MDHHS-ORRCase File Review - INVESTIGATION
Date: / Agency: / ORR Reviewer:case number / TOTAL
ACKNOWLEDGEMENT LETTER
Copy of Complaint sent with Acknowledgement Letter
STATUS REPORTS
30 Day Status Report contains: Allegations, Citations. Issues. Investigative Progress to Date, and Expected Date of Completion
60 Day Status Report contains: Allegations, Citations. Issues. Investigative Progress to Date, and Expected Date of Completion
If necessary, further Status Reports issued on a timely basis
REPORT OF INVESTIGATIVE FINDINGS - ALLEGATION
Identifies date received by ORR
Identifies complainant
Identifies date of incident
Provides a succinct description of alleged violation
If necessary, is clarifying information related to additional information or other investigations included?
REPORT OF INVESTIGATIVE FINDINGS - CITATIONS
Are all relevant provisions of the Mental Health Code or other applicable laws cited?
Are all relevant provisions of the Administrative Rules?
Are all relevant provisions of Agency policy cited?
REPORT OF INVESTIGATIVE FINDINGS - ISSUES
Are all relevant issue questions addressed?
Do the issue questions use the appropriate elements of the allegation and citations?
REPORT OF INVESTIGATIVE FINDINGS - FINDINGS
Do the findings indicate that the complainant was interviewed? If not, is an explanation provided?
Do the findings indicate that the recipient was interviewed? If not, is an explanation provided?
Do the findings indicate that all potential witnesses were interviewed? If not, is an explanation provided?
case number / TOTAL
Do the findings indicate that the accused was interviewed? If not, is an explanation provided?
Do the findings contain dates of interviews, dates documents were examined, and implementation dates of policies?
REPORT OF INVESTIGATIVE FINDINGS - CONCLUSION
Is the definition of preponderance of evidence provided?
Are all issue questions referenced?
REPORT OF INVESTIGATIVE FINDINGS - CONCLUSION
Is there detailed, clear, and logical support for the answer to each issue question?
Is there a clear statement of whether or not the right was violated based on a preponderance of the evidence?
Does this statement identify the staff person(s) or entity responsible for the violation?
Does this statement identify the Code protected right that was violated?
If the violation is substantiated against an “entity” is there an explanation as to why?
REPORT OF INVESTIGATIVE FINDINGS - RECOMMENDATIONS
Does this section contain a restatement of MHC 330.1722(2)?
Does this section contain a restatement of AR 330.7035 (1) or AR 330.1780 (1) as appropriate?
If the violation requires disciplinary action, is that recommended in the appropriate manner?
Do the recommendations address actions that will remedy the violation and prevent recurrence?
REPORT OF INVESTIGATIVE FINDINGS – OTHER REQUIREMENTS
Does the RIF identify the writer and the date the report was issued?
Is there documentation in the file that the report was sent to the RMHA and respondent (if necessary)?
case number / TOTAL
If this case involves ABUSE, NEGLECT, RETALIATION/HARASSMENT, is there documentation that the investigation was initiated immediately?
If this case involves any other rights violation is there documentation that the investigation was initiated in a timely and efficient manner?
SUMMARY REPORTS
Does the report contain the allegation statement from the RIF?
Does the report contain the citations from the RIF?
Does the report contain the issue questions from the RIF?
Does the report provide a summary of the investigative findings which is sufficient to enable the reader to determine if the findings are complete and accurate?
Does the report contain the conclusion of the Rights Office from the RIF?
Does the report contain the recommendations of the Rights Office from the RIF?
Does the report contain an indication of all action taken to remedy the violation and prevent its recurrence, or does it provide a plan of action which addresses the violation, will be implemented in a timely manner, and attempts to prevent its recurrence?
Does the report identify the person or persons who have violated the right?
Is there a statement of the right to appeal and information on the option to mediate included with the Summary Report?
Does this statement address timeframes, grounds, and process for submitting an appeal?
Does the statement offer information and agencies that can assist with the appeals process or offer the assistance of the Rights Office?
case number / TOTAL
CASE FILE INFORMATION
Does the case file contain all relevant evidence gathered during the course of the investigation?
If required, is there documentation that disciplinary action was taken, and it met the requirements set forth in AR 7035 (1)?
Is there documentation of all remedial action taken?
Was information distributed as a result of this investigation done within the parameters identified in MHC 330.1748?
Was information distributed as a result of this investigation done within the parameters of all rights of employees?
If there was a plan of action identified in the Summary Report is there documentation that indicates that potential appellants and ORR were notified when the action was completed and that potential appellants were notified of their right to appeal the action?
If there was a plan of action identified in the Summary Report and the action that was taken is different is there documentation that indicates that potential appellants and ORR were notified and that potential appellants were notified of their right to appeal?
Revised 03/18 Page 1 of 4