CHAPTER 5 DDA POLICY MANUAL PAGE 1 OF 17 ISSUED 07

CHAPTER 5

DDA POLICY MANUAL PAGE 1 OF 17 ISSUED 07/2024

DEVELOPMENTAL DISABILITIES ADMINISTRATION

Olympia, Washington

TITLE: PROTECTION FROM ABUSE: MANDATORY REPORTING 5.13

Authority: 42 C.F.R. 483.420 Condition of participation: Client protections

Chapter 9A.16 RCW Defenses

Chapter 11.130 RCW Uniform Guardianship, Conservatorship, and Other Protective

Arrangements Act

Chapter 18.20 RCW Assisted Living Facilities

Chapter 18.51 RCW Nursing Homes

Chapter 18.130 RCW Regulation of Health Professions—Uniform Disciplinary Act

Chapter 26.44 RCW Abuse of Children

Chapter 70.124 RCW Abuse of Patients

Chapter 70.127 RCW In-Home Services Agencies

Chapter 70.128 RCW Adult Family Homes

Chapter 70.129 RCW Long-Term Care Resident Rights

Chapter 71A.12 RCW State Services

Chapter 71A.20 RCW Residential Habilitation Centers

Chapter 72.36 RCW Soldiers’ and Veterans’ Homes and Veterans’ Cemetery

Chapter 74.34 RCW Abuse of Vulnerable Adults

References: DSHS Administrative Policy 8.02, Client Abuse

DSHS Administrative Policy 9.01, Incident Reporting

DSHS Administrative Policy 18.89, Investigations

DDA Policy 12.01, Incident Management and Reporting

DSHS/Washington State Patrol Protocol

DSHS/AAG Medicaid Fraud Control Unit Memorandum of Understanding

Resources: How to Report Child Abuse and Neglect

Information for Mandatory Reporters (Vulnerable Adults)

TITLE: PROTECTION FROM ABUSE: MANDATORY REPORTING 5.13

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BACKGROUND

Several state laws require Department of Social and Health Services employees, volunteers, and

contractors to report suspected abuse, neglect, exploitation, and abandonment of children and

vulnerable adults:

• Chapter 26.44 RCW mandates the reporting of any suspected abuse or neglect of a child

to either Department of Children, Youth and Families Child Protective Services or law

enforcement.

• Chapter 74.34 RCW mandates that when there is reasonable cause to believe that

abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has

occurred, mandated reporters shall immediately report to DSHS. When there is

suspected sexual or physical assault of a vulnerable adult, or there is reasonable cause to

believe that an act has caused fear of imminent harm it must be reported to DSHS and

law enforcement.

• RCW 70.124.030 mandates the reporting of suspected abuse or neglect of state hospital

patients.

• Chapter 74.34 RCW divides reporters into two types: mandated and permissive.

Mandated reporters include all DSHS employees, service providers, law enforcement

officers, social workers, and others (see the RCW 74.34 or Definitions section of this

policy for complete description). Under state law, volunteers at a facility or program

providing services to vulnerable adults fall into the permissive category.

• For a contractor, volunteer, intern, or work-study student to work in a regional Field

Services office, Residential Habilitation Center, Youth Transitional Care Facility, or a State-

Operated Community Residential Program they must agree to follow mandatory

reporting requirements.

PURPOSE

This policy establishes the process the Developmental Disabilities Administration uses to prevent

abuse and neglect and to protect, to the extent possible, the health, safety, and well-being of

clients, and ensure that allegations involving abuse, neglect, exploitation, and abandonment of

clients is reported.

SCOPE

This policy applies to all DDA employees, contractors (except as identified below), volunteers,

interns, and work-study students.

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Note: Contracted community residential service providers and state-operated community

residential providers must follow the requirements of DDA Policy 6.12, Mandatory

Reporting Requirements for Residential Providers. County and County-Contracted

providers must follow the requirements of DDA Policy 6.08, Mandatory Reporting

Requirements for County and County Contracted Providers. These provider types do not

fall under this policy.

DEFINITIONS

See Attachment A for a complete list of definitions of terms used in this policy. Attachment B

contains different types of abuse and neglect.

POLICY

A. Abuse and neglect of children and vulnerable adults is prohibited by law and will not be

tolerated. All administration employees, contractors, volunteers, interns, and work-study

students must report every incident of observed, reported, or suspected abuse, neglect,

exploitation, and abandonment, as well as injuries of unknown origin.

B. A mandated reporter does not have to witness or have proof that an incident occurred.

As long as there is reasonable cause to believe that a child or a vulnerable adult has been

abused or neglected, a mandated reporter must make a report.

C. Failure to report can result in disciplinary action. Furthermore, failure to report is a gross

misdemeanor under Washington State law (RCW 74.34.053 and RCW 26.44.080). Any

DDA employee, contractor, or volunteer found to have knowingly failed to report in their

capacity as a mandated reporter will be reported to the appropriate law enforcement

agency and may be prosecuted to the extent the law allows. In Washington State, the

maximum punishment for a gross misdemeanor is 364 days in county jail or a fine of up

to $5,000.

D. DDA does not tolerate harassment or retaliation toward any reporter who reports in

good faith.

E. A reporter who reports in good faith is immune from prosecution and protected from

dismissal under RCW 70.124.060.

F. A false report made intentionally, maliciously, or in bad faith is a misdemeanor under

RCW 74.34.053 and RCW 26.44.080. Any DDA employee, contractor, or volunteer found

to have knowingly made a false report is reported to the appropriate law enforcement

agency and may be prosecuted to the extent the law allows. In Washington State, a

misdemeanor maximum punishment is 90 days in jail and up to a $1,000 fine.

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G. In accordance with RCW 74.34.035, a facility or agency must not develop policies or

procedures that interfere with mandatory reporting requirements.

H. When a report is made to the DSHS APS Central Intake, the mandatory reporter has the

right to remain anonymous, except as permitted by RCW 74.34.035(8) and RCW

74.34.095(1). The investigative agency will not release the reporter’s name unless a name

is required for reporting to, or coordinating with, other investigative entities, as required

by judicial proceeding, or the reporter consents to disclosure.

PROCEDURES

A. What to Report

1. A mandated reporter must report allegations of abuse, neglect, exploitation and

abandonment of children and vulnerable adults under Washington State Law

Chapter 26.44 RCW and Chapter 74.34 RCW..

Note: If there is reason to suspect that physical or sexual abuse has occurred, or

there is reasonable cause to believe that an act has caused fear of imminent harm

to a vulnerable adult, a mandated reporter must also immediately report the

incident to the appropriate local law enforcement agency.

2. Under RCW 74.34.035, a mandated reporter must also report any suspicious

death of a vulnerable adult to the local coroner or medical examiner and local law

enforcement. To determine the local coroner or medical examiner for a specific

county, visit the Member Directory on the Washington Association of County

Officials website.

3. A report must be made to the Department of Health if there are provider practice

and license-related issues for professionally licensed people, such as a: physician;

pharmacist; nursing assistant-registered (NA-R); certified nursing assistant (CAN);

licensed practical nurse (LPN); or registered nurse (RN). To file a complaint,

submit a DOH complaint form.

4. A mandated reporter must report injuries to a client that are of unknown origin

and raise suspicion of possible abuse or neglect, to the appropriate reporting

department. When determining whether to report an injury of unknown origin,

the reporter must consider the following:

a. The extent of the injury;

TITLE: PROTECTION FROM ABUSE: MANDATORY REPORTING 5.13

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b. The location of the injury (e.g., the injury is located in an area not

generally vulnerable to trauma);

c. The presence of multiple injuries;

d. Repeated injuries of unknown origin; or

e. Injuries inconsistent with the client’s condition, pattern of behavior, or

routine.

B. When to Report

1. When a DDA employee, contractor, volunteer, intern, or work-study student in

the course of their duties has reasonable cause to believe that any client has been

abused, neglected, or exploited, regardless of the source of information, they

must immediately make a report to the investigative agency (see Section C

below).

2. “Immediately” means there should be no delay between reporter awareness of

the incident/allegation and making the report. Reporting should occur as soon as

the safety of all clients is assured, and all necessary emergency measures have

been taken.

3. Reports must be made immediately regardless of employee leave or days off. A

mandated reporter’s responsibilities are not limited to the workplace, and apply

at all times, including off-duty hours, per DSHS Administrative Policy 8.02, Client

Abuse Reporting.

4. When a DDA employee becomes aware of an incident, the employee must make

a report to DDA Central Office. See DDA Policy 12.01, Incident Management and

Reporting, for additional information on timelines and requirements.

C. Information in a Report

1. When making a report to APS, CPS, and RCS, each report, oral or written, must

contain as much information as possible, including:

a. Victim name – The name and address of the vulnerable adult or child and

the name of the facility or agency providing care for the vulnerable adult

or child;

b. The nature and extent of the allegation;

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c. Perpetrator name – The identity of the alleged perpetrator(s), if known;

d. Contact information – The name, address, and phone numbers of the

alleged victim, witnesses, and the legal guardian or alternate decision

maker;

e. Reporter’s information – The name, phone number, and address of the

person making the report;

f. History – Any history of previous allegations of abuse, neglect,

exploitation, or abandonment; and

g. Any other information that may be helpful in establishing the extent of the

allegations.

D. Notifying a Supervisor

1. Immediately after making the report to the investigative agency, a mandated

reporter must also report the incident to their supervisor in the manner specified

by their office or facility procedures. If the immediate supervisor is not available,

the mandated reporter must report the incident to the next highest supervisor or

management representative so designated by the office or facility.

2. If the suspected perpetrator is the person to whom the mandated reporter would

usually report, report the incident to the next highest supervisor or management

representative at the office or facility.

E. How to Report – Mandatory Reporting Contacts

1. Reports involving children

Contact the local Child Protective Services (CPS) office using the DCYF Mandatory

Reporters website

For after-hours reports, call the DCYF statewide number at 1-866-End-Harm (1-

866-363-4276)

2. Reports involving 18–21-year-olds in children’s licensed staffed residential

facilities and certified state-operated facilities providing 24-hour care for children

DCYF statewide number– 1-866-363-4276 (1-866-End-Harm)

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3. Reports involving 13–17-year-old youth at the Youth Transitional Care Facility

DCYF statewide number– 1-866-363-4276 (1-866-End-Harm)

4. Reports involving vulnerable adults

Report Adult Abuse website

DSHS Adult Protective Services (APS) Central Intake – 1-877-734-6277

5. Reports related to provider practice issues involving adults living in nursing

homes, assisted living facilities, adult family homes, or supported living program

settings

Report Adult Abuse website

Residential Care Services (RCS)/Complaint Resolution Unit (CRU) statewide

number: 1-800-562- 6078. TTY – 1-800-737-7931.

6. Reports involving adult patients at Eastern and Western State Hospitals

Eastern State Hospital – 1-509-565-4000

Western State Hospital – 1-253-761-7599

F. Office, Facility, and Agency Procedures

1. All administration offices, facilities, and contractors must have written procedures

in place to implement this policy and provide training to staff and volunteers on

recognizing and reporting suspected client abuse, neglect, exploitation, and

abandonment.

2. DDA offices and facilities must use this policy as the regional and local facility

policy regarding mandatory reporting. Any additional local procedures must have

the prior written approval of DDA’s Assistant Secretary or designee.

3. Written procedures and training must be available to all employees, volunteers,

interns, contractors, and work-study students, and include:

a. Timelines for reporting suspected abuse, neglect, exploitation, and

abandonment;

b. Reference to, or attachments of, relevant state and federal statutes and

regulations regarding client abuse and the specific types of programs to

which they pertain;

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c. Current links and information of the investigative agencies for filing

reports by telephone or online;

d. The responsibilities of reporting staff, supervisors, administrative staff,

and witnesses;

e. Instruction on recognizing abuse, neglect exploitation, and abandonment;

f. Instructions for notifying local law enforcement if there is reason to

suspect that sexual or physical assault or fear of imminent harm has

occurred;

g. Instructions for reporting a suspicious death to the medical examiner or

coroner and local law enforcement;

h. Instructions for protecting clients in an emergency;

i. Instructions for coordinating with a sexual assault specialist or center, as

appropriate;

j. Instructions for protecting evidence when necessary;

k. Investigation procedures, where applicable;

l. Implementing preventive measures and corrective action; and

m. Instructions for initiating an external review when a report of known or

suspected client abuse or neglect involves the acts or omissions of an

administrator or supervisor.

4. Upon hire, each DDA employee, volunteer, intern must take the online DSHS

Mandatory Reporter Training. This training is required every two years for all DDA

employees.

5. If a DSHS employee is an alleged perpetrator:

a. The appropriate management representative must comply with:

i. DSHS Administrative Policy 18.62, Allegations of Employee Criminal

Activity;

ii. DSHS Administrative Policy 8.02, Client Abuse Reporting;

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iii. The DSHS/Washington State Patrol Interagency Agreement;

iv. Any negotiated agreements; and

v. Other applicable policies.

b. The appointing authority should contact their Human Resources

Consultant for advice before placing an employee on an alternative work

assignment.

EXCEPTIONS

No exceptions to this policy are allowed.

SUPERSESSION

DDD Policy 5.13, Protection from Abuse: Mandatory Reporting

Issued April 15, 2024

Approved: Date: July 1, 2024

Deputy Assistant Secretary

Developmental Disabilities Administration

Attachment A – Definitions

Attachment B – Clarifying Examples of Abuse, Neglect, Personal and Financial Exploitation, and

Self-Neglect

ATTACHMENT A

Definitions

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GENERAL

ALTSA means the Aging and Long-Term Support Administration.

Adult Protective Services (APS) means the ALTSA Division that conducts investigations of

reported allegations and may offer protective services to the alleged adult victim.

Agency means all service providers identified in the scope.

Child Protective Services (CPS) means the Department of Children, Youth, and Families unit that

takes a report of abuse, neglect, abandonment or exploitation, conducts the investigation, and

may offer protective services if the alleged victim is under age 18, or is age 18-21 and receives

services from a children’s staffed residential home or a certified state-operated facility providing

24-hour care for children.

Client means a person determined eligible for DDA services.

Complaint Resolution Unit (CRU) means the Residential Care Services (RCS) Division unit that

takes reports of abandonment, abuse, neglect, personal or financial exploitation, or provider

practice concerns when the alleged victim receives services from a supported living, adult family

home, group home, group training home provider or resides in a licensed facility.

Division of Licensed Resources (DLR) means the Department of Children, Youth, and Families

that licenses out-of-home settings. DLR staff are also responsible to investigate reported

licensing concerns when there has been a violation or allegation of violation of minimum

licensing requirements. This includes children’s group home providers, licensed staffed

residential settings, and staff working at these facilities.

Good faith means a state of mind indicating honesty and lawfulness of purpose.

Injury of Unknown Origin means an injury that was not observed directly by the reporting person

and the injury is not reasonably determined to be related to the client’s condition, diagnosis,

known and predictable interaction with surroundings, or related to a known sequence of prior

events.

Youth Transitional Care facility means a staff-secure and voluntary facility offering specialized

treatment for suitable youth.

Mandated reporter means an employee of the Department of Social and Health Services or the

Department of Children, Youth, and Families; law enforcement officer; social worker;

professional school personnel; individual provider; an operator of a facility or a certified

residential services and supports agency under chapter 71A.12 RCW; an employee of a facility;

ATTACHMENT A

Definitions

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DDA POLICY 5.13, ATTACHMENT A PAGE 11 OF 17 ISSUED 07/2024

an employee of a social service, welfare, mental health, adult day health, adult day care, home

health, home care, hospice, or certified residential services and supports agency; county coroner

or medical examiner; Christian Science practitioner; or health care provider subject to

chapter 18.130 RCW. Refer to RCW 26.44.030 for a list of people with a duty to report child

abuse or neglect.

Reasonable cause to believe means that the reporter, in making the report of abuse or neglect,

acts with good faith intent, judged in light of all the circumstances then present.

Residential Care Services (RCS) means the ALTSA division responsible for the licensing and

oversight of adult family homes, assisted living facilities, nursing facilities, intermediate care

facilities for individuals with intellectual disabilities, and certified community residential services

and supports.

Suspicious death means there is no medically reasonable explanation for the cause of death, or it

is possible that criminal activity, substandard care, negligence, or abusive treatment may have

caused or was a factor in the death.

CHILDREN (RCW 26.44.020)

Child or Children means any person under age 18.

Abuse or neglect means sexual abuse, sexual exploitation, female genital mutilation as defined in

RCW 18.130.460, or injury of a child by any person under circumstances which cause harm to

the child's health, welfare, or safety, excluding conduct permitted under RCW 9A.16.100; or the

negligent treatment or maltreatment of a child by a person responsible for or providing care to

the child.

Negligent treatment or maltreatment means an act or a failure to act, or the cumulative effects

of a pattern of conduct, behavior, or inaction, that evidences a serious disregard of

consequences of such magnitude as to constitute a clear and present danger to a child's health,

welfare, or safety, including but not limited to conduct prohibited under RCW 9A.42.100. When

considering whether a clear and present danger exists, evidence of a parent's substance abuse

as a contributing factor to negligent treatment or maltreatment shall be given great weight. The

fact that siblings share a bedroom is not, in and of itself, negligent treatment, or maltreatment.

Poverty, homelessness, or exposure to domestic violence as defined in RCW 7.105.010 that is

perpetrated against someone other than the child does not constitute negligent treatment or

maltreatment in and of itself.

Sexual exploitation includes allowing, permitting, or encouraging a child to engage in prostitution

by any person; or allowing, permitting, encouraging, or engaging in the obscene or pornographic

photographing, filming, or depicting of a child by any person.

ATTACHMENT A

Definitions

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VULNERABLE ADULTS (RCW 74.34.020)

Abandonment means action or inaction by a person or entity with a duty of care for a vulnerable

adult that leaves the vulnerable person without the means or ability to obtain necessary food,

clothing, shelter, or health care.

Abuse means the intentional, willful, or reckless action or inaction that inflicts injury,

unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of

abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or

mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse

includes sexual abuse, mental abuse, physical abuse, and personal exploitation of a vulnerable

adult, and improper use of restraint against a vulnerable adult which have the following

meanings:

(a) Sexual abuse means any form of nonconsensual sexual conduct including, but not

limited to, unwanted or inappropriate touching, rape, molestation, indecent

liberties, sexual coercion, sexually explicit photographing or recording, voyeurism,

indecent exposure, and sexual harassment. Sexual abuse includes any sexual

conduct between a staff person, who is not also a resident or client, of a facility or

a staff person of a program authorized under Chapter 71A.12 RCW, and a

vulnerable adult living in that facility or receiving service from a program

authorized under Chapter 71A.12 RCW, whether or not it is consensual.

(b) Physical abuse means the intentional, willful, or reckless action of inflicting bodily

injury or physical mistreatment. Physical abuse includes, but is not limited to,

striking with or without an object, slapping, pinching, choking, kicking, shoving, or

prodding.

that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably

confines, or punishes a vulnerable adult. Mental abuse may include ridiculing,

yelling, or swearing.

(d) Personal exploitation means an act of forcing, compelling, or exerting undue

influence over a vulnerable adult causing the vulnerable adult to act in a way that

is inconsistent with relevant past behavior or causing the vulnerable adult to

perform services for the benefit of another.

ATTACHMENT A

Definitions

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DDA POLICY 5.13, ATTACHMENT A PAGE 13 OF 17 ISSUED 07/2024

(e) Improper use of restraint means or the inappropriate use of chemical, physical, or

mechanical restraints for convenience or discipline or in a manner that:

(i) Is inconsistent with federal or state licensing or certification requirements

for facilities, hospitals, or programs authorized under chapter 71A.12

RCW;

(ii) Is not medically authorized; or

(iii) Otherwise constitutes abuse under this section.

Chemical restraint means the administration of any drug to manage a vulnerable adult’s

behavior in a way that reduces the safety risk to the vulnerable adult or others, has the

temporary effect of restricting the vulnerable adult’s freedom of movement, and is not standard

treatment for the vulnerable adult’s medical or psychiatric condition.

Facility means a residence licensed or required to be licensed under Chapter 18.20 RCW,

assisted living facilities; Chapter 18.51 RCW, nursing homes; Chapter 70.128 RCW, adult family

homes; Chapter 72.36 RCW, soldiers' homes; or Chapter 71A.20 RCW, residential habilitation

centers; or any other facility licensed or certified by the department.

Financial exploitation means the illegal or improper use, control over, or withholding of the

property, income, resources, or trust funds of the vulnerable adult by another person or entity

for any person’s or entity’s profit or advantage other than the vulnerable adult’s profit or

advantage. Financial exploitation includes, but is not limited to:

(a) The use of deception, intimidation, or undue influence by a person or entity in a

position of trust and confidence with a vulnerable adult to obtain or use the

property, income, resources, or trust funds of the vulnerable adult for the benefit

of a person or entity other than the vulnerable adult;

(b) The breach of a fiduciary duty, including, but not limited to, the misuse of a power

of attorney, trust, or a guardianship appointment, that results in the unauthorized

appropriation, sale, or transfer of the property, income, resources, or trust funds

of the vulnerable adult for the benefit of a person or entity other than the

vulnerable adult; or

without lawful authority, by a person or entity who knows or clearly should know

that the vulnerable adult lacks the capacity to consent to the release or use of

their property, income, resources, or trust funds.

ATTACHMENT A

Definitions

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Mechanical restraint means any device attached or adjacent to the vulnerable adult’s body that

the person cannot easily remove that restricts freedom of movement or normal access to their

body. “Mechanical restraint” does not include the use of devices, materials, or equipment that

are:

(a) Medically authorized, as required; and

(b) Used in a manner that is consistent with federal or state licensing or certification

requirements for facilities, hospitals, or programs authorized under chapter

71A.12 RCW.

Neglect means:

(a) A pattern of conduct or inaction by a person or entity with a duty of care that fails

to provide the goods and services that maintain physical or mental health of a

vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain

to a vulnerable adult; or

(b) An act or omission that demonstrates a serious disregard of consequences of

such a magnitude as to constitute a clear and present danger to the vulnerable

adult's health, welfare, or safety, including but not limited to conduct prohibited

under RCW 9A.42.100.

Physical restraint means the application of physical force without the use of any device, for the

purpose of restraining the free movement of a vulnerable adult’s body. “Physical restraint” does

not include:

(a) Briefly holding without undue force a vulnerable adult in order to calm or comfort

the person; or

(b) Holding a vulnerable adult’s hand to safely escort the person from one area to

another.

Self-neglect means the failure of a vulnerable adult, not living in a facility, to provide for oneself

the goods and services necessary for the vulnerable adult's physical or mental health, and the

absence of which impairs or threatens the vulnerable adult's well-being. This definition may

include a vulnerable adult who is receiving services through home health, hospice, or a home

care agency, or an individual provider when the neglect is not a result of inaction by that agency

or individual provider.

ATTACHMENT A

Definitions

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Vulnerable adult means a person age 18 or older who:

(a) Is sixty years of age or older who has the functional, mental, or physical inability

to care for oneself;

(b) Subject to a guardianship under RCW 11.130.265 or adult subject to

conservatorship under RCW 11.130.360;

(d) Is admitted to a licensed facility (i.e., boarding home, nursing home, adult family

home, soldiers’ home, intermediate care facility for individuals with intellectual

disabilities, or any other facility licensed by DSHS);

(e) Is receiving services from home health, hospice or home care agencies licensed or

required to be licensed under Chapter 70.127 RCW;

(f) Is receiving services from an individual provider; or

(g) Self-directs their own care and receives services from a personal aide under

Chapter 74.39 RCW.

ATTACHMENT B

Clarifying Examples of Abuse, Neglect, Financial Exploitation, And Self-Neglect

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DDA POLICY 5.13, ATTACHMENT B PAGE 16 OF 17 ISSUED 07/2024

The following examples, which are not all-inclusive, are provided to assist staff in identifying

suspected or actual abuse, neglect, exploitation, and self-neglect. While many examples are

straightforward, others may be less obvious and need to be considered in a larger context.

A. Physical Abuse

• Biting

• Choking

• Kicking

• Pinching

• Pushing

• Shaking (especially a child under three years of age)

• Shoving

• Prodding

• Slapping

• Striking with or without an object

• Twisting limbs (joint torsion)

• Causing or willfully allowing the person to do bodily harm to themselves or

willfully allowing another client to physically harm them

• Controlling a person through corporal punishment

• Not allowing the client to eat, drink, or care for physical needs such as elimination

• Retaliation following a physical attack, verbal abuse, or other unwelcome action by a

client

• Using excessive force when restraining an agitated client

B. Sexual Abuse

• Any sexual contact between staff or volunteer of a facility and a client, whether or

not it is consensual

• Inappropriate or unwanted sexual touching including but not limited to:

o Fondling

o Intercourse

o Oral sex

o Rape

o Sodomy

• Sexual coercion

• Sexual harassment

• Sexually explicit photographing, filming, or videotaping

• Showing, selling, or otherwise distributing pornographic materials

• Female genital mutilation as defined in RCW 18.130.460

C. Mental Abuse

• Coercion

• Harassment

ATTACHMENT B

Clarifying Examples of Abuse, Neglect, Financial Exploitation, And Self-Neglect

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DDA POLICY 5.13, ATTACHMENT B PAGE 17 OF 17 ISSUED 07/2024

• Inappropriately isolating a vulnerable adult or child from family, friends, or regular

activity

• Making derogatory or disparaging remarks about a person and their family in front of

the person or within hearing distance of any client

• Oral, written or gestural language threatening harm or intended to frighten clients

• Verbal assault such as ridicule, intimidation, yelling, or swearing

D. Neglect

• Abandoning a client in situations where other persons, objects or the environment

may injure the client

• Allowing the physical environment to deteriorate to the point that a client is subject

to hazardous situations, such as electrical, water, and structural hazards

• Failure to promptly respond to medical emergencies or requests for medical

treatment

• Failure to follow prescribed treatments

• Failure to attend to clients in hostile or dangerous situations

• Failure to supervise which results in a client wandering, missing, or running away

• Willful failure to protect the client from physical abuse by another client or staff

• Willful failure to protect a child from sexual contact with another child

E. Exploitation (Including Personal and Financial)

• Using clients to perform work that should be done by paid employees

• Using client financial resources for personal gain or for activities not related to client

care

F. Self-neglect

Self-neglect occurs when a vulnerable adult is unwilling or unable to do needed self-care

for their physical or mental health. This can include such things as:

• Not eating enough food to the point of malnourishment

• Living in filthy, unsanitary, or hazardous conditions, refusing urgent medical care or a

pattern of declining necessary medical care