In the Matter of the Appeal by Angela Khanai of the Maltreatment Determinations, Orders of Disqualification, Order to Pay a Fine, and Orders of Revocation.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2016).

STATE OF MINNESOTA
IN COURT OF APPEALS
A17-0310

In the Matter of the Appeal by Angela Khanai of the Maltreatment Determinations,
Orders of Disqualification, Order to Pay a Fine, and Orders of Revocation.

Filed December 26, 2017
Affirmed
Reilly, Judge

Minnesota Department of Human Services
OAH Docket No. 14-1800-32758

Mary E. Cincotta, Throndset Michenfelder, LLC, St. Mich ael, Minnesota (for relator
Angela Khanai)

Lori Swanson, Attorney Genera l, Kathleen M. Ghreichi, Assi stant Attorney General, St.
Paul, Minnesota (for respondent Commissioner of Human Services)

Considered and decided by Worke, Presid ing Judge; Rodenberg, Judge; and Reilly,
Judge.
U N P U B L I S H E D O P I N I O N
REILLY, Judge
Relator challenges the commissioner of human services’ decision affirming three
maltreatment determinations, disqualifying relator from administering department of
human services’ (DHS) programs, and revoking relator’s licenses to operate a foster-care
home. Because the decision was based on substantial evidence in the record, we affirm.

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FACTS
In 2015, relator Angela Khanai operated a foster-c are home for two vulnerable
adults (VAs, singularly VA1 and VA2) at her residence. That summer, DHS received three
reports of maltreatment at relator’s facility . DHS investigated the reports and found
substantiated maltreatment for all three incident s. First, DHS determined relator secured
her front door shut with a bungee cord and periodically locked the door to the VAs’ living
area in the lower level, which limited their free access to all the living areas in the residence.
Second, DHS determined relator failed to keep adequate records of the VAs’ medications,
and DHS could not verify that the VAs had received their proper medications for a period
of three months. Third, DHS determined relator failed to assist a VA after a nighttime bout
with diarrhea.
DHS found that the maltreatment was recu rring and disqualified relator from any
position allowing direct contact with or access to pe rsons receiving services from
DHS-licensed programs. The commissioner also revoked relator’s license to provide adult
foster care and home- and community-based services.
On review, the administrative-law judge (ALJ) concluded that DHS proved each
incident of relator’s maltreatment of the VA s by a preponderance of the evidence. The
ALJ found the maltreatment to be recurring and found that DHS properly disqualified
relator from direct contact with persons receiving DHS services. The ALJ concluded that
relator failed to prove by a preponderance of the evidence that she was in full compliance
with the law during the incide nts of maltreatment. The ALJ al so determined that relator
did not comply with the applicable laws or rules and that relator’s license revocation was

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justified. Relator did not testify at the AL J hearing and offered on ly one exhibit, which
was included to impeach VA1’s testimony.
The commissioner adopted the ALJ’s finding s of fact and conclusions of law and
issued her decision. The commissioner affirmed the maltreatment determinations, relator’s
disqualification, and the licen se revocations. The commissioner also denied relator’s
request for reconsideration. This appeal follows.
D E C I S I O N
Relator challenges the commissioner’s finding s as lacking the support of substantial
evidence in the record. On review of an agency decision in a contested case, this court may
reverse or remand if the decision is unsupported by substantial evidence in view of the
entire record as submitted. Minn. Stat. § 14 .69(e) (2016). A contested case is any
proceeding before an ag ency in which the “leg al rights, duties, or privileges of specific
parties are required by law . . . to be determined after an ag ency hearing.” Minn. Stat.
§ 14.02, subd. 3 (2016). Maltreatment determinations and disqualifications for recurring
maltreatment are contested cases, because they are entitled to an agency hearing for review.
Minn. Stat. § 256.045, subds. 3(4), 3(10) (2016).
This court will reverse a commissioner’s de cision if it is unsupported by substantial
evidence in the record. Sweet v. Comm’r of Human Servs. , 702 N.W.2d 314, 318 (Minn.
App. 2005), review denied (Minn. Nov. 15, 2005). Substa ntial evidence is: “(1) such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion;
(2) more than a scintilla of ev idence; (3) more th an some evidence; (4) more than any
evidence; and (5) evidence cons idered in its entirety.” Dourney v. CMAK Corp. , 796

4
N.W.2d 537, 539 (Minn. App. 2011) (quotation omitted). An administrative agency’s
decision enjoys a presumption of correctness, and the appellate court defers to the agency’s
expertise and special knowledge in its field. In re Cities of Annandale & Maple Lake, 731
N.W.2d 502, 513-14 (Minn. 2007).
I.
A Minnesota Statute defines maltreatment as including “abus e” and “neglect.”
Minn. Stat. § 626.5572, subd. 15 (2016). “Abuse” is “[c]onduct which is not an accident
or therapeutic conduct . . . which produces or could reasonably be expected to produce
physical pain or injury or emotional distress.” Id., subd. 2(b) (2016). Such conduct could
include “use of repeated or malicious . . . lang uage . . . considered . . . to be disparaging,
derogatory, humiliating, harassing, or threatening” and “use of any aversive or deprivation
procedure, unreasonable confinement, or involuntary seclusion . . . .” Id., subds. 2(b)(2)-
(3). “Neglect” is “[t]he failure or omission of a caregiver to supply a vulnerable adult with
care or services, including . . . health care[] or supervision which is . . . reasonable and
necessary to obtain or maintain the vulnera ble adult’s physical or mental health or
safety. . . .” Id., subd. 17(a)(1) (2016). Additio nally, under licensing standards,
residential-care residents must have “use of and free access to common areas in the
residence.” Minn. Stat. § 245D.04, subd. 3(b)(3) (2016).
There is substantial evidence in the reco rd to support each of the commissioner’s
three maltreatment determinations.
First, DHS documentation, DHS inves tigator testimony, and VA1’s testimony
support the commissioner’s maltreatment determination that relator limited the VAs’ free

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access to the living areas in the residence. According to the eviden ce, relator routinely
locked the door from the basement to the upstairs living area, denying the VAs “free access
to common areas in the residence.” Id. The use of a chair and an alarm system to block
access to the kitchen and the main floor during the night also limited “free access.” Id.
The front door tethered with a bungee cord prevented “free access” to and from the front
entrance of the house. Id. Further, relator told VA1 that she should not use the bathroom
upstairs because she was dirty and smelly. VA2 reported not feeling accepted while living
there. Confining the VAs to the bottom floor of a residence is not acceptable conduct for a
foster-care provider under Minnesota law. Substantial evidence in the record supports this
maltreatment determination.
Second, DHS documentation, DHS investig ator testimony, pharmacy records, and
relator’s own documentation of the VAs’ medical care support the commissioner’s
maltreatment determination that relator failed to administer necessary health care to the
VAs. Under Minnesota law, a residential-care license- holder must record a VA’s
medication on their medication administra tion record (MAR) for each medication
administered. Minn. Stat. § 245 D.05, subd. 2(c)(1-5) (2016). The VAs in this case were
prescribed antipsychotics, an tidepressants, and antianxiety medications, among others.
There is evidence in the record that relator did not administ er the correct medications to
the VAs. Relator completed MARs for March a nd some of April, but not May, June, or
July. Even where relator completed an MAR, numerous medications were missing from
the record, and the commissi oner fairly inferred that the medications were not
administered. Relator failed to keep adequate records or provide the VA s the correct

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medications, which provides substantial evidence of “neglect,” or, the “absence of care . . .
essential to obtain or maintain the vulnerable adult’s health . . . .” Minn. Stat. § 626.5572,
subd. 17(b) (2016). Substantial evidence in the record suppor ts this maltreatment
determination.
Finally, DHS documentation, DHS invest igator testimony, and VA1’s testimony
supports the commissioner’s maltreatment determ ination that relator failed to assist VA1
after a nighttime bout of diarrhea. “Neglect” is “[t]he failure or omission by a caregiver to
supply a vulnerable adult with care or services , including . . . health care[] or supervision
which is . . . reasonable and necessary to obtain or maintain the vulnerable adult’s physical
or mental health or safety . . . .” Id., subd. 17(a)(1). The evidence establishes that relator
did not assist VA1 after she woke up in the middle of the night covered in diarrhea. Relator
told VA1 to take a shower an d to leave her bedding in the bathtub. VA1’s care plan
described how she would need assistance while bathing, which is such “supervision which
is . . . reasonable and necessary to . . . mainta in the [VA’s] physical or mental health or
safety . . . .” Id.; see also Minn. Stat. § 626.557, subd. 14 (2016) (requiring a caregiver to
provide care outlined in a resident’s care plan ). VA1 reported being in the shower for 45
minutes, because it took a long time to wipe a nd clean all of the diarrhea from her body.
Relator did not assist VA1 with bathing or changing her bed linens. Substantial evidence
in the record supports this maltreatment determination.
Relator did not testify or present meaningf ul evidence at the ALJ hearing. As a
result, DHS presented most of the evidence. Viewing the reco rd as a whole, there is no

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evidence controverting the commissioner’s fi ndings, and we conclude that there is
substantial evidence in the record to support the decision.
II.
Relator challenges the commissioner’s failu re to provide a conditional license or
other equitable relief. Under Minn. Stat. § 245A.07, subd. 1 (2016), the commissioner may
revoke a license when the license-holder does not comply with the applicable law. When
deciding whether to invoke sanctions, the commissioner must consider the “nature,
chronicity, or severity” of the violations and the effect on the persons served by the license-
holder. Id.; see also Minn. Stat. § 245C.02, subd. 16 (2016) (defining “recurring
maltreatment” as more than one incident of maltreatment for which the person is
responsible); Minn. Stat. § 245C.15, subd. 4(b)(2) (2016) (disqualifying an individual from
working with DHS clients for seven years after substantiated recurring maltreatment). We
presume the agency’s decision is correct and show deference to an agency’s conclusion in
an area of its expertise. W. McDonald Lake Assoc. v. Minn. Dep’t of Nat. Res., 899 N.W.2d
832, 837 (Minn. App. 2017) (quotation omitted). We will reverse a commissioner’s
decision if it is not supported by substantial evidence in the record. Sweet, 702 N.W.2d at
318.
Relator offers no factual or legal supp ort for her argument that the commissioner
erred by failing to grant a conditional license or other equitable relief. Relator simply lists
the alternative penalties available to the commissioner without providing any reasons why
they should have been imposed. See Minn. Stat. § 245A.06, subd . 1 (2016) (describing
correction orders and conditional licenses as alternative penalties for failing to comply with

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the applicable law). Relator makes no arguments about the “nature, chronicity, or severity”
of the maltreatment episodes. Minn. Stat. § 245A.07, subd. 1. The commissioner did not
err by revoking relator’s licenses to operate a residential-care home , and we affirm the
decision.
Affirmed.