(a) Application.  This Section applies to referrals received by the Office of Client Advocacy (OCA) which OCA refers to a facility for an internal CCR in accordance with OAC 340:2-3-35(a)(2).  This Section does not apply to allegations involving maltreatment of a Hissom class member or person receiving Developmental Disabilities Services Division (DDSD) waiver services.  

(b) Assignment to a facility to conduct a CCR.

• (1) When OCA receives a referral that indicates possible caretaker misconduct, in lieu of an investigation OCA intake may refer it to the facility where it allegedly occurred for handling as a CCR if:
  • (A) there is no injury or evidence that the client might have been exposed to a significant risk of harm;
  • (B) there is a minor physical injury and it is not a suspicious injury;
  • (C) there is a serious physical injury and the known credible information makes it unlikely that the serious injury was the result of abuse or neglect;  • 1  or
  • (D) excessive or unauthorized use of force is alleged and there is no injury or only a minor injury that is not suspicious.
• (2) In addition to the referrals in subsection (b)(1), at Oklahoma Department of Human Services (OKDHS) operated facilities, a referral indicating possible maltreatment may be referred to the facility for handling as a CCR if the allegation involves a serious physical injury that occurred under unexplained or unusual circumstances.

(c) Protocol for conducting a CCR.  When OCA intake assigns a facility the responsibility to conduct a CCR, the administrator or designee takes necessary steps to ensure the safety of all clients and to protect the integrity of all evidence.  A facility employee designated to conduct a CCR follows the investigative procedures described in OAC 340:2-3-36, with the exception of tape recording the interviews in OAC 340:2-3-36(i)(1),  • 2 including:

• (1) reviewing pertinent documentation, records, and evidence collected;
• (2) viewing any injuries and photos of injuries, and obtaining photos of injuries;
• (3) obtaining written statements and conducting interviews with:
  • (A) each alleged victim;
  • (B) each eyewitness;
  • (C) other persons with knowledge relevant to the allegation; and
  • (D) each accused caretaker;
• (4) reviewing statutes, policies, directives, standards, rules, or practices relevant to the allegation;
• (5) analyzing the accused caretaker's actions in relation to relevant statutes, policies, directives, standards, rules and practices; and
• (6) determining the appropriate finding(s) in accordance with OAC 340:2-3-36(l).

(d) Returning the investigation responsibility to OCA.  If at any time during the CCR information is learned that gives cause to believe that a client was the victim of caretaker misconduct resulting in a serious injury, abuse or neglect, the administrator immediately discontinues the CCR and contacts OCA intake to report the new information warranting an OCA investigation.  OCA intake notes the new information and changes the disposition on Form 15GN001E,  Office of Client Advocacy Intake Referral, or its electronic equivalent, and the case is assigned to an OCA investigator for investigation in accordance with OAC 340:2-3-35(c).

(e) Written report of CCR.  After completion of the CCR process and determination of the appropriate finding, the person conducting CCR prepares a written report.  Facilities are encouraged, but not required, to use the OCA format for CCR reports, Form 15IV007E, Caretaker Conduct Review Report.  The written report contains:

• (1) the allegation(s), including the dates, times, and location of the alleged incident(s), the date the allegation was reported to OCA, and the OCA case number;
• (2) a statement of any injury sustained by the alleged victim(s) and, in cases involving an injury, a statement whether photographs were taken of the injury and if so, the date they were taken;
• (3) the finding(s), whether caretaker misconduct did or did not occur, in accordance with OAC 340:2-3-36(m);
• (4) a list of the involved parties, their titles and role in the matter, whether they were interviewed and, if so, when;
• (5) citation to pertinent statutes, policies, directives, standards, rules, and practices, when applicable;
• (6) an explanation of the basis for the finding(s);
• (7) a summary of pertinent information obtained in interviews conducted during the review;
• (8) a list of relevant documents and records reviewed;
• (9) a list of attachments to the report;
• (10) a list of areas of concern identified during the course of the investigation regarding facility or OKDHS practices or procedures which have implications for the safety, health, or welfare of clients but which do not rise to the level of abuse or neglect; and
• (11) either on a cover memo or at the end of the report, the signature and date signed by the person who conducted the CCR, and the signature of the person who reviewed and approved the report.

(f) Time for completion of report.  The final written report is submitted to the advocate general within 30 calendar days from the date that OCA intake notified the administrator that an allegation is referred for CCR.

(g) OCA processing of CCR reports.  The administrator transmits the completed CCR to the advocate general.  The advocate general or designee reviews the CCR report for completeness and appropriateness of the finding.  If a report is incomplete or the finding is questionable, OCA contacts the administrator to request further inquiry into the allegation.  OCA opens an investigation if a report indicates the need.

(h) Review by Developmental Disabilities Services Division (DDSD) director.  Within five working days of completion of a CCR report at the Southern Oklahoma Resource Center (SORC), the Northern Oklahoma Resource Center of Enid (NORCE), or the Greer Center Facility (Greer), the facility administrator or designee informs the client and the client's guardian or parent of the result of the CCR.  If the client or the guardian or parent does not concur with the finding(s), the facility administrator or designee notifies the advocate general in writing by e-mail or letter.  The advocate general refers the matter to OCA's grievance coordinator to process for review by the DDSD director as a contested grievance in accordance with OAC 340:2-3-46 and 340:2-3-51(g) and the client or guardian or parent who did not concur with the finding(s) is considered the grievant for purposes of that review.  If the grievant does not concur with the proposed resolution of the division director or designee, the matter is reviewed by the Grievance and Abuse Review Committee (GARC) in accordance with OAC 340:2-3-62 and 340:2-3-64.

(i) State office administrator's report.  The findings in a CCR are considered final when the time for requesting review pursuant to the paragraph (h) of this Section has expired and review has not been requested, or that review was timely requested and has concluded.

• (1) Within 60 calendar days of the finding becoming final, the state office administrator or designee informs the advocate general in writing of:
  • (A) any personnel action taken or to be taken;
  • (B) any corrective action taken or to be taken; and
  • (C) for each worker found to have engaged in caretaker misconduct, whether there has been any prior confirmation by OCA or the facility for client maltreatment by the worker and, if so, the basis for each finding and the personnel action taken in response.
• (2) If personnel action is involved, the state office administrator also notifies the  OKDHS Human Resources Management Division director.
• (3) If a CCR has not resulted in a confirmed finding, no information or material pertaining to the allegation or the investigation is placed in the personnel files of any employee named in the report.