Kiesel v Wadoc Wa Pab Appeal Dismissal 1993 Medical Neglect
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1 BEFORE THE PERSONNEL APPEALS BOARD 2 STATE OF WASHINGTON 3 4 ) SHARON KIESEL, Appellant, 5 v. 6 7 DEPARTMENT OF CORRECTIONS, Respondent. 8 9 ) ) ) ) ) ) ) ) ) Case No. 093-145 MOTION AND ORDER OF DISMISSAL The Appellant hereby notifies the Personnel Appeals Board that she 10 wishes 11 DATED to~draw J VI ""-!. the above-entitled appeal. 6, If7Y } 12 ~RI1~ :.? ~~ rney/Representative 13 14 This matter carne on regularly before the Personnel Appeals Board on 15 the consideration of the request of the Appellant to withdraw her 16 appeal. The Board having reviewed the files and records herein, being fully advised in the premises, and it appearing to the Board 17 that the Appellant has requested to withdraw her appeal, now enters 18 the following: 19 ORDER NOW, THEREFORE, IT IS HEREBY ORDERED that the Appellant's request to 20 withdraw her appeal is granted and the appeal is 21 DATED this 13i'"' day of QLtr\\..Q.. d~smissed. ' 1994. 22 23 24 25 26 27 28 29 30 WASHINGTON STATE PERSONNEL APPEALS BOARD (206) 586·1481 STATE OF WASHINGTON 2828 Capitol Blvd. PO Box 40911 Olympia, WA 98504-0911 (SCAN) 321-1481 PERSONNEL APPEALS BOARD (FAX) 753.0139 June 13, 1994 Robert F. Spaulding Attorney At Law P.O. Box 7846 Olympia, Washington 98507-7846 Re: Sharon Kiesel v. Department Of Corrections, Suspension Appeal, Case No. D93-145 Dear Mr. Spaulding: Enclosed is a copy of the order of the Personnel Appeals Board in the above-referenced matter. The order was entered by the Board on June 13, 1994. Very truly yours, gw:L. \::'. -f41.;J:lp"I ~. Judy cIarson Confidential Secretary gmh Enclosure cc: Sharon Kiesel, APP Joe Olson, AAG Jennie Adkins. PO Sue Zukowski, WFSE o STATE OF WASHINGTON 2828 capitol Blvd. PO BOll 40911 Olympia, WA 98504-0911 (206) 586-1481 (SCAN) 321-1481 (FAX) 753·0139 PERSON NEL APPEALS BOARD June 1, 1994 Robert F. Spaulding P.O. Box 7846 Olympia, Washington 98507-7846 Re: Sharon Kiesel v. Department of Corrections, Case Nos. 093-144 and~ Dear Mr. Spaulding: The Personnel Appeals Board (PAB) has recently been authorized by the Legislature and the Governor to become a full-time board. Therefore the Board requested that all cases which have not yet been heard on the merits be returned by hearings examiners. As you know, the above-referenced cases were previously assigned to be heard by Hearings Examiner Jennifer Woods. In reviewing these cases, it appears that a settlement is pending between the parties. Please let us know by June 17, 1994, what the status of the cases are or whether we should begin the sch~duling process. If the cases have settled, please sign, date and return the enclosed Motion and Order of Dismissal. Very truly yours, q~t'.~ Judy K. Larson Confidential Secretary njh Enclosure cc: ., Sharon Kiesel, App Joseph Olson, AAG Jennie Adkins, PO Sue Zukowski, WFSE Jennifer Woods, HE o CERTIFICATE OF MAILING I ccrtiCy that I mailed a copy of this dol;wneot by depositing with consolidaled~ Services on 2~94 to all panics or their c:ounsel of record. I ccrtiCy under penalty o f ' of the: laws of tile SllIIe of Washiagton Ihat tile foregoiDg is true and com:ct. 9. """'....... '-r, WA. 1 -sJw.1J4r. re@ \& ~ ~ 0 ~ rEu . , PERS~~~;RO 2 ~PflE~ 3 BEFORE THE PERSONNEL APPEALS BOARD STATE OF WASHINGTON 4 S SHARON KIESEL, 6 Appellant, 7 v. 8 9 STATE OF WASHINGTON, DEPARTMENT OF CORRECTIONS, 10 Respondent. 11 8 .'994 NO. D93-144 NO. D93-145 - - !; NOTICE OF SUBSTITUTION OF COUNSEL '. 13 VICTORIA W. SHELDON, Executive Secretary, Washington State Personnel Appeals Board; SHARON KIESEL, Appellant, and her attorney, ROBERT F. SPAULDING. 14 NOTICE 12 TO: ) ) ) ) ) ) } } } } } IS HEREBY GIVEN that JOSEPH W. for MICHAEL Assistant lS Attorney General, 16 Assistant Attorney General, as the attorney for Respondent in the 17 above-entitled action. 18 pleadings herein be served upon the undersigned attorney at the 19 Office of the Attorney General at the address given below. 20 hereby substitutes OLSON, P. SELLARS, It is requested that any and all further DATED this 4th day of February, 1994. 21 22 23 J. SEPH W. OLSON ssistant Attorney General WSBA No. 20706 Attorney for Respondent 24 2S 26 ATTORNEY GENERAL OF WASHINGTON Labor & PenollllCl Division 670 WoodIaDd Square Loop SE NOTICE OF SUBSTITUTION OF COUNSEL -1- PO BOX4014S Olympia, WA 98504-0145 (206) 407-<XlO9 C. F. (RICK) CORDES, III JOHN MCCUTCHEON PARR DARREL L. PEEPLES R. ALAN SWANSON EDWARD EARL YOUNGlDVE, III SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, P.S. ATIORNEYS AT LAW EASTSIDE PROFESSIONAL PLAZA 924 EAST SEVENTIi AVENUE P.O. BOX 7846 OLYMPIA, WASHINGTON 98507-7846 FACSIMILE (206) 754-9268 RAlPH G. SWANSON OF COUNSEL (206) 357-7791 February 2, 1994 WIUlAM LEE PARR (1976) CUFFORD F. CORDES, JR. (1980) fR(fE~fEOWfElDJ FEB 3 ;994 PERSONNEL APPEALS BOARD Ms. Victoria Sheldon Personnel Appeals Board 2828 Capitol Boulevard KKK-11 Olympia, WA 98504-491~ Re: Kiesel vs. DOC Case No. D93-~44 & D93-~45 • Dear Ms. Sheldon: Enclosed, for filing, is our Notice of Withdrawal and Consent to Substitution of Counsel in this matter. By copy of this letter we are hereby serving Mike Sellars, Assistant Attorney General. Very truly yours, . SWANSON, PARR, CORDES, YOUNGLOVE & PE LES, P.S. DLP/jel Enclosure cc: Mike Sellars, AAG Sue Zukowski, WFSE Jennifer Woods, HE ~~©~PII~IDJ 1 FEB 3 1994 2 PERSONNEL BEFORE THE PERSONNEL APPEALS BOARD APPEALS BOARD 3 STATE OF WASHINGTON 4 5 SHARO~ KIESEL, Appellant, 6 7 vs. 8 DEPARTMENT OF CORRECTIONS, 9 Respondent. ) ) ) ) ) ) ) ) ) No. D93-144 D93-145 NOTICE OF WITHDRAWAL AND CONSENT TO SUBSTITUTION OF COUNSEL 10 11 TO: TO: TO: JENNIFER WOODS, Hearing Examiner; and PERSONNEL APPEALS BOARD; and MICHAEL P. SELLARS, Assistant Attorney General. 12 YOU, AND EACH OF YOU, WILL PLEASE TAKE NOTICE that DARREL L. 13 PEEPLES hereby withdraws as attorney for the Appellant, SHARON KIESEL, 14 and consents to the substitution of ROBERT F. SPAULDING of SWANSON, 15 PARR, CORDES, YOUNGLOVE & PEEPLES, P.S., 924 E. 7th Avenue, Suite A, 16 P.O. Box 7846, OlYmpia, Washington 98507-7846, as attorney for said 17 Appellant. 18 DATED this 19 20 21 22 23 2. J! day of February, 1994. SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, P.S. . N, PARR, CORDES, & PEEPLES, P.S. ~)uNGLOVE IM~e"~~:!;:;~t:;~t::=~",~I#;,~;::::~_ ROBERT F. SPA ING WSBA 17323 WSBA 24 25 26 SWANSON, PAIUI, 00JlDES, YOlIMGtCNl!. PJ!I!PLES • W\'CtDJ'P, P.s. II Substitution of Counsel Page 1 A11'ORNEYS AT lAW EASTSIDE PROFI!SSIONAL PlAZA. SUITI! A 924 EAST SEVEN1lI AVI!N1JI! P.O. BOX 7846 OLYMPIA" WASHINGTON 118507-7846 PACSIMlIJ! (206) 7S4-1l268 (2Il6) 357-7791 C. F. (RICJ<) CORDES, ID JOHN McCUiCHEON PARR DARREL L. PEEPLES R. ALAN SWANSON EDWARD EARL YOUNGLOVE, III SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, P.S. A'ITORNEYS AT LAW EASTSIDE PROFESSlONAL PLAZA 924 EAST SEVENTII AVENUE P.O. BOX 7846 OLYMPIA, WASHINGTON 98507-7846 FACSIMILE (206) 754-9268 RALPH G. SWANSON OF COUNSEL (206) 357-7791 January 27, 1994 WIWAM LEE PARR (t976) CUFFORD F. CORDES, JR. (t980) ~1E©IEH/IEfD) JAN 28 1994 PERSONNEL.: APPEALS BOARD Ms. Victoria Sheldon Personnel Appeals Board 2828 Capitol Boulevard KKK-11 Olympia, WA 98504-4911 Re: Kiesel vs. DOC Case No. D93-144 & 093-145 Dear Ms. Sheldon: Enclosed, for filing, is our Notice of Withdrawal and Consent to Substitution of Counsel in this matter. By copy of this letter we are hereby serving Mike Sellars, Assistant Attorney General. Very truly yours, . SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, P.S. , .-" ... _.--;><.....; (. ---7.... ~~.- - '-.-._.__ .~.;// [";6;7)0(/-'. '7~/!-£"L----_1-./ \# /,' Judith . )i.utl';er ~ Legal A~~~~~ant ---..pLP-/ jel Enclosure cc: Mike Sellars, AAG Sue Zukowski, WFSE Jennifer Woods, HE f&1E~IEDWlIE 1 2 3 BEFORE THE PERSONNEL APPEALS BOARD 4 STATE OF WASHINGTON 5 SHARON. KIESEL, 6 JAN 28 1994 PERSONNEL' APPEALS BOARD } ) } } Appellant, 7 vs. } 8 DEPARTMENT OF CORRECTIONS, ) ) } 9 Respondent. } No. D93-144 D93-145 NOTICE OF WITHDRAWAL AND CONSENT TO SUBSTITUTION OF COUNSEL 10 11 TO: TO: TO: JENNIFER WOODS, Hearing Examiner; and PERSONNEL APPEALS BOARD; and MICHAEL P. SELLARS, Assistant Attorney General. 12 YOU, AND EACH OF YOU, WILL PLEASE TAKE NOTICE that EDWARD E. 13 YOUNGLOVE hereby withdraws as attorney for the Appellant, SHARON 14 KIESEL, 15 and consents to the substitution of DARREL L. PEEPLES of SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, P.S., 924 E. 7th Avenue, 16 Suite A, P.O. Box 7846, Olympia, Washington 98507-7846, as attorney 17 for said Appellant. 18 DATED this 19 1r day ~ of January, 1994. SWANSON, PARR, CORDES, :: 22 23 YOUNG(;§, L~VE. & .PEEPLES. P. S • ~/i ~ZLZ~ ~ ---c/tIC· ~/- __-------EDWARD .BY.' --YOUNGLOVE =D~~E~L~PE-¥E~~~"""""':""'--~----- WS~~873--~' WSBA 885 24 25 26 SWANSOH. PAII1l" lDIIDlS, 'YDUNGIDVE" PI!EPU!S a: WYaDFP. P.5. II Substitution of Counsel Page 1 ATIORN£'tS AT lAW EASTSIDE PROFESSIONAL PlAZA. SUITE A 924 EAST SEVENTH AVENUE P.O. BOX 7846 OLYMI'IA, WASHINGTON 98507·7846 FACSIMILE (206) 754-9268 (206) 357·7791 !M~~IE~W~IDJ 1 BEFORE THE PERSONNEL APPEALS BOARD 2 STATE OF WASHINGTON 3 SHARON KIESEL, Appellant, 4 vs. 5 6 DEPARTMENT OF CORRECTIONS, 7 R~spondent. ) ) ) ) ) ) ) ) ) ) JAN 7 - 1994 PERSONNEL APPEALS BOARD - Case Nos. D93-144 and 145 NOTICE OF HEARING - 8 TO: SHARON KIESEL, Appellant, and EDWARD EARL YOUNGLOVE, III, her attorney; AND TO: MICHAEL P. SELLARS, Assistant Attorney General; 9 10 11 PLEASE TAKE NOTICE that the above-captioned matter will come 12 on for hearing before JENNIFER WOODS, Hearings Examiner, on Monday, 13 March 7, 14 Division of Community Corrections, 10109 South Tacoma Way, Building 15 C, Tacoma, Washington. 16 1994 at 10:00 a.m. at the Department of Corrections, DATED this 6th day of January, 1994. 17 PERSONNEL APPEALS BOARD STATE OF WASHINGTON 18 \5\ 19 , By: 20 \ JENNIFER WOODS Hearings Examiner 21 cc: 22 23 Jennie Adkins Laura Saint Linda Giles Victoria Sheldon 24 25 26 27 28 NOTICE OF HEARING -1- JENNIFER WOODS Attorney at Law 715 North 193rd Place Seattle, WA 98133 (206) 546-9081 CASE ASSIGNMENT 11/19/93 RE: Case No.: Case Name: D93-145 Sharon Kiesel v. DOC The above-referenced case has been assigned to: Hearings Examiner Phone: Jennifer Woods 715 N 193rd PI Seattle, WA 98133 206-546-9081 You will be contacted by the hearings examiner to arrange a date and location for the hearing. cc: Sharon Kiesel Edward Earl Younglove Michael P. Sellars Sue Zukowski 5 WlIE ~ IU VI IE lID .TIFICATEOF MAILING I ea1lfy !bat I mailed a copy of lhIs doc:umem by depoaillDg wiIb Consolidaled Mail Services on 11-08-93 to aU panics or lhcir COlIDSd of record. I certify WIder pcoalty of perjury of Ihc laws of Ihc swc of WllShiIIgton lbat Ihc forcgoiDg is true aud comet. 1 s;;.. . .,. ~ Cl . W V NOV 101993 PERSONNEL ~ ~ APPEALS BOARD BEFORE THE PERSONNEL APPEALS BOARD 2 STATE OF WASH:INGTON 3 SHARON KIESEL, } ) 4 Appellant, 5 v. 6 7 STATE OF WASHINGTON, DEPARTMENT OF CORRECTIONS, 8 Respondent. } } } ) ) ) } NO. 093-144 and 093-145 NOTICE OF APPEARANCE } ) 9 TO: 11 VICTORIA W. SHELDON, Wash. State Personnel Appeals Board; SWANSON, PARR, CORDES, YOUNGLOVE & PEEPLES, Attorneys for Appellant; SUE ZUKOWSKI, Washington Federation of State Employees. 12 PLEASE TAKE NOTICE that the Respondent, State of Washington, 13 Department of Corrections, without waiving objection as to the 14 sufficiency of service of process or jurisdiction of this Board, 15 does hereby enter its appearance in the above-entitled action, by 16 and 17 General, and MICHAEL P. SELLARS, Assistant Attorney General, and 18 requests that all further pleadings herein be served upon said 19 Respondent at the Office of the Attorney General at the address 20 given below. 10 21 through its attorneys, CHRISTINE 0.' GREGOIRE, Attorney DATED this 8th day of November, 1993. 22 CHRISTINE O. GREGOIRE Attorney General 23 ~ELLARS Assistant Attorney General 24 WSBA No. 21331 Attorney for Respondent 25 26 NOTICE OF APPEARANCE -1- ATfORNEY GENERAL OF WASHINGTON Labor It Pmonnd Division 670 Woodland Square Loop SE PO BOX 40145 Olympia, WA 98504-0145 (206) 4ff1-«X» 1 2 STATE OF WASHINGTON 4 NOV 04 1993 Respondent. 9 10 BU©~n/~fD) BEFORE THE PERSONNEL APPEALS 3 TO: The Department of Corrections, by and through its Attorney, KATHY NOLAN: 11 12 13 NOTICE IS HEREBY GIVEN that the firm of YOUNGLOVE & PEEPLES, P.S., hereby makes its behalf of the appellant, above named, and a should be served upon said firm at the office DATED this 14 L day of SWANSON, PARR, CORDES, appearance for and on copy of all pleadings address below stated. /l~ 1993. 15 16 17 18 19 20 Office and Post Office Address: 21 23 Eastside Professional Plaza, Suite A 924 E Seventh Avenue PO Box 7846 Olympia, washington 98507 (206) 357-7791 24 cc: 22 Sue Zukowski 25 26 SWANSON. PABR. amms, lOUNGLOVE Ir PEEl'UiS, p.s. ATTOIlNEYS AT lAW EASlSIDE PROFESSIONAL PlAZA. sum A 924 EAST SEVEN11I AVENUE P.O. BOX 78016 OLYMPIA, WASHINGTON 118507·78016 FACSIMILE (206) 754-9268 NOTICE OF APPEARANCE (206) 357·7791 2828 Capitol 8lvd. STATE OF WASHINGTON PO Box 40911 PERSONNEL APPEALS BOARD Olympia. WA 98504-0911 (206) 51J6.1481 (SCAN) 321-1481 (fAX) 753-0139 . November 1, 1993 Sue Zukowski, Area Representative Washington Federation of State Employees 10116 - 36th Avenue Court SW, 116 Tacoma, Washington 98499 RE: Sharon Kiesel v. Department of Corrections, Suspension Appeal Case No. 093-145 and Dismissal Appeal Case No. 093-144 Dear Ms. Zukowski: Your letters of appeal to the Personnel Appeals Board were received on October 27, 1993. These matters are being assigned to Hearings Examiner Jennifer Woods. You will be contacted to arrange a date, time and location for the hearing. Sincerely, Victoria W. Sheldon Executive Secretary VWS:njh cc: Sharon Kfesel, App Cordes, Younglove & Peeples, Atty Kathy Nolan, AAG Jennie Adkins, PO o .. ~~ 3,. .JiiM.t.6..vac. w; ntit UihSW4UAMt.4#AA4J..mA4. . j. ,( )tdt.tt.h3..ttP..&kh.k.t.&. ( i""'W.Q.. (W.w.&.«:&.&Xtw. 'M:«««!.cm"~IQ< .J&..M:;;,M. . h .M &.£.Q.0.:3 AQ.GW.@$&.J ... lUMPJtt.t,. tn.MM> CHASE AIVELANO Sectelary STATE OF WASHINGTON DEPARTMENT OF CORRECTIONS McNEIL ISLAND CORRECTIONS CENTER P. O. Box 900 • Steilacoom, Washington 98388·0900 October 7, 1993 Sharon Kiesel 8521 29th Ave. Ct. S. #6 Tacoma, WA 98409 CONFIDENTIAL -PERSONAL SERVICE Ms. Kiesel: This is official notification that you are being suspended without pay from your position as a Pharmacy Assistant-A from the beginning of your workshift on October 11, 1993 through the end of your workshift on October 15, 1993. This disciplinary action is taken pursuant to the Civil Service Laws of Washington State, Chapter 41.06, Revised Code of Washington, and the Merit System Rules, Title 356, Washington Administrative Code (MSR), and Sections 356 -34 - 010 (1) (a) Neglect of Duty, (b) Ineff iciency, (c) Incompetence, and 356-34-030 Suspension - Duration - Procedure. Specifically, you neglected your duty, and were inefficient and incompetent when on June 9, 1993 you 1) incorrectly filled a prescription for inmate Henry C., No. 177695, by dispensing a lower dosage than what was prescribed by the physician; and 2) produced two prescription labels' with erroneous instructions and affixed them to containers which you filled with medication for dispensation to inmates Robert F., No. 177731, and Dean S., No. 177723, respectively. These actions are described in more detail in the Employee Conduct Report, which was completed on July 20, 1993 (attachment 1). As a licensed Pharmacy Assistant A, you have a duty to dispense medication appropriately and accurately. In fact, the safety and wellbeing of inmates depend on it. With your nearly twelve years of relevant experience, I can find no excuse for you not accomplishing your job requirements in a timely, accurate and competent manner. You have an obligation to ensure that your work is done precisely; however, the errors which you made on June 9, 1993, illustrate a continuous pattern of inattention to detail which you have unfortunately developed subsequent to your assuming your Pharmacy Assistant position at this institution. You have been counseled relative to your carelessness and warned about the consequences should these serious errors continue. Evidence of this counseling and identification of possible consequences is included in two corrective interview documents, dated May 14, 1993, and June 2, 1993, (attachments. 2 and 3 respectively) which specifically cite several instances of prescription dispensation errors on your part. Sharon Kiesel October 7, 1993 Page 2 of 2 Additionally, on May 28, 1993, you received a letter of reprimand for incorrectly filling one prescription and failure to fill two others (attachment 4). By your failure to properly fill prescriptions you have placed this institution in an untenable position; open to litigation, and other repercussions to the inmates in our care ranging from minimal medical reactions to loss of physical well-being, up to and including the loss of life. You have seriously neglected your duty, and demonstrated inefficiency and incompetence by the careless way in which you have carried out your duties. Additionally, you have neglected your duty by disregarding the numerous instances of supervisory direction you received. Although you have only been at MICC since March 15, 1993, I am appalled at the level of unacceptable performance in such a short time. Your previous work in a similar setting demonstrated your ability to perform your duties in an acceptable manner. I believe the disciplinary action outlined in paragraph one is warranted, and sincerely hope that it convinces you of the seriousness of your actions and deters you from further incidents of t~is nature. Future wrongdoing on your part may result in further corrective or disciplinary action being taken against you, up to and including dismissal. Attachments one through four are attached hereto and by this reference, made a part hereof as though fully set forth herein. Under the provisions of WAC 358-20-010 and WAC 358-20-040, you have a right to appeal this action to the Personnel Appeals Board. Your appeal must be filed in writing at the Office of the Executive Secretary, Personnel Appeals Board, thirty (30) days after the first day of your suspension as stated in paragraph one of this letter. The Merit System Rules, Washington Administrative Code, and Department of Corrections policies are available for your review in the personnel Off~~ Eldon Vail, Superintendent Attachment(s) cc: Dennis Karras, Director, Department of Personnel Jennie Adkins, Director, Division of Human Resources James Blodgett, Assistant Director, Division of Prisons K&thy Nolan, Sr. Assistant Attorney General Donna Grazzini, Area Personnel Manager Katherine Nagel, MIce Personnel Officer Personnel file 093--}L{, ~~~~~\Yl~~ APPEAL FORM OCT 27 1993 WASHIOO'ION STATE PERSONNEL APPEALS BOARD 2828 Capitol Boulevard P. o. Box 40911 Olympia, WA 98504-0911 PH: F~ SCAN 321-1481 (206) 586-1481 (206) 753-0139 PERSONNEL APPEALS BOARD 'Ibis fo.rm will help you provide necessary infoJ:mation to the Personnel Appeals Board when you file an appeal. You are !!Qt. required to use this fODn; however, appeals JnY§t. be filed in accordance. with the requirements set forth in Chapter 358-20 WAC. If the space on the form is insufficient or if you wish to provide additional infonnation, you may attach addi tiona! pages. PRIm OR TYPE - SIGN ON PAGE 2 PART I. APPELi.ANJ,' ID~FlCA'I'IQl KIESEL, SHARON ~: (last name, first name, middle initial) HOME ADDRESS: 8521 29th Avenue Ct S. #6 (Number and street) Tacoma, WA 98409 (City, state and ZIP code) PHONE NUMBERS: EMPLOYI~ 'AA)R1(; (SCAN): HOME: (Include area code) AGENCY OR INSTrTtJT.I:ON: _ (Off-SCAN): _ (206) 584-9325 _ Department of Corrections (McNeil Island_ ee) . 't ' that t 00k a c t · are a ppeal'J.ng: ution oniyou Agency or ulSti DOC _ REPBESmrA'I'IVE' S NAME, ADDRESS AND TELEPHCNE NUMBER: Swanson, Parr, Cordes, Younglove Sue Zukowski 'Peeples and Wyckoff, P.S. Area Representative PO Box 7846 10116 36th Avenue Court, #16 .9Jym~ia\= WA 98507 (PH:357-7791ka Tacoma. WA 98499 (PH: 58t-4402) An .ApPel. arr may aUUlUL:.LZe a represe five to act on me!her behalf. '!he Board must be notified. of any change in .representation. PART III. TYPE OF APPEAL Check one of the following to indicate the type of appeal you are filing: PART II. X a. Disciplinary: (check applicable action(s». _ _Dismissal, _x_Suspension, _ _Demotion, b. Disability separation c. Rule or law Violation (complete PART IV. of this form) d Reduction in Force/layoff (complete PART IV. of this fom) e. Allocation (position classification) (complete PART V. of this fom) f. Declaratory Ruling (see g. Exemption of Pesition ~ 358-20-050) 1 . '~ (.hi .M _ _Reduction in Pay. MAtA ....... _.4# M&Ul.<.':' . . M.l.&.Mi ..W .. .K;;W.. MW,l.UW:mPW&..&.v... h..AJ.s.t .c33&U:x:( Appeal form Revised 7·1·93 .... e.: Q.@.t¥.. Q. ; . J , ;. ..P:' WMt=X@i 1m; .. aws hX.! :.. It PART IV. FOR. ROLE VIQLA'1![~ OR REDUCTIctJ-IN-FtIRCE APPEALS cm,y What Rule(s) or Law(s) do you :believe were violated? Explain the particular circumstances of the alleged violation How were you adversely affected by the alleged violation? . What remedy are you requesting in this case? PART V. FOR ALU::CAT.ICN APPEALS cm,y Has there been a review of your allocation? If so, by whom? _ _Yes or _ _No _ What is your present classification? _ To which class do you think your position should be allocated? SIGNED ..... '. 2 Appell Form Rulud 7.t.9]