Department of HUMAN SERVICES Kim Reynolds Adam Gregg Jerry R. Foxhoven Governor Lt. Governor Director December 24, 2018 Ali Hohman RE: Jesus Lopez -- Child Abuse Assessments Dear Ms. Hohman: I am in receipt of you request for child abuse information regardan Mr. Lopez. Per Iowa Code 235A415(2)(a)(1), as attorney for Jesus Lopez, you entitled to child abuse information regarding Jesus Lopez Accordingly, attached please find the following: I CA 2015275100' Not Confirmed - CA 2015275128 -- Not Confirmed I CA 2015275129 -- Confirmed I CA 2015275130 - Not Confirmed you have any questions please let me know. 7511?; Protective Policy Specialist lowa Department of Human Services Division of Field Operations Hoover State Office Building -- 5th Floor 1301 E. Walnut Street Des Moines, Iowa 50319 Email: amontoy@dhs.state laus 1305 Walnut Street Des Moines, IA 5031970114 Iowa Department of Human Services Child Protective Services Child Abuse Assessment Summary case Nemeis) Jesus Lopez Address: Home Phone: mner Pnone: incldenlx: Compleiion Dale: um: 10/30/2015 20152751 no |maka male; child protection Worker: County Name I County 10/02/2015 02:25 PM Christy Nook Page 73 Asemmeni Findings: Satay Assessment Findings: ii Safe, net. Safety Plan 2! Not confirmed I safe comwemm Confirmed. n01 placed on Conditionally Safe "Mam 0' RamV'k WW I: Removal Requesi, Cnurt denied Unsale Founded Voluntary Addendum in previous Relative summary Non-Relau've 3 Emergency Custody Jesus Lopez Child Subjeci 1386338 ICAR MOM UNKNOWN Perenl 9999996 ICAR DAD UNKNOWN Parent 9999999 Parent 0 Christine Domes Address: DFHSAChildren's Administration 900 E. College Way. Suite 200 MOUNT VERNON. WA 98273 Phone Name CARL SONKSEN 0923816 470-3240 (Rev. 04/16) page 1 Iowa Depamnenl of Human Services Child Protective Services Child Abuse Assessment Summary Case Nam w--j Jesus Lopez Address: Home Phone: Other Phone: incident completion Date: Addendum Date: 2015275123 10/30/2015 fine Date: Child Protection Worker: minty Name County '1 10/02/2015 02:25 PM Christy Nook Page 73 Assessment Flndings: Safety Assessment Find|n95: Tconflifionally Safe, Date Safety Plan Safe computed: 7 Noi confirmed Confirmed, not placed on registry Founded Addendum to previous summary Conditionally Safe Unsafe If Unsafe, Date 0' Removal: Removal Requal, Court denied Voluntary Fla/alive Non-Relative 3 Emergency Custody Name Jesus Lopez Name. Christine Domes Address: DFHS-Children's Administration 900 E. College Way, Su/ie 200 MOUNT VERNON: WA 95273 CARL SONKSEN 0923816 470-3240 (Rev. 04/16) Page 1 Address: Home Phone: Work Phone: Mental Injury Sexual Abuse Deniai of Critical Care Child Prostitution Presence of Illegal Drugs Physical Abuse Manufacturing] Possession of Dangerous El Bestiality in presence 01? a Allows Access by a Registered Substances with intent to manufacture minor Sex Offender Allows Access to Obscene Material It is alleged that Staff member, Dalton Rucker restrained resident, Jesus Lopez (age 17) on 8/29/2015 and used excessive force and inappropriate restraint technique, as a result Jesus had numerous marks and bruises on his person. Denial of Critical Care, Failure to Provide Adequate Supervision is alleged. Oserved On: 1010511 Jesus Lo ild(ren) pe Seen Justi?cation Reason: Child seen, timeframe delayed Child seen, timeframe delayed Custodial Parent(s) Interview ICAR MOM UNKNOWN Interviewed On: ICAR DAD UNKNOWN Interviewed On: Non-Custodial Parent Interview (if applicable) Christine Domes Interviewed On: Evaluation of Home Environment Completed 10/05/2015 Safety Assessment Completed 10/27/2015 Safety Plan Completed (if applicable) Risk Assessment Completed 1010772015 Additional process information: In accordance with Iowa Code 232.71I, when conducting an assessment, the Department of Human Services completes an evaluation of the family which includes the identi?cation of and needs of the child, and of the child?s parents, home, and family. This information is documented in the Family Risk Assessment (Form 470- 4133), Safety Assessment (Form 470-4132), and when applicable 3 Safety Plan (Form 470-4461). The information is available only to the child, parents, and others with legal access to this information, and then only upon request. 470-3240 (Rev. 04/16) Page 2 Yes No If Yes, give justificationzThe integrity of information obtained would be jeopardized if the parents were contacted ?rst. Con?dential Access: 10/2/2015 12:00:00 Date of Contact AM . Summam of Contact 02:25 pm. Intake accepted and assigned to CPW. Supervisor Corbitt extended the time frame until Monday. 10/5/2015 12:00:00 Date of Contact AM Summary of Contact 08:38 am. CPW emailed Troy Kroeger with to inform him of the open assessments at Clarinda Academy. CPW asked Troy to assist with the interviews since the allegations were against four supervisors. Dates and times were arranged for both CPW and Troy to be present during the interviews for each day interviews were conducted. Throughout the case, communication was held between CPW and Troy Kroeger with DIA. 10/5/2015 12:00:00 Date of Contact AM Summary of Contact 09:26 am. CPW met with Jesus Lopez in private at the Clarinda Academy and discussion was held regarding the allegations. Jesus said he tried to go truant and ran downstairs. Jesus then said that one staff grabbed his ankles and the other grabbed his wrist and carried him to the shoe closet. Jesus said he was laying down when one staff put him in a stretch where his arms were pulled back and the other staff were on his legs. Jesus said he was ?ghting at this time and the staff took him to his room. Now there were four staff members present and Jesus said every time they asked him if he was ready to go to bed and he answered staff would come behind him, put their arms beneath his arms and pulled him back and then the staff would throw him to the ground. Jesus said this occurred about 10 times with different staff taking turns. Jesus said the staff continued to pull him backwards and then drop him to the ground. - . Jesus said he told staff that they were doing the restraints wrong but they told him not to speak. Jesus said at one point, he was knocked out and remembers a nurse trying to wake him up. Jesus kept asking CPW how much longer the interview would last because he was in a hurry to get back to Algebra. Jesus was unable to provide CPW the staffs names but said that this happens to other kids but it?s not being reported. CPW asked Jesus if he had any injuries on this date but he said all of his bruises had healed. 10/6/2015 12:00:00 Date of Contact AM Summary of Contact 01:35 pm. 470-3240 (Rev. 04/16) Page 3 CPW phoned Reggie who is the executive director of the academy and discussion was held regarding the allegations. Reggie said he will be on vacation when the interviews are being conducted but offered to come to the academy to CPW told Reggie that he presence wouldn't be necessary for the interviews. Date of Contact 10/6/2015 12:00:00 AM Summary of Contact 1:21 pm Phone call to reporter and information obtained. Date of Contact 10/13/2015 Summary of Contact 1:40 pm. CPW along with Troy Kroeger with DIA met with Dalton Rucker. Dalton has worked at the academy for three years and is a team leader on Lincoln Hall. Dalton said he was called to Washington Hall and when he arrived Jesus was in the shoe closet and was in a supine position. Mitchell was on Jesus? legs while Bob and Kyle were on Jesus? hands. Dalton said he switched out Bob and Dalton was talking to Jesus, de-escalating him out of the restraint. Dalton satin the connecting hallway for 2 1/2 - 3 hours trying to calm him down. Dalton said that Jesus would escalate and staff wanted him to go to bed. Dalton said he has been working lots of hours and that day he worked from 7:00 am. 11:00 pm. Staff told Jesus that they needed to get him to bed. Dalton said that Jesus tried to elope and tried to bolt through Mitch and Daniel. Dalton said he switched out and David Rupp took Jesus? legs. Dalton took the left arm and Mitch or Daniel took the right arm which Dalton said was a bad decision. Dalton said that one bad choice led to another by the staff. Dalton said he switched out with Mitch or Daniel to a single upper torso. Jesus was pushing his body weight against Dalton?s body and Dalton took Jesus to a seated position. Dalton admits that he wasn?t at a 90 degree angle and held Jesus in that position until he quit ?ghting. Jesus was stood up again and tried to transition to the bed. Dalton said that Jesus did it again and was kicking his legs. Dalton said he might have pulled his legs up but isn?t sure. Dalton switched out to Wayne and Dalton never returned. Dalton said he walked by Jesus? bedroom door but the door was closed. Dalton is unsure who asked for the door to be closed. Dalton said he was suspended from work for three days along with being placed on probation for 90 days. Also, Dalton had to attend a 2-day training on behavior cycles. David said he likes to see progress in the students and feel like he?s part of something by working at the academy. Dalton has a history in his personnel ?le with being reprimanded for improper restraints. On 07/07/2013, 08/01/2014 and 09/02/2015 Dalton signed paperwork addressing the improper restraints. Dalton has been provided additional training to address these issues. CPW will meet with Dalton Rucker on 11/02/2015 at the academy. At that time, Dalton will be told by CPW if another referral is received from the academy with a child having injuries and Dalton is the alleged perpetrator, he will be placed on the Central Abuse Registry. Date of Contact 10/23/2015 12:00:23 Summary of Contact 11:31 am. Voicemail received from Christine Domes who is the supervisor on Jesus Lopez? case with Washington state. 02:29 pm. 470-3240 (Rev. 04/16) Page 4 Phone call returned to Christine Domes. Christine said she spoke with Troy Kroeger who provided CPWs phone number to her. Christine is upset with the academy because they were never noti?ed that Jesus was restrained and since there has been TPR on Jesus' parents, they are the guardian of his case. CPW told Christine that this worker was still working on the case but would assure they receive parental noti?cations and a c0py of the report. Date of Contact 10/28/2015 1220022311 Summary of Contact Phone call to Director Mike Butt. CPW asked to meet with each of the supervisors who are involved with the assessment next week to discuss the outcome of their reports. It was agreed that CPW will be at the academy on November 2nd at 8:00 am. 470-3240 (Rev. 04/16) Page 5 The allegation of PHYSICAL ABUSE, Bruise, is NOT CONFIRMED based upon the following factors: Factor 1: Victim is a child. Jesus Lopez is a child as evidenced by his birth date. This factor has been met. Factor 2: Person responsible is a caretaker. Dalton Rucker is a staff member at the Ciarinda Academy and was a caretaker at the time of the abuse. This factor has been met. Factor 3: Physical injury occurred. Jesus Lopez sustained bruising to his forehead, arms, legs and back. This factor has been met. Factor 4: injury is nonaccidental or history given is at variance with the injury. On 08129121015, the child sustained injuries during numerous restraints where four staff members admitted that improper restraints were initiated. Although, Dalton admits that improper restraints were initiated by himself, Dalton was not found to be responsible for the injuries that Jesus Lopez sustained. This factor has has been met. Factor 5: Injury resulted from the acts or omissions of the caretaker. Dalton Rucker was not found to be responsible for the injuries that Jesus sustained during the restraints. This factor has not been met. Describe the threats of maltreatment that are present at this time (aggravating factors that combine to produce a potentially dangerous situation): Describe the child?s vulnerability to maitreatrnent (the degree to which a child cannot, on the child?s own, avoid, negate, or minimize the impact of present or impending danger): Describe the caretaker?s protective capacities (family and resources that reduce, control, or prevent threats of maltreatment from arising, as well as factors and de?ciencies that have a negative impact on child safety): Summary and Analysis of SafetyIRisk Assessments Identi?ed Summary and Analysis Addendum Date 470-3240 (Rev. 04/16) Page 6 Final Risk Level (based upon completion of the standardized risk assessment): El Low Moderate High . .. -- A lnforrnation or information and Referral-no additional services Community Care (Referral Date:) recommended Service recommendations were discussed with the family and a service plan is appropriate to address the following: No referral to Community Care was made due to the following exception reason Already engaged in DHS Services El Court action by DHS or already engaged in JCS Services Abuse occurred in out of home setting Parent not willing to accept Community Care Already engaged in Community Care Family does not need additional supports beyond current formal/informal systems Department Services (Referral Date: Case transferred to Social Work Case Manager or Supervisor: The case is not being referred to DHS Service due to the following exception reason: The abuse occurred in an out of home setting (such as child care, PMIC, or hospital), the person responsible has no access to the child, and the parent or caretaker had no prior knowledge of the alleged abuse. CI The child victim is deceased and there are no other children in the home. CI The entire family moved out of the state prior to the completion of the assessment and the CPW has noti?ed that state?s child protective services. Other (explanation required). Additional Service Information Jurisdiction Date Type of Action Requested Juvenile 10/29/2015 Juvenile court already involved Criminal 10/29/2015 None Signature: Christy Nook 7 Dae: 10/29/201 Supervisor Signature: Katie Corbitt Date: 10/30/2015 cc:County Attorney: PAGE COUNTY ATTORNEY Date Sent: cc:Juvenile Court: Date Sent: 470-3240 (Rev. 04/16) Page 7 Address: Home Phone: Work Phone: Physical Abuse Mental Injury El Sexual Abuse Denial of Critical Care Child Prostitution Presence of Illegal Drugs Manufacturing] Possession of Dangerous Bestiality in presence of a Allows Access by a Registered Substances with intent to manufacture minor Sex Offender Allows Access to Obscene Material It is alleged that Staff member, David Rupp restrained resident, Jesus Lopez (age 17) on 8/29/2015 and used excessive force and inappropriate restraint technique, as a result Jesus had numerous marks and bruises on his person. Denial of Critical Care, Failure to Provide Adequate Supervision is alleged. W- Jesus Lope 105/201 Justi?cation Reason: Child seen, timeframe delayed Child seen, timeframe delayed Custodial Parent(s) interview Non?Custodial Parent interview (if applicable) Christine Domes interviewed On: Evaluation of Home Environment Completed 10/05/2015 Safety Assessment Completed 10/27/2015 Safety Plan Completed (if applicable) Risk Assessment Completed 10/07/2015 Additional process information: in accordance with lowa Code 232.71 B, when conducting an assessment, the Department of Human Services completes an evaluation of the family which includes the identi?cation of and needs of the child, and of the child?s parents, home, and family. This information is documented in the Family Risk Assessment (Form 470- 4133), Safety Assessment (Form 470-4132), and when applicable a Safety Plan (Form 470-4461). The information is available only to the child, parents, and others with legal access to this information, and then only upon request. 470-3240 (Rev. 04/16) Page 2 Con?dential Access: Yes No If Yes, give justification:The integrity of information obtained would be jeopardized if the parents were contacted ?rst. 10/2/2015 12:00:00 Date of Contact AM Summary of Contact. 02:25 pm. Intake accepted and assigned to CPW. Supervisor Corbitt extended the time frame until Monday. Date of Contact 10/5/2015 Summary of Contact 08:38 am. CPW emailed Troy Kroeger with to inform him of the open assessments at Clarinda Academy. CPW asked Troy to assist with the interviews since the allegations were against four supervisors. Dates and times were arranged for both CPW and Troy to be present during the interviews for each day interviews were conducted. Throughout the case, communication was held between CPW and Troy Kroeger with DIA. Date of Contact 10/5/2015 Summary of Contact 09:26 am. CPW met with Jesus Lopez in private at the Clarinda Academy and discussion was held regarding the allegations. Jesus said he tried to go truant and ran downstairs. Jesus then said that one staff grabbed his ankles and the other grabbed his wrist and carried him to the shoe closet. Jesus said he was laying down when one staff put him in a stretch where his arms were pulled back and the other staff were on his legs. Jesus said he was ?ghting at this time and the staff took him to his room. Now there were four staff members present and Jesus said every time they asked him if he was ready to go to bed and he answered staff would come behind him, put their arms beneath his arms and pulled him back and then the staff would throw him to the ground. Jesus said this occurred about 10 times with different staff taking turns. Jesus said the staff continued to pull him backwards and then drop him to the ground. Jesus said he told staff that they were doing the restraints wrong but they told him not to speak. Jesus said at one point, he was knocked out and remembers a nurse trying to wake him up. Jesus kept asking CPW how much longer the interview would last because he was in a hurry to get back to Algebra. Jesus was unable to provide CPW the staffs names but said that this happens to other kids but it?s not being reported. CPW asked Jesus if he had any injuries on this date but he said all of his bruises had healed. Date of Contact 10/6/2015 12:00: [23' Summary of Contact 01:35 pm. 470-3240 (Rev. 04/16) Page 3 1 CPW phoned Reggie who is the executive director of the academy and discussion was held regarding the allegations. . Reggie said he will be on vacation when the interviews are being conducted but offered to come to the academy to CPW told Reggie that he presence wouldn't be necessary for the interviews. Date of Contact 10/6/2015 1200:2131 Summary of Contact 1:21 pm Phone call to reporter and information obtained. Date of Contact 10/13/2015 12:00:00 AM Summary of Contact 1:40 pm. bed. Dalton said he has been working lots of hours and that day he worked from 7:00 am. 11:00 pm. Staff told Jesus that they needed to get him to bed. Dalton said that Jesus tried to elope and tried to bolt through Mitch and Daniel. Dalton said he switched out and David Rupp took Jesus? legs. Dalton took the left arm and Mitch or Daniel took the right arm which Dalton said was a bad decision. Dalton said that one bad choice led to another by the staff. Dalton said he switched door to be closed. Dalton said he was suspended from work for three days along with being placed on probation for 90 days. Also, Dalton had to attend a 2?day training on behavior cycles. David said he likes to see progress in the students and feel like he?s part of something by working at the academy. Date of Contact 10/23/2015 12:00:00 AM Summam of Contact 11:31 am. Voicemail received from Christine Domes who is the supervisor on Jesus Lopez' case with Washington state. 02:29 pm. Phone call returned to Christine Domes. Christine said she spoke with Troy Kroeger who provided CPWs phone number to her. Christine is upset with the academy because they were never noti?ed that Jesus was restrained and since there has been TPR on Jesus' parents, they are the guardian of his case. CPW told Christine that this worker was still working on the case but would assure they receive parental noti?cations and a copy of the report. 470-3240 (Rev. 04/16) Page 4 Date of Contact 10/28/2015 12002:; Summag of Contact Phone call to Director Mike Butt. CPW asked to meet with each of the Supervisors who are invoived with the assessment next week to discuss the outcome of their reports. It was agreed that CPW will be at the academy on November 2nd at 8:00 am. 470-3240 (Rev. 04/16) Page 5 The allegation of PHYSICAL ABUSE, Bruise, is NOT CONFIRMED based upon the following factors: Factor 1: Victim is a child. Jesus Lopez is a child as evidenced by his birth date. This factor has been met. Factor 2: Person responsible is a caretaker. David Rupp is a staff member at the Clarinda Academy and was a caretaker at the time of the abuse. This factor has been met. Factor 3: Physical injury occurred. Jesus Lopez sustained bruising to his forehead, arms, legs and back. This factor has been met. Factor 4: Injury is nonaccidental or history given is at variance with the injury. On 08/29/2105 the child sustained injuries during numerous restraints where four staff members admitted that improper restraints were initiated. Although, David admits that improper restraints were initiated by himself, David was not found to be responsible for the injuries that Jesus Lopez sustained. This factor has been met. Factor 5: Injury resulted from the acts or omissions of the caretaker. David Rupp was not found to be responsible for the injuries that Jesus sustained during the restraints. This factor has not been metst?um Describe the threats of maltreatment that are present at this time potentially dangerous situation): (aggravating factors that combine to produce a Describe the child?s vulnerability to maltreatment (the degree to which a child cannot, on the child?s own, avoid, negate, or minimize the impact of present or impending danger): Describe the caretaker?s protective capacities (family and resources that reduce, control, or prevent threats of maltreatment from arising, as well as factors and de?ciencies that have a negative impact on child safety): Summary and Analysis of Safety/Risk Assessments Identi?ed Summary and Analysis Addendum Date 470-3240 (Rev. 04/16) Page 6 Final Risk Level (based upon completion of the standardized risk assessment): Low Moderate High Ww??m?q lnfonnation or Information and Referral-no additional services recommended Community Care (Referral Date:) El Service recommendations were discussed with the family and a service plan is appropriate to address the following: No referral to Community Care was made due to the following exception reason El Already engaged in DHS Services El Court action by DHS or already engaged in JCS Services Abuse occurred in out of home setting Parent not willing to accept Community Care El Already engaged in Community Care Family does not need additional supports beyond current formal/informal systems Department Services (Referral Date: El Case transferred to Social Work Case Manager or Supervisor: I: The case is not being referred to DHS Service due to the following exception reason: The abuse occurred in an out of home setting (such as chiid care, PMIC. or hospital), the person responsible has no access to the child, and the parent or caretaker had no prior knowledge of the alleged abuse. The child victim is deceased and there are no other children in the home. The entire family moved out of the state prior to the completion of the assessment and the CPW has noti?ed that state?s child protective services. '3 Other (explanation required). Additional Service information Jurisdiction 7 Date Type io Juvenile 10/29/2015 Juvenile court already involved Criminal 10/29/2015 None WW -, .- .. CPW Signature: Christy Nook Supervisor Signature: Katie Corbitt Date: 10/30/2015 cc:County Attorney: PAGE COUNTY ATTORNEY Date Sent: cchuvenile Court: Date Sent: 470-3240 (Rev. 04/16) Page 7 Iowa Department of Human Services Child Protective Services Child Abuse Assessment Summary Case Mama") Jesus Lopez Manse: Home Phone: other Phone: Incident 3: Completion Date: Addendum Dnle: 2015275129 10/30/2015 lnhak. Data: Child Protection Worker: County Name I County 3: 10/02/2015 0 :25 PM Christy Nook Page I 73 Assessment Findings: Safety Assessmem Findings: If Conditionally Safe, Dale Safety Plan No! confirmed Safe Comp|e?ed: Confirmed, not placed on Conditionally Sale "Ma's, "3'9 0' Rem" reQIstry Removal Request Court denied Unsafe Founded Voiun'ary previous 3 Relative summary Nan-Relative l: Emergency Custody Name: Christine Domes Address: DFHS--Children's Administration 900 E. College Way. Suite 200 MOUNT VERNON. WA 98273 Phone Nam. CARL SONKSEN 092381 6 470.3240 (Rev. 04/16) Page 1 05/11/1994 Daniel Mullen Address: Home Phone: 1820 N. 16th 31:. Work Phone: Clarinda 51632 Physical Abuse ?3 Mental Injury Sexual Abuse Denial of Critical Care Child Prostitution Presence of Illegal Drugs El Manufacturing] Possession of Dangerous Bestiality in presence of a Allows Access by a Registered Substances with intent to manufacture minor Sex Offender Allows Access to Obscene Material It is alleged that Staff member, Daniel Mullen restrained resident, Jesus Lopez (age 17) on 8/29/2015 and used excessive force and inappropriate restraint technique, as a result Jesus had numerous marks and bruises on his person. Denial of Critical Care, Failure to Provide Adequate Supervision is alleged. i Jesus ,steen Justification Reason: Child seen, timeframe delayed Child seen, timeframe delayed Custodial Parent(s) Interview Non-Custodial Parent Interview (if applicable) Christine Domes Interviewed On: Evaluation of Home Environment Completed 10/05/2015 Safety Assessment Completed 10/27/2015 Safety Plan Completed (if applicable) Risk Assessment Completed 10/07/2015 Additional process information: In accordance with Iowa Code 232.71 B, when conducting an assessment, the Department of Human Services completes an evaluation of the family which includes the identi?cation of and needs of the child, and of the child?s parents, home, and family. This information is documented in the Family Risk Assessment (Form 470- 4133), Safety Assessment (Form 470-4132), and when applicable a Safety Plan (Form 470-4461). The information is available only to the child, parents, and others with legal access to this information, and then only upon request. 470-3240 (Rev. 04/16) Page 2 ?dais-nuCon?dential Access: Yes No if Yes, give justification:The integrity of information obtained would be jeopardized if the parents were contacted ?rst. 10/2/2015 12:00:00 Date of Contact AM Summary of Contact 02:25 pm. Intake accepted and assigned to CPW. Supervisor Korbitt extended the time frame until Monday. 10/5/2015 12:00:00 Date of Contact AM Summary of Contact 09:26 am. CPW met with Jesus Lopez in private at the Clarinda Academy and discussion was held regarding the allegations. Jesus said he tried to go truant and ran downstairs. Jesus then said that one staff grabbed his ankles and the other grabbed his wrist and carried him to the shoe closet. Jesus said he was laying down when one staff put him in a stretch where his arms were pulled back and the other staff were on his legs. Jesus said he was ?ghting at this time and the staff took him to his room. Now there were four staff members present and Jesus said every time they asked him if he was ready to go to bed and he answered staff would come behind him, put their arms beneath his arms and pulled him back and then the staff would throw him to the ground. Jesus said this occurred about 10 times with different staff taking turns. Jesus said the staff continued to pull him backwards and then drop him to the ground. Jesus said he told staff that they were doing the restraints wrong but they told him not to speak. Jesus said at one point, he was knocked out and remembers a nurse trying to wake him up. Jesus kept asking CPW how much longer the interview would last because he was in a hurry to get back to Algebra. Jesus was unable to provide CPW the staff?s names but said that this happens to other kids but it?s not being reported. CPW asked Jesus if he had any injuries on this date but he said all of his bruises had healed. Date of Contact 10/5/2015 12.00123! Summary of Contact 08:38 am. CPW emailed Troy Kroeger with to inform him of the open assessments at Clarinda Academy. CPW asked Troy to with the interviews since the allegations were against four supervisors. Dates and times were arranged for both CPW and Troy to be present during the interviews for each day interviews were conducted. Throughout the case, communication was held between CPW and Troy Kroeger with Date of Contact 1016/2015 Summary of Contact 01:35 pm. 470-3240 (Rev. 04/16) Page 3 CPW phoned Reggie who is the executive director of the academy and discussion was held regarding the allegations. - Reggie said he will be on vacation when the interviews are being conducted but offered to come to the academy to CPW told Reggie that he presence wouldn't be necessary for the interviews. 10/6/2015 12:00:00 Date of Contact AM Summary of Contact 01:21 pm. Phone call to reporter and information obtained. 10/13/2015 12:00:00 Date of Contact AM Summary of Contact 03:34 pm. CPW along with Troy Kroeger with met with Daniel Mullen. Daniel has worked at the academy for one year and is a group leader. Daniel said that day when the incident happened he had worked a double shift and said he had no breaks that day/night. Daniel said he worked from 7:00 am. 12:30 am. that day. Discussion was held regarding the allegations. Daniel said he saw Jesus walking towards the door and waved at staff. Daniel said he sent Kyle Williams after Jesus after he eloped from the hall, but Kyle left the hall without a radio. Daniel then sent Mitch out with a radio and after ?ve minutes all three of them came back in. Jesus was by the shoe closet kicking and ?ailing. Daniel said he tried to de?escalate Jesus and to check to see what was wrong. Daniel said that Jesus was calm at certain times. Daniel and David Rupp began to escort Jesus to his room and Daniel said that Jesus continued to kicking and flailing his arms. Daniel and David carried Jesus to his bedroom after someone said that Jesus needed to get to bed. Daniel said that Jesus was thrashing around in his room and was placed in a seated position by Dalton. Jesus was brought back up and again down to a seated position because Daniel said that Jesus was ?ailing his legs. Wayne then took over and Dalton left Wayne then placed Jesus into a seated position. Daniel said that he thought Wayne brought Jesus back up and the Mitch had him in a standing position. Daniel then placed Jesus into a seated position. When Daniel was asked if Jesus hit his head while he had placed Jesus into a seated position, Daniel said he didn?t know of Jesus hitting his head but said it could have happened. Daniel said that everyone was wrong that evening with the restraints saying that the restraints were over the 90 degree angle when Jesus was in a seated position. Daniel said he remembers Jesus going past the 90 degrees. Daniel said due to the incident he was suspended from his job for 3 days, is on probation for 90 days and had to attend a 2 day training on behavior cycles. Date of Contact 10/23/2015 12:00:20]1 .. Summary of Contact 11:31 am. Voicemail received from Christine Domes who is the supervisor on Jesus Lopez' case with Washington state. 02:29 pm. Phone call returned to Christine Domes. Christine said she spoke with Troy Kroeger who provided CPWs phone number to her. Christina is upset with the academy because they were never noti?ed that Jesus was restrained and since there has been TPR on Jesus' parents, they are the guardian of his case. CPW told Christine that this worker was still working on the case but would assure they receive parental noti?cations and a copy of the report. 470-3240 (Rev. 04/16) Page 4 Date of Contact 10/28/2015 Summary of Contact Phone call to Director Mike Butt CPW asked to meet with each of the supervisors who are involved with the assessment next week to discuss the outcome of their reports. It was agreed that CPW will be at the academy on November 2nd at 8:00 am. 470-3240 (Rev. 04/16) Page 5 The allegation of Factor 1: Victim is a child. Jesus Lopez is a child as evidenced by his birth date. This factor has been met. Factor 2: Person responsible is a caretaker. Daniel This factor has been met. Factor 3: Physical injury occurred. Jesu This factor has been met. Factor 4: injury is nonaccidental or history d. On 08/29/2015, Jesus had severe bruising to his forehea during the restraint, it was determined that Daniel Mull Jesus into a seated position to the floor, hitting Jesus' Jesus? head hit the ?oor. Although, Daniel did not admi happened. This factor has been met. Factor 5: Injury resulted fro Although, Daniel didn't Other staff members Jesus' head on the floor causing the injury. This factor has been met. CAL ABUSE, Bruise, is CONFIRMED based upon uilen is a staff member at the Clarinda Academy and was a an cause head on the floor. Other staff members report see to hitting Jesus? head on the ?oor, Daniel said it could have admit to hitting the child's head on the ?oor hared concern when they observed Daniel the following factors: caretaker at the time of the abuse. Lopez sustained bruising to his forehead, arms, legs and back. given is at variance with the injury. taff members present he forcefully placed ing and hearing After interviews were conducted with the the injuries to Jesus' forehead, when the acts or omissions of the caretaker. during a restraint, Daniel said it could have happened. lacing Jesus into a seated position using force, hitting Chil Jesus Lopez Person Responsible: Daniel Mullen Assessment Finding: Con?rmed Abuse Type: Bruise Justi?cation:The inci abuse in which the department has dete reoccur. Pursuant to Iowa Code section 232.71 an dent is Con?rmed and will NOT be placed in the rrnined the injury resulting from entral abuse registry because the ?nding of physical the abuse was minor, AND isolated, AND unlikely to 441 Iowa Administrative Code section 175.39. 470-3240 (Rev. 04/16) Page 6 . 2 I. A . potentially dangerous situation): Describe the threats of maltreatment that are present at this time (aggravating factors that combine to produce a ?um? Describe the child?s vulnerability to maltreatment (the degree to which a child cannot, on the child?s own, avoid, negate, or minimize the impact of present or impending danger): Describe the caretaker?s protective capacities (family and resources that reduce, control, or prevent threats of maltreatment from arising, as well as factors and de?ciencies that have a negative impact on child safety): Summary and Analysis of Safety/Risk Assessments Identified Summary and Analysis Addendum Date Final Risk Level (based upon completion of the standardized risk assessment): Low Moderate High [1 470-3240 (Rev. 04/ 1 6) Page 7 Di nformation and Referral Community Care (Referral Datez) Service recommendations were discussed with the ?no additional services recommended owing: family and a service plan is appropriate to address the toll No referral to Community Care was made due to the following exception reason Already engaged in DHS Services Court action by DHS or already engaged in JCS Services Abuse occurred in out of home setting Parent not willing to accept Community Care Already engaged in Community Care Family does not need additional supports beyond current fonnallinformal systems Department Services (Referral Date: Case transferred to Social Work Case Manager or Supervisor: The case is not being referred to DHS Service due to the following exception reason: of home setting (such as child care, or hospital), the person responsible has The abuse occurred in an out caretaker had no prior knowledge of the alleged abuse. no access to the child, and the parent or The child victim is deceased and there are no other children in the home. The entire family moved out of the state prior to the completion of the assessment and the CPW has noti?ed that state?s child protective services. Other (explanation required). Additional Service lnfon'nation Juvenile 10/29/2015 Juvenile court already involved Criminal 10/29/2015 None Date: 10/29/2015 Si nature: Christy Nook Date: 10/30/2015 Supervisor Signature: Katie Corbitt cc:County Attorney: PAGE COUNTY ATTORNEY Date Sent: cc:Juvenile Court: Date Sent: 470-3240 . ev 04/16) Page 8 Cm Name") Jesus Lopez Iowa Department of Human Services Child Protective Services Child Abuse Assessment Summary Not confirmed Confirmed. nut p|aoed on regish'y Fuunded Addendum to previous summary Condkionauy Safe Unsala :1 If Unsafe, Date of Removal: Address: Home Phone: other Phone: Completion Date: Addendum Dace: 2015275130 10/30/2015 Intake Data: Protection Worker: County Name] County 10/02/2015 02:25 PM Christy Nook Page I 73 Assessment Flndinga: Safety Assessment Findings: If Conditionally Silo, Date Safety Plan I 55,5 Compmed: Removal Request. Coun denied Voluntary Relative Non-Relative Emergency Custody Name: Christine Domes Address: DFHS--Cl'lildren's Administration 900 E. College Way, Suite 200 MOUNT VERNON, WA 58273 Phone CARL SONKSEN 0923816 4704.240 (Rev' 04/16) Page 1 Address: Home Phone: Work Phone: Mental Injury Sexual Abuse Denial of Critical Care Child Prostitution Presence of Illegal Drugs El Manufacturing! Possession of Dangerous Bestiality in presence of a Allows Access by a Registered Substances with intent to manufacture minor Sex Offender El Allows Access to Obscene Material It is alleged that Staff member, Wayne Peterson restrained resident, Jesus Lopez (age 17) on 8/29/2015 and used excessive force and inappropriate restraint technique, as a result Jesus had numerous marks and brunses on his person. Denial of Critical Care, Failure to Provide Adequate Supervision is alleged. bserved . .. see; Jesus Lopez Se n: 0/05/2015 Justi?cation Reason: Child seen, timeframe delayed Child seen, timeframe delayed Custodial Parent(s) Interview Non-Custodial Parent interview (if applicable) Christine Domes interviewed On: Evaluation of Home Environment Completed 10/05/2015 Safety Assessment Completed 10/27/2015 Safety Plan Completed (if applicable) Risk Assessment Completed 10/07/2015 Additional process information: In accordance with Iowa Code 232.718, when conducting an assessment, the Department of Human Services completes an evaluation of the family which includes the identi?cation of and needs of the child, and of the child?s parents, home, and family. This information is documented in the Family Risk Assessment (Form 470- 4133), Safety Assessment (Form 470-4132), and when applicable a Safety Plan (Form 470-4461). The information is available only to the child, parents, and others with legal access to this information, and then only upon request. 470?3240 (Rev. 04/16) Page 2 Yes El No If Yes, give justification:The integrity of information obtained would be jeopardized if the parents were contacted ?rst. Con?dential Access: 10/2/2015 12:00:00 Date of Contact AM Summary of Contact 02:25 pm. Intake accepted and assigned to CPW. Supervisor Korbitt extended the time frame until Monday. Date of Contact 10/5/2015 12.002; Summary of Contact 09:26 am. CPW met with Jesus Lopez in private at the Ciarinda Academy and discussion was held regarding the allegations. Jesus said he tried to go truant and ran downstairs. Jesus then said that one staff grabbed his ankles and the other grabbed his wrist and carried him to the shoe closet. Jesus said he was laying down when one staff put him in a stretch where his arms were pulled back and the other staff were on his legs. Jesus said he was ?ghting at this time and the staff took him to his room. Now there were four staff members present and Jesus said every time they asked him if he was ready to go to bed and he answered staff would come behind him, put their arms beneath his arms and pulled him back and then the staff would throw him to the ground. Jesus said this occurred about 10 times with different staff taking turns. Jesus said the staff continued to pull him backwards and then drop him to the ground. Jesus said he told staff that they were doing the restraints wrong but they told him not to speak. Jesus said at one point, he was knocked out and remembers a nurse trying to wake him up. Jesus kept asking CPW how much longer the interview would last because he was in a hurry to get back to Algebra. Jesus was unable to provide CPW the staff?s names but said that this happens to other kids but it?s not being reported. CPW asked Jesus if he had any injuries on this date but he said all of his bruises had healed. Date of Contact 10/5/2015 12:00:23.4 Summary of Contact 08:38 am. CPW emailed Troy Kroeger with DIA to inform him of the open assessments at Clarincla Academy. CPW asked Troy to assist with the interviews since the allegations were against four supervisors. Dates and times were arranged for both CPW and Troy to be present during the interviews for each day interviews were conducted. Throughout the case, communication was held between CPW and Troy Kroeger with DIA. Date of Contact 10/6/2015 12:00:22? Summary of Contact 01:35 pm. 470-3240 (Rev. 04/16) Page 3 CPW phoned Reggie who is the executive director of the academy and discussion was held regarding the allegations. . Reggie said he will be on vacation when the interviews are being conducted but offered to come to the academy to assist. CPW told Reggie that his presence would n't be necessary for the intervrews. Date of Contact 10/6/2015 12:00:20 Summary of Contact 01:21 pm. Phone call to reporter and infom'iation obtained. Date of Contact 10/8/2015 12:00:00 AM Summary of Contact 09:55 am. CPW along with Troy Kroeger with DIA interviewed Wayne Petersen who is the overnight team leader on Washington Hall. Wayne has worked at the academy for 7 years and prior to the Ciarinda Academy, Wayne worked for Tarkio Academy for 8 years. Wayne said he arrived for his shift between 9:30 - 10:00 pm. Wayne?s shift starts at 11:00 pm. Wayne said that Jesus was in the shoe closet and already had been restrained when he arrived for his shift. Jesus was on the floor processing with David Rupp on one side and Daniel Mullen on the other side of Jesus. The two staff were talking to Jesus with Jesus threatening to run. This went on for 30-40 minutes. Jesus got off the ?oor, then sat down, got up and walked into Mitch and Daniel. Mitch had Jesus in a standing position and suggested they take Jesus into his bedroom to put him to bed. Jesus refused to go to bed and four staff carried Jesus into his room by a hook transport. it was Dalton?s decision to move Jesus into his room and to also close the door once staff were inside the bedroom. Wayne said it was tight quarters in the bedroom with Dalton, Dave, Mitch, Daniel, and himself all in the room together. Again, Jesus was asked if he was ready to go to bed but Jesus said no. Jesus was placed in a seated restraint by Dalton and Wayne said that Dalton was leaning over but not bad. Dalton then brought Jesus to his feet to a standing position. Jesus was asked again if he was ready to go to bed. Jesus said, ?I?m not fucking going to bed and Dalton put Jesus back down to a seated position. Wayne said that Dalton was rough during this time and was leaning more on Jesus?s back this time. Daniel Mullen switched out with Dalton and Jesus?s head went to the floor while he was still in a seated position. Wayne said that Daniel went forward on Jesus too far. Wayne said he knew the restraint had gone too far and he placed himself on Jesus?s legs to prevent Jesus's head to hit the ?oor again. Wayne said he was on Jesus?s legs for a couple of minutes when he heard someone from behind say let?s bring him up. Wayne took over with the standing position and asked Jesus if he knew what the expectations were. Jesus replied by yea or nah. Wayne put Jesus in a seated position and admits that he was getting frustrated with the whole situation. Wayne knows that he was wrong by placing Jesus in a seated position because Jesus wasn?t ?ghting or being aggressive. Wayne said he had Jesus bent over a little until he could get positioned. Wayne said he got tapped out by David. Jesus was brought back to a standing position and Wayne stepped out to the hailway to check on staff. Wayne stepped back into Jesus? room and observed Jesus on the floor in a seated position but his legs weren?t straight and Jesus was bent over with his head touching the ?oor. David was holding him forward and Jesus wasn?t saying a thing. David?s body weight was on Jesus. David and Daniel were present when Daniel had Jesus in a seated position and brought Jesus back to a standing position. Dalton then took over and said we?re just going to put him to bed and placed Jesus on the bed. Wayne said he sat in a chair in Jesus?s bedroom and told John that he was concerned about Jesus. Jesus didn?t move in his bed for two hours. and Wayne were in Jesus?s bedroom 3-4 times because he wasn?t moving and Wayne never left his door all night. Wayne said he seen the mark on Jesus?s forehead in the same area where Jesus? head hit the floor during a restraint. Wayne said they are supposed to have a small staf?ng after a restraint but this did not occur that evening and Wayne said he didn?t want to get staff together because he didn?t want to leave Jesus. David Rupp said to Wayne the following day that he wasn?t comfortable with what happened. Wayne contacted Paul Rieken on Sunday morning and told him he wasn?t comfortable with what happened to Jesus on Saturday night. Wayne admits that not only he but other staff were performing improper restraints. 470-3240 (Rev. 04/16) Page 4 When CPW and Troy asked Wayne what he thought happened that evening, Wayne said that too many staff are working double shifts and their tired and frustrated. Wayne felt that staff were just ready to get off that evening and felt things were rushed to get Jesus into his bedroom. Wayne said that Jesus should have never been put in the different restraints for just telling staff he wasn?t ready to go to bed. Wayne said that once Jesus had come back into the building after trying to elope, Jesus wasn?t aggressive or ?ghting and was limp as a noodle. Wayne said he has been working double shifts and because of the incident was suspended from his job for three days, 90 days probation and had to attend 2 days of training on behavior cycles. Date of Contact 10/23/2015 12002221 Summag of Contact 11:31 am. Voicemail received from Christine Domes who is the supervisor on Jesus Lopez' case with Washington state. 02:29 pm. Phone call returned to Christine Domes. Christine said she spoke with Troy Kroeger who provided CPWs phone number to her. Christine is upset with the academy because they were never noti?ed that Jesus was restrained and since there has been TPR on Jesus' parents, they are the guardian of his case. CPW told Christine that this worker was still working on the case but would assure they receive parental noti?cations and a copy of the report. Date of Contact 10/28/2015 12:00:23 Summary of Contact Phone call to Director Mike Butt. CPW asked to meet with each of the supervisors who are involved with the assessment next week to discuss the outcome of their reports. it was agreed that CPW will be at the academy on November 2nd at 8:00 am. 470-3240 (Rev. 04/16) Page 5 The allegation of PHYSICAL ABUSE, Bruise, is NOT CONFIRMED based upon the following factors: Factor 1: Victim is a child. Jesus Lopez is a child as evidenced by his birth date. This factor has been met. Factor 2: Person responsible is a caretaker. Wayne Petersen works at the Clarinda Academy and was a caretaker at the time of the abuse. This factor has been met. Factor 3: Physical injury occurred. Jesus Lopez sustained injuries to his forehead, arms, legs and back. This factor has been met. Factor 4: Injury is nonaccidental or history given is at variance with the injury. 2 On 08/29/2015, the child sustained injuries during numerous restraints where four staff members admitted that improper restraints were initiated. Although, Wayne admits that improper restraints were initiated by himself, Wayne was not found to be responsible for the injuries that Jesus Lopez sustained. This factor has been met. Factor 5: Injury resulted from the acts or omissions of the caretaker. Wayne contacted Paul Rieken a director with the academy on 08/30/2015, sharing that he had concerns with the restraints that were initiated on Jesus Lopez the night before by all staff members. Wayne admitted he placed Jesus into a restraint that he should?ve because Jesus was not being aggressive and was not a threat. Although Wayne admits he initiated an improper restraint the injuries that Jesus sustained was not caused by Wayne Petersen. This factor has not been met. Describe the threats of maltreatment that are present at this time (aggravating factors that co potentially dangerous situation): Describe the child?s vulnerability to maltreatment (the degree to which a child cannot, on the child?s own, avoid, negate, or minimize the impact of present or impending danger): Describe the caretaker?s protective capacities (family and resources that reduce, control, or prevent threats of maltreatment from arismg, as well as factors and de?ciencies that have a negative impact on child safety): 470-3240 (Rev. 04/16) Page 6 Summary and Analysis of Safety/Risk Assessments Identi?ed Summary and Analysis Addendum Date Jesus Lopez came to the attention of DHS after it was alleged that Jesus was restrained and excessive force and inappropriate restraint technique. As a result Jesus had numerous marks and bruises on his person. The DHS Family Risk Assessment indicates Jesus Lopez is at MODERATE risk of future abuse or neglect. This is primarily due to Jesus's behaviors and DHS's current involvement with the family. Information or Information and Referral-no additional services recommended Community Care (Referral Date:) Service recommendations were discussed with the family and a service plan is appropriate to address the following: No referral to Community Care was made due to the following exception reason Already engaged in DHS Services Court action by DHS or already engaged in JCS Services Abuse occurred in out of home setting Parent not willing to accept Community Care Already engaged in Community Care Family does not need additional supports beyond current formal/informal systems Department Services (Referral Date: Case transferred to Social Work Case Manager or Supervisor: The case is not being referred to DHS Service due to the following exception reason: The abuse occurred in an out of home setting (such as child care, PMIC. or hospital), the person responsible has no access to the child, and the parent or caretaker had no prior knowledge of the alleged abuse. The child victim is deceased and there are no other children in the home. The entire family moved out of the state prior to the completion of the assessment and the CPW has noti?ed that state?s child protective services. Other (explanation required). Additional Service Information ion -. Jurisdiction Type ofc Juvenile 10/29/2015 Juvenile court already involved Criminal 10/29/2015 None 470-3240 (Rev. 04/16) Page 7 +5 x, .. Supervisor Signature: Katie Corbitt Date: 1 01301201 5 cc:County Attorney: PAGE COUNTY ATTORNEY cc:Juvenile Court: 470-3240 (Rev. 04/16) Date Sent: Date Sent: Page 8