during the entire period of probation. Petitioner shall continue with the recovery plan recommended by the treatment/rehabilitation program or a licensed mental health examiner and/or other ongoing recovery groups. (1) ABSTAIN FROM USE OF PSYCHOTROPIC (MOOD-ALTERING) =..=..:::..::::_=-Petitioner shall completely abstain from the possession, injection or consumption by any route of all psychotropic (mood altering) drugs, including alcohol, except when the same are ordered by a health care professional legally authorized to do so as part of document~d medical treatment. -10

17 Petitioner shall have sent to the board, in writing and within 1 days, by the prescribing health professional, a report identifying the medication, dosage, the date the medication was prescribed, petitioner's prognosis, the date the medication will no longer be required, and the on the recovery plan, if appropriate. Petitioner shall identify for the board a single physician, nurse practitioner or physician assistant who shall be aware of petitioner's history of substance abuse and will coordinate and monitor any prescriptions for petitioner for dangerous drugs, controlled substances or mood-altering drugs. The coordinating physician, nurse practitioner, or physician assistant shall report to the board on a quarterly basis petitioner's compliance 'with this condition. If any substances considered addictive have been prescribed, the report shall identify a program for the time limited use of any such substances. The board may require the single coordinating physician, nurse practitioner, or physician assistant to be a specialist in addictive medicine, or to consult with a specialist in addictive medicine. (1) SUBMIT TO TESTS AND SAMPLES- Petitioner, at her expense, shall participate in a random, biological fluid testing or a drug screening program which the board approves. The length of time and frequency will be subject to approval by the board. Petitioner is responsible for keeping the board informed ofpetitioner's current telephone number at all times. Petitioner shall also ensure that messages may be left at the telephone number when she is not available and ensure that reports are submitted directly by the testing agency to the board, as directed. Any confirmed positive finding shall be reported immediately to the board by the program and petitioner shall be considered in violation of probation. In addition, petitioner, at any time during the period of probation, shall fully cooperate with the board or any of its representatives, and shall, when requested, submit to such tests and samples as the board or its representatives may require for the detection of alcohol, narcotics, hypnotics, dangerous drugs, or other controlled substances. Ifpetitioner has a positive drug screen for any substance not legally authorized and not reported to the coordinating physician, nurse practitioner, or physician assistant, and the board files a petition to revoke probation or an accusation, the board may suspend petitioner from pra.tice pending the final decision on the petition to revoke probation or the' atc\is.ation. This period of suspension will not apply to the reduction of this probationary time period. ' ;. ;. l -11

18 Ifpetitioner fails to participate in a random, biological fluid testing or drug screening program within the specified time frame, petitioner shall immediately cease practice and shall not resume practice until notified by the board. After taking into account documented evidence of mitigation, if the board files a petition to revoke probation or an accusation, the board may suspend petitioner from practice pending the final decision on the petition to revoke probation or the accusation. This period of suspension will not apply to the reduction of this probationary time period. (1) MENTAL HEALTH EXAMINATION- Petitioner shall, within days of the effective date of this decision, have a mental health examination including psychological testing as appropriate to determine her capability to perform the duties of a registered nurse. The examination will be performed by a psychiatrist, psychologist or other licensed mental health practitioner approved by the board. The examining mental health practitioner will submit a written report of that assessment and recommendations to the board. All costs are the responsibility ofpetitioner. Recommendations for treatment, therapy or counseling made as a result of the mental health examination will be instituted and followed by petitioner. If petitioner is determined to be unable to practice safely as a registered nurse, the licensed mental health care practitioner making this determination shall immediately notify the board and petitioner by telephone, and the board shall request that the Attorney General's offtce prepare an accusation or petition to revoke probation. Petitioner shall immediately cease practice and may not resume practice until notified by the board. During this period of suspension, petitioner shall not engage in any practice for which a license issued by the board is required, until the board has notified petitioner that a mental health determination permits petitioner to resume practice. This period of suspension will not apply to the reduction ofthis probationary time period. If petitioner fails to have the above assessment submitted to the board within the -day requirement, petitioner shall immediately cease practice and shall not resume practice until notified by the board. This period of suspension will not apply to the reduction of this probationary time period. The board may waive or postpone this suspension only if significant, documented evidence of mitigation is provided. Such evidence must establish good faith efforts by petitioner to obtain the assessment, and a specific date for compliance must be provided. Only one such waiver or extension may be permitted. '. :.. ~ (1) THERAPY OR COUNSELING PROGRAM~ P~titioner, at her expense, shall participate in an on-going counseling program until such time as the board releases her from this requirement and ohly!upqn the recommendation., -

19 ofthe counselor. Written progress reports from the counselor will be required at various intervals. DATED: N(J'(tmb-er 1-, VJil -1

20 BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Petition to Revoke Probation Against: KATHY ANN ARREDONDO Case No Willow Ave. Clovis, CA Registered Nurse License No. Respondent DECISION AND ORDER The attached Stipulated Surrender of License and Order is hereby adopted by the Board of Registered Nursing, Department of Consumer Affairs, as its Decision in this matter. I! I This Decision shall become effective on --=N..;..;o=...;v;..;:e;.;..;m;.;.;b;;..;;e:;.:.,r_.:1;..=..._,=20:...:0:..:'-- IT IS SO ORDERED October 1, 200 President Board of Registered Nursing Department of Consumer Affairs State of California

21 EDMUND G. BROWN JR., Attorney General of the State of California ARTHUR D. TAGGART Supervising Deputy Attorney General ELENA L. ALMANZO, State Bar No. 110 Deputy Attorney General 100 I Street, Suite P.O. Box 2 Sacramento, CA 2-20 Telephone: (1) 22-2.Facsimile: (1) 2- Attorneys for Complainant BEFORETHE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Second Amended Accusation Case No and Petition to Revoke Probation Against: OAH No KATHY ARREDONDO Respondent. STIPULATED SURRENDER OF LICENSE AND ORDER IT IS HEREBY STIPULATED AND AGREED by and between the parties in this 1 proceeding that the following matters are true: 1 PARTIES 1 1. Ruth Ann Terry, M.P.H., R.N. (Complainant) is the Executive Officer of 20 the Board of Registered Nursing. She brought this action solely in her official capacity and is 21 represented in this matter by Edmund G. Brown Jr., Attorney General of.the State of California, 22 by Elena L. Almanzo, Deputy Attorney General Kathy Ann Arredondo (Respondent) is representing herself in this matter. 2. On or about May, 200, the Board of Registered Nursing issued 2 Registered Nurse License No. ("license") to Kathy Ann Arredondo, also known as 2 Kathi Ann Arredondo ("Respondent"). The license was in effect at all times relevant to the 2 charges brought herein, and will expire on May 1, 200, unless renewed. 2 1

22 JURISDICTION. The Second Amended Accusation and Petition to Revoke Probation No was filed before the Board of Registered Nursing (Board), Department of Consumer Affairs, and is currently pending against Respondent. The Second Amended Accusation and Petition to Revoke Probation and all other statutorily required documents were properly served on Respondent on March, 200. Respondent timely filed her Notice of Defense contesting the Second Amended Accusation and Petition to Revoke Probation. A copy of Second Amended Accusation and Petition to Revoke Probation No is attached as exhibit A and incorporated herein by reference. ADVISEMENT AND WAIVERS. Respondent has carefully read and understands the charges and allegations in the Second Amended Accusation and Petition to Revoke Probation No Respondent also has carefully read and understands the effects of this Stipulated Surrender of License and Order.. Respondent is fully aware of her legal rights in this matter, including the right to a hearing on the charges and allegations in the Second Amended Accusation and Petition to Revoke Probation; the right to be represented by counsel, her own expense; the right to confront and cross-examine the witnesses against her; the right to present evidence and to testify on her own behalf; the right to the issuance of subpoenas to compel the attendance of witnesses and the production of documents; the right to reconsideration and court review of an adverse decision; and all other rights accorded by the California Administrative Procedure Act and other applicable laws.. Respondent voluntarily, knowingly, and intelligently waives and gives up each and every right set forth above. CULPABILITY. Respondent admits the truth of each and every charge and allegation in the Second Amended Accusation and Petition to Revoke Probation No , agrees that cause exists for discipline and hereby surrenders her Registered Nurse License No. for the 2

23 Board's formal acceptance.. Respondent understands that by signing this stipulation she enables the Board to issue an order accepting the surrender of her Registered Nurse license without further process. CONTINGENCY 10. This stipulation shall be subject to approval by the Board ofregistered Nursing. Respondent understands and agrees that counsel for Complainant and the staff of the Board of Registered Nursing may communicate directly with the Board regarding this stipulation and surrender, without notice to or participation by Respondent. By signing the stipulation, Respondent understands and agrees that she may not withdraw her agreement or seek to rescind the stipulation prior to the time the Board considers and acts upon it. If the Board fails to adopt this stipulation as its Decision and Order, the Stipulated Surrender and Disciplinary Order shall be of no force or effect, except for this paragraph, it shall be inadmissible in any legal action between the parties, and the Board shall not be disqualified from further action by having considered this matter. 11. The parties understand and agree that facsimile copies of this Stipulated Surrender of License and Order, including facsimile signatures thereto, shall have the same force and effect as the originals.. In consideration ofthe foregoing admissions and stipulations, the parties agree that the (Board) may, without further notice or formal proceeding, issue and enter the following Order: ORDER IT IS HEREBY ORDERED that Registered Nurse License No., issued to Respondent Kathy Ann Arredondo is surrendered and accepted by the Board of Registered Nursing. 1. The surrender of Respondent's Registered Nurse license and the acceptance of the surrendered license by the Board shall constitute the imposition of discipline against Respondent. This stipulation constitutes a record ofthe discipline and shall become a

24 part ofrespondent's license history with the Board I Respondent shall lose all rights and privileges as a registered nurse in California as of the effective date of the Board's Decision and Order. 1. Respondent shall cause to be delivered to the Board both her wall license certificate and, if one was issued, pocket license on or before the effective date of the Decision and Order. 1. Respondent fully understands and agrees that if she ever files an application for licensure or a petition for reinstatement in the State of California, the Board shall treat it as a petition for reinstatement. Respondent must comply with all the laws, regulations and procedures for reinstatement of a revoked license in effect at the time the petition is filed, and all of the charges and allegations contained in the Second Amended Accusation and Petition to Revoke Probation No shall be deemed to be true, correct and admitted by Respondent when the Board determines whether to grant or deny the petition. 1. Upon reinstatement of the license, Respondent shall pay to the Board costs associated with its investigation and enforcement pursuant to Business and Professions Code section. in the amount of Three Thousand Dollars and No Cents ($,000.00). Respondent shall be permitted to pay these costs in a payment plan approved by the Board. 1. Should Respondent ever apply or reapply for a new license or certification, or petition for reinstatement of a license, by any other health care licensing agency in the State of California, all of the charges and allegations contained in the Second Amended Accusation and Petition to Revoke Probation, No I shall be deemed to be true, correct, and admitted by Respondent for the purpose of any Statement oflssues or any other proceeding seeking to deny or restrict licensure. I. Respondent shall not apply for licensure or petition for reinstatement for one (1) years from the effective date ofthe Board of Registered Nursing's Decision and Order. II II 2

25 ACCEPTANCE I have carefully read the above Stipulated Surrender oflicense and Order. I.. understand the stipulation and the effect it will have on my Registered Nurse License No.. I enter into this Stipulated Surrender oflicense and Order voluntarily, knowingly, and intelligently, and agree to be bound by the Decision and Order of the Board ofregistered Nursing. DATED:

26 1 ENDORSEMENT 2 The foregoing Stipulated Surrender of License and Order is hereby respectfully submitted for consideration by the Board ofregistered Nursing ofthe Department ofconsumer EDMUND G. BROWN JR., Attorney General ofthe State ofcalifornia ARTHURD. TAGGART Supervising Deputy Attorney General Attorneys for Complainant

27 Exhibit A Second Amended Accusation and Petition to Revoke Probation No

28 l EDMUND G. BROWN JR., Attorney General of the State of California ARTHUR D. TAGGART Supervising Deputy Attorney Gene,ral ELENA L. ALMANZO, State Bar No. 110 Deputy Attorney General California Department of Justice 100 I Street, Suite P.O. Box 2 Sacramento, CA 2-20 Telephone: (1) 22-2 Facsimile: (1) 2- Attorneys for Complainant BEFORE THE BOARD OF REGISTERED NURSING DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA In the Matter of the Second Amended Accusation and Case No Petition to Revoke Probation Against: SECOND AMENDED ACCUSATION AND PETITION TO REVOKE KATHY ANN ARREDONDO, aka KATHI ANN ARREDONDO 1 Willow Avenue PROBATION Clovis, California Registered Nurse License No. Respondent Ruth Ann Terry, M.P.H., R.N. ("Complainant") alleges: PARTIES 1. Complainant brings this Second Amended Accusation and Petition to Revoke Probation solely in her official capacity as the Executive Officer of the Board of Registered Nursing, Department o{ Consumer Affairs. Registered Nurse License 2: On.or about May, 200, the Board ofregistered Nursing issued... '. Registered Nurse License No. ("license") to Kathy Ann Arredondo, also known as Kathi Ann Arredondo ("Respondent"). The license was in effect at all times relevant to the charges brought herein, and will expire on May 1, 200, unless renewed.

29 Prior Discipline Effective March 2, 200, pursuant to the Stipulated Settlement and Disciplinary Order in Statement oflssues No , the Board ofregistered Nursing issued and then immediately revoked Respondent's Registered Nurse License.No.. Said nursing license was not issued until May, 200. The revocation was stayed and Respondent's license was placed on probation for a period ofthree () years with conditions. A copy ofthe Stipulated Settlement and Disciplinary Order is attached as Exhibit A and is incorporated herein by reference. On May 2, 200, the Board requested the Attorney General's office to prepare an Accusation and Petition to Revoke Probation against Respondent..JURISDICTION. Section 20 of the Business and Professions Code ("Code") provides, in pertinent part, that the Board may discipline any licensee, including a licensee holding a temporary or an inactive license, for any reason provided in Article (commencing with Code section 20) of the Nursing Practice Act.. Section 2 of the Code provides, in pertinent part, that the expiration of a license shall not deprive the Board ofjurisdiction to p~oceed with a disciplinary proceeding against the llcensee or to render a decision imposing discipline on the license. Under Code section 211, subdivision (b), the Board may renew an expired license at any time within eight years after the expiration.. Code section 11, subdivision (b), provides, in pertinent part, that the expiration of a license shall not deprive the Board ofjurisdiction to proceed with a disciplinary action during the period within which the license may be renewed, restored, reissued or reinstated ";. : STATUTORY PROVISIONS. Code section 21 states, in pertinent part: The board may take' disciplinary action against a certified or licensed nurse or deny an application for a certificate or license for any of the following: (a) Unprofessional conduct, which includes, but is not limited to, the following: