101223(a)(3) · Personal Rights (a) (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion... physical functioning.

evidenced by Staff 3 (S3) no longer works at the facility. Facility submitted a behavior management plan, training agenda, and staff sign in sheet from training conducted on 6/18/2025. Based on LPAs record review and interviews Staff 3 (S3) made physical contact with Child 1 (C1) during an incident which poses an immediate personal rights risk to children in care. Martha Malane NAME OF LICENSING PROGRAM MANAGER: Sarah Garcia NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.