Akberet Tekle, V. Washington Department Of Social And Health Services

CourtCourt of Appeals of Washington
DecidedFebruary 18, 2025
Docket86862-4
StatusUnpublished

This text of Akberet Tekle, V. Washington Department Of Social And Health Services (Akberet Tekle, V. Washington Department Of Social And Health Services) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Akberet Tekle, V. Washington Department Of Social And Health Services, (Wash. Ct. App. 2025).

Opinion

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

AKBERET TEKLE, No. 86862-4-I

Appellant, DIVISION ONE

v. UNPUBLISHED OPINION STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES,

Respondent.

SMITH, C.J. — Many people are unable to provide the amount of care and

supervision their vulnerable adult family members need. Society and these

families are served by the existence of residential care facilities, which are

licensed by the State and allow individuals to live in a residential setting while

providing various levels of care and services.

Akberet Tekle was the owner and operator of an adult family home (AFH).

In November 2019, in the early morning hours, one of Tekle's residents left the

home while unattended. The Department of Social and Health Services (DSHS)

cited Tekle for failing to support the resident’s safety and failing to report the

resident missing. Tekle requested an administrative proceeding, where the

administrative law judge (ALJ) affirmed DSHS’s decision. Tekle then petitioned

for review with the Board of Appeal, which affirmed the ALJ’s findings. Tekle No. 86862-4-I/2

now petitions for judicial review of the Board’s decision. Finding no error, we

affirm.

FACTS

Akberet Tekle owned and operated two adult family homes: St. Mary’s

Adult Family Home and Orchard’s Adult Family Home. Tekle has worked as a

caregiver for elderly patients in various settings since 1999. She opened St.

Mary’s in 2008 and Orchard’s in 2019.

Carl1 was admitted to Orchard’s in September 2019. Carl had previously

been a resident at another AFH, but was asked not to return because of his

challenging behaviors. Prior to Carl’s admittance to Orchard’s, an Adult Family

Home Assessment and Plan of Care were prepared. According to the

assessment, Carl suffered from numerous ailments, including dementia without

behavioral disturbances and Alzheimer’s disease. Carl frequently became

agitated and knocked against doors, walls, and other objects, resulting in

abrasions and bruising to his feet, knees, and legs.

According to Carl’s plan of care, 24-hour supervision is required to assist [Carl] with all activities of daily living. Schedule, meals, medications, and finances must be provided for him. He can complete some self-care tasks with set up, repeated cueing, and assistance. He requires accompanying for safety to walk to a safe area in the event of an emergency evacuation.

Carl’s care plan did not define “24-hour supervision.” The plan similarly

failed to include anything about exit-seeking behavior, but Carl regularly

1 To protect his privacy, only Carl’s first name will be used.

2 No. 86862-4-I/3

attempted to exit Orchard’s into the home’s backyard. Prior to the incident at

issue, Carl had never tried to exit through the front door without permission.

Carl’s bed was fitted with an alarm that alerted the caregiver on duty if

Carl tried to exit the bed. Orchard’s also had an alarm for the front door that

sounded anytime someone walked through. When Tekle installed the alarm, she

tested it near the front door but did not check to see if she could hear it in other

rooms of the home. But Tekle testified she heard the alarm activated many times

before the incident in question.

In the morning hours of November 30, 2019, Tekle and her husband were

the two sole caregivers on duty at Orchard’s. Around 5:00 a.m., Carl awoke and

Tekle went to his bedroom. Tekle noticed that Carl had a bowel movement

during the night that required cleaning. She cleaned Carl, removed his soiled

diaper, and placed him in a wheelchair. Tekle then left Carl in the bedroom while

she went to dispose of the garbage and start a shower for him. Tekle testified

these activities took her about five minutes. When Tekle returned to Carl’s room,

she noticed he was missing and began searching the home. Tekle testified she

was searching the house when the doorbell rang and Samantha Boyer, a

neighbor, brought Carl to the door.

Boyer, who lived in the same cul-de-sac as Orchard’s, testified that

sometime in the morning on November 30, 2019, she looked out her window and

saw an “elderly gentleman with only a sweatshirt on, on his knees in front of his

wheelchair, yelling for help.” She stated the man—later identified as Carl—was

outside for about 30 minutes before she called 911 at 5:38 a.m. After calling

3 No. 86862-4-I/4

911, Boyer went outside to assist Carl. She did not check Carl for injuries, but

noticed he had scrapes on his knees and was bleeding. She placed him back in

his wheelchair and wheeled him to Orchard’s. Although Boyer had recently

moved to the area and was not familiar with Orchard’s, it was the only house in

the cul-de-sac with a wheelchair ramp.

A man answered the door when Boyer knocked. When Boyer asked for

“somebody that works here,” the man indicated she was asleep. Upon Boyer’s

request, the man went to get Tekle, who came to the door shortly thereafter.

When Boyer inquired if Carl was a resident, Tekle replied, “[h]ow did you know

he lived here?”2 Boyer stated she found him near her house and assumed he

lived at Orchard’s. Tekle retrieved Carl and brought him back into the home.

Once inside, Tekle checked Carl’s temperature, blood pressure, pulse,

and oxygen levels. Tekle did not note anything abnormal. She also did not

observe any bleeding on his knees or legs. Emergency responders arrived

shortly thereafter and performed an evaluation. They did not note anything

concerning and left.

Linda Conrad, a nurse delegator for Adult Protective Services (APS),

visited Orchard’s in December 2019, five days after Carl’s incident. Conrad

visited the home every 90 days to ensure the clients were “stable and

predictable.” She had only seen Carl once prior to her December visit. During

the December visit, Conrad noted Carl had injuries consistent with the scrapes

2 Tekle testified she responded to Boyer by saying, “yeah, he’s my resident.”

4 No. 86862-4-I/5

and bruising she associated with his behavioral disturbances but nothing that

required more than superficial wound care.

Mary Boyd, an investigator with APS, spoke with Carl’s legal

representative and physician after the incident. Neither expressed concerns

regarding Carl’s safety or his placement at Orchard’s.

Shawn Shawnstrom, an AFH licenser with Residential Care Services

(RCS), also investigated the November 2019 incident involving Carl. Based on

Shawnstrom’s investigation, RCS concluded Tekle violated WAC 388-76-

10400(b)(3) for failing to actively support Carl's safety on November 30, 2019.

Additionally, RCS cited Tekle under WAC 388-76-10225(1)(b)(iii) for failing to

report Carl was missing from Orchard's. Following the investigation, RCS

required Orchard’s to have two caregivers awake and on staff at all times. RCS

also imposed a fine. At a follow-up inspection in February 2020, the RCS

inspector found no deficiencies and deemed the earlier cited deficiencies

corrected.

In June 2020, the Department of Social and Health Services (DSHS)

informed Tekle of its determination that she had neglected a vulnerable adult.

Tekle requested an administrative hearing to challenge the finding of neglect. At

the hearing, Shawnstrom testified DSHS cited Tekle because “the elopement

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