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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.

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\& ~

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.

,

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
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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

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Appeal form
Revised 7·1·93

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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]

 

 

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