Clawson v. Board of Registered Nursing ( 2021 )


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  • Filed 12/17/21
    CERTIFIED FOR PUBLICATION
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    FIRST APPELLATE DISTRICT
    DIVISION FIVE
    WILLIAM MICHAEL CLAWSON,
    Plaintiff and Appellant,                 A159990
    v.
    BOARD OF REGISTERED NURSING,                    (City & County of San Francisco
    Defendant and Respondent.                Super. Ct. No. CPF19516578)
    Plaintiff appeals from the denial of his petition for writ of
    administrative mandate following the revocation of his nursing license by the
    Board of Registered Nursing (Board) for gross negligence and unprofessional
    conduct in carrying out licensed nursing functions and unprofessional
    conduct–deceit. We affirm.
    FACTUAL AND PROCEDURAL BACKGROUND
    I.     Board Hearing
    Nina’s Care Home (Nina’s) was a residential care facility for the elderly
    (RCFE) licensed by the Community Care Licensing Division (CCL) of the
    State Department of Social Services. Following the unexpected death of the
    Nina’s administrator, an attorney for the administrator’s estate, Lisa Russ,
    hired plaintiff to assist with the closure of Nina’s. Plaintiff, who was a
    registered nurse and a certified legal nurse consultant, agreed to assess each
    of the residents and recommend a new facility for them, as required by the
    1
    RCFE closing procedures. The purpose of the assessments was to help the
    residents choose an appropriate facility based upon their needs.1
    On May 11, 2013, plaintiff and Mia B.2 performed the assessment for
    J.N., an 83-year-old resident of Nina’s. Mia B. lifted up J.N.’s clothing so that
    the plaintiff could see her skin condition. Plaintiff testified the assessment
    was “very quick. We were in there for maybe two minutes.” Plaintiff found
    that J.N.’s skin on her coccyx and on each of her heels was red and
    nonblanching to the touch, which he believed was significant.3 He did not
    touch the bandages covering J.N.’s feet. Nor did he notice that one of J.N.’s
    knees was significantly contracted.
    Plaintiff signed the resident appraisal form using his “RN” initials and
    described J.N.’s overall health condition as: “Frail and cachextic [sic] female
    1     Health and Safety Code section 1569.682, subdivision (a)(1)(A)
    requires that prior to transferring a resident to another facility an RCFE
    must “[p]repare . . . a relocation evaluation of the needs of that resident,
    which shall include: [¶] . . . [r]ecommendations on the type of facility that
    would meet the needs of the resident based on the current service plan.”
    Health and Safety Code section 1569.70 provides guidelines for the varying
    levels of care provided by an RCFE, and section 1569.72, subdivision (a)
    states, with a limited exception for some temporary illnesses, “no resident
    shall be admitted or retained in a residential care facility for the elderly
    if . . . : [¶] . . . [t]he resident requires 24-hour, skilled nursing or intermediate
    care [or] [¶] . . . is bedridden . . . .”
    2Mia B. had worked at Nina’s as a care worker for 24 years. She did
    not have any nursing credentials. When the administrator of Nina’s died,
    Mia B. became the interim administrator. She did not wish to be the interim
    administrator and did not understand why she became the interim
    administrator. Mia B.’s English was limited, such that she was not
    comfortable completing paperwork.
    3 An expert witness for the Board testified, “By definition, a non-
    blanchable area . . . already demonstrates a skin compromise . . . and that is
    a stage one [pressure ulcer].”
    2
    with severe cognitive impairment, poor appetite, chronic nausea and
    diarrhea, and weight loss. Soft diet tolerated fair. Skin is friable with
    redness to bony prominences. Scratches self severely with fingernails.”
    Plaintiff also signed a “Needs and Services Plan” in which he described J.N.
    as: “Frail, pleasant elderly female with severe cognitive impairment,
    cachexia, and fragile skin. Disoriented, alert, unable to respond
    appropriately. Unable to walk, but can stand briefly with assistance. Unable
    to self-transfer from bed to chair or wheel chair. Minimally able to reposition
    self in chair or bed. Longstanding history of alcohol abuse per medical
    record. Easily agitated and becomes very anxious, requiring medication.
    Conservator is Public Guardian, Kelly Schwartz. Significant medical history
    includes rheumatoid arthritis, depression, low thyroid, urinary incontinence
    with chronic and severe urinary tract infections (requiring hospitalization),
    anorexia with significant weight loss, Alzheimer’s dementia, diarrhea, and
    poor nutrition and fluid intake with hospitalization for dehydration. Long
    standing history of self-injury from fingernail scratching to face and body per
    care providers. Overall skin condition is fragile with compromised skin
    integrity to groin, significant redness to bony prominences including coccyx,
    heels, toes. Foot dressings cover toes.” (All caps omitted.) On both forms,
    plaintiff’s signature certified that “to the best of [his] knowledge [J.N.] does
    not need skilled nursing care.” (All caps omitted.)
    On May 23, 2013, the caregivers from the new RCFE, Frye’s Care
    Home, came to transfer J.N. They immediately noticed that J.N. was in
    significant pain. Every time they moved J.N. she cried out in pain. When
    they arrived at Frye’s, the caregivers tried to give J.N. a shower and body
    check. They discovered multiple bandages on her arm, knee and toes. The
    bandages “were stuck to [J.N.’s] skin and her wounds,” and they were not
    3
    freshly placed. The wounds “all smelled really bad.” The sore on the back of
    J.N.’s knee was very large, and her tendons were visible. J.N.’s toes were
    black, and she had “a very strong infection odor.” One witness described
    J.N.’s condition as “very horrifying.” The Frye’s caregivers called 911 and
    went to the hospital with J.N. J.N. died several weeks later.
    On May 31, 2013, a CCL investigator contacted plaintiff. Plaintiff
    identified himself to the CCL investigator as a registered nurse specializing
    in elder care in CCL-licensed facilities and explained that he had been hired
    by the estate and the estate’s attorney. A few months later, the CCL
    investigator conducted a recorded interview with plaintiff. Plaintiff stated he
    had performed J.N.’s assessment and described how he had directed Mia B.
    to perform tasks at his direction. He stated he performed a “head-to-toe”
    assessment by having Mia B. lift J.N.’s clothing so that plaintiff could see
    areas of “bony prominences . . . .” He asked Mia B. to touch J.N.’s skin where
    it was very red so he could see how quickly the “capillary refill” occurred. He
    recalled looking at J.N.’s coccyx and stated there was no wound there.
    Plaintiff told the investigator that J.N.’s feet were covered in dressings,
    which he did not remove to look at her skin. He understood from Mia B. that
    the dressings had been placed there by J.N.’s podiatrist. He did not know
    what the wound care plan was and did not see any documentation in J.N.’s
    records regarding the treatment plan for J.N.’s feet. Plaintiff stated that
    there was no malodor of J.N. during the assessment or when he was at the
    facility on May 23 when J.N. was transferred to Frye’s. He stated that he
    “would have been assessing if there were any odors of feces or urine or
    bacterial infection as a registered nurse, that’s what we do, and [his]
    assessment skills are fine.” In the May 2013 time frame, plaintiff further
    4
    confirmed to others orally and in writing that he had performed J.N.’s
    assessment.
    About 14 months after the incident, the Board interviewed plaintiff as
    part of its investigation. At that time, plaintiff denied performing J.N.’s
    physical assessment, stating that Mia B. “was the one in charge.” He told the
    investigator that Mia B. “decided what body part would be looked at and
    whether or not the clothing was moved, and if any of the gauze or bandages
    on the residents would be moved to expose anything.” He further denied even
    guiding or instructing Mia B. during the assessment. Plaintiff told the
    investigator that he was not acting as a registered nurse at the time of J.N.’s
    assessment. At the administrative hearing, plaintiff testified that he acted
    as a “scribe” by filling out the resident appraisal form based on the
    information Mia B. provided as she performed the assessment.
    II.   Board Decision
    Following the eight-day administrative hearing, and submission of
    briefs by the parties, the administrative law judge (ALJ) issued a proposed
    decision. The ALJ found clear and convincing evidence that plaintiff
    committed gross negligence in connection with the appraisal of J.N.,
    unprofessional conduct in carrying out nursing functions in connection with
    the appraisal of J.N., and unprofessional conduct by not being truthful with
    the Board investigator regarding the care provided to J.N. The ALJ
    summarized his conclusions as follows: “[Plaintiff] had the express
    responsibility to perform resident appraisals and to make recommendations
    regarding the level of care each resident required, and by directly observing
    and assessing J.N., [plaintiff] was in the best position to identify and
    thoroughly document her serious condition.
    5
    “Even as [plaintiff] described J.N. as ‘emaciated,’ he neglected or
    overlooked the most important point in the Resident Appraisal and Needs
    and Services Plan: J.N. was far too sick to reside in an RCFE without the
    addition of . . . skilled nursing services, and he neither documented the
    specifics of her skin condition, nor her inability to reposition herself in bed, or
    her inability to independently take medication. Any of these issues required
    an enhanced level of care that is not provided by an RCFE, without special
    home health or other specialized services. [Plaintiff] did not identify the need
    for these services to be available following J.N.’s transfer, nor did he contact
    her physician to request that they be ordered. As a nurse he was require [sic]
    to do so. (Health & Saf. Code, § 1569.72, subd. (b)(1); Cal. Code Regs., tit. 16,
    § 1443.5.)
    “In the subsequent investigation of J.N.’s care, [plaintiff] first described
    one set of facts, but a year later when speaking to a different investigator, he
    characterized the critical few minutes he spent doing the assessment in much
    different terms. In the second retelling, he placed [Mia B.] in charge, while in
    the former, he acknowledged conducting the appraisal. The Resident
    Appraisal he prepared clearly reflected his thoughts and conclusions, not
    those of someone speaking limited English and without medical training.
    This second characterization was untruthful.”
    The Board adopted the ALJ’s proposed decision and revoked plaintiff’s
    nursing license.
    III.   Petition for Writ of Administrative Mandate
    Plaintiff challenged the Board’s decision in a petition for writ of
    administrative mandate. He argued that the Board’s decision should be
    reversed because: (1) the performance of the RCFE appraisal was not a
    “nursing function”; (2) the Board failed to plead that plaintiff violated any
    6
    RCFE statutes or regulations, and the Board has no power to discipline
    plaintiff for any such violations; (3) plaintiff had no obligation to render
    nursing services to J.N. because no nurse–patient relationship existed
    between them; and (4) Business and Professions Code section 27614 does not
    authorize disciplining plaintiff for dishonesty during the investigation. On
    October 16, 2019, the trial court issued an order rejecting each of plaintiff’s
    arguments and denying the petition. Judgment was entered on January 8,
    2020.
    DISCUSSION
    On appeal, plaintiff raises the same issues he argued in the trial court.
    We review questions of law de novo, and we review the trial court’s factual
    findings under the substantial evidence standard, resolving all conflicts in
    evidence and indulging all reasonable inferences in favor of the trial court’s
    judgment. (Rand v. Board of Psychology (2012) 
    206 Cal.App.4th 565
    , 574–
    575 (Rand).) We find no errors of law and that substantial evidence supports
    the judgment. Accordingly, we affirm.
    I.      Substantial evidence supports the finding that plaintiff engaged
    in a “usual nursing function” when he performed J.N.’s resident
    appraisal.
    Plaintiff argues that he cannot be disciplined for negligently
    performing J.N.’s appraisal because doing so was not a “nursing function.”
    He contends that because the RCFE statutes and regulations do not require
    facility licensees to hold nursing licenses (Health & Saf. Code, § 1569.15), and
    because they state that either the “facility” or the “licensee” must prepare
    resident appraisals (Cal. Code Regs., tit. 22, §§ 87456, subd. (a), 87457, subd.
    (c), 87463, subd. (a); Health & Saf. Code, § 1569.682, subd. (a)(1)), it
    All statutory references are to the Business and Professions Code
    4
    unless otherwise stated.
    7
    necessarily follows that performing resident appraisals is not a nursing
    function. According to plaintiff, if resident appraisals constitute a nursing
    function, then the RCFE regulations permit non-nurse licensees to practice
    nursing without a license.
    We disagree. First, simply because a resident appraisal may be
    performed by a person who is not a licensed nurse does not mean that when a
    nurse undertakes the task, using his or her scientific knowledge and
    technical skills, he or she must not be performing a nursing function. Under
    section 2761, subdivision (a)(1), a nurse may be disciplined for unprofessional
    conduct constituting “gross negligence in carrying out usual certified or
    licensed nursing functions.” Further, as the trial court explained, section
    2725, subdivision (a)(4) specifies that nursing functions include
    “ ‘[o]bservation of signs and symptoms of illness, reactions to treatment,
    general behavior, or general physical condition, and . . . determination of
    whether the signs, symptoms, reactions, behavior, or general appearance
    exhibit abnormal characteristics,’ as well as ‘implementation, based on
    observed abnormalities, of appropriate reporting, or referral . . . .’ ”
    Substantial evidence supports the finding of the ALJ and the trial court
    that when plaintiff conducted his appraisal of J.N. he was performing a
    nursing function. Plaintiff signed both the appraisal and the needs and
    services plan using his “RN” designation. He described J.N. using scientific
    or technical terms such as “cachectic,” which the Board’s decision explains
    refers to “general physical wasting and malnutrition usually associated with
    chronic disease.” He told the CCL investigator that part of his assessment of
    J.N. included “assessing if there were any odors of feces or urine or bacterial
    infection as a registered nurse, that’s what we do, and my assessment skills
    are fine.” He also testified that he agreed with his own expert “that
    8
    performing a resident appraisal, the function is clinical nursing.” Plaintiff’s
    expert, who was a registered nurse and worked as a legal nurse consultant,
    testified that she does not perform resident appraisals when she acts as a
    legal nurse consultant because doing so constitutes patient care. 5
    Additionally, two registered nursing experts with experience as RCFE
    administrators testified on behalf of the Board that RCFE resident appraisals
    involve usual nursing functions.
    Rand, supra, 
    206 Cal.App.4th 565
    , addressed an analogous situation in
    which a licensed psychologist was disciplined for conduct while acting as a
    court-appointed special master in a divorce proceeding and while acting as an
    expert witness in another family law matter. (Id. at pp. 569–572.) The court
    rejected Rand’s argument that he could not be disciplined by the Board of
    Psychology for conduct he believed he performed in his judicial capacity. (Id.
    at pp. 579–580.) It found that the evidence, including the parties’ agreement,
    supported the finding that the tasks Rand was asked to perform, including
    managing interpersonal conflict and minimizing the impact of such conflict
    on the children, involved the application of psychological principles. (Ibid.)
    Further, the Board’s experts opined that Rand engaged in the practice of
    psychology while acting as a special master. (Id. at p. 580.) The court
    rejected Rand’s argument that because nonpsychologists may be appointed
    special masters, the activities of special masters do not involve the practice of
    psychology. (Id. at p. 581.)
    Here, too, the evidence supports the trial court’s finding that in
    performing the appraisal, plaintiff observed J.N. for symptoms of illness and
    5Plaintiff’s expert opined that in this case Mia B. performed the
    appraisal and that plaintiff only transcribed what she told him. But she
    acknowledged that if, in fact, plaintiff had performed the appraisal it would
    have constituted patient care.
    9
    evaluated her general physical condition to determine her suitability for
    transfer to another facility, and that these tasks were “textbook nursing
    functions.” Plaintiff argues Rand is distinguishable because the attorney for
    the estate who hired plaintiff testified that she did not hire him “ ‘as a
    nurse’ ” and plaintiff expressly told her that he was not providing nursing
    care. We are not persuaded that this testimony meaningfully distinguishes
    Rand, particularly because other documentary evidence indicates that
    plaintiff was hired because of his nursing background. The contract between
    plaintiff and the attorney for the estate requires that plaintiff have and
    maintain his license to practice nursing. Further, the administrators of the
    estate wrote to CCL, stating that plaintiff had been hired “to evaluate each of
    the residents for relocation and recommend the best type of facility for each
    resident . . . .” Plaintiff then did so and signed the required documentation as
    a registered nurse using his “RN” designation. Plaintiff’s efforts to
    distinguish Rand are unpersuasive.
    II.   The Board applied the correct standard of care.
    Plaintiff argues the Board should not have applied a nursing standard
    of care to the resident appraisal and that the ALJ erred by relying on expert
    testimony to make this legal determination. Plaintiff’s argument is entirely
    dependent upon his position that he did not perform the duties of a registered
    nurse. As discussed ante, substantial evidence supports the factual finding
    that plaintiff engaged in a “nursing function” when he conducted J.N.’s
    resident appraisal. Thus, applying a nursing standard of care to evaluate
    plaintiff’s conduct was proper.
    The Board’s regulations establish that the standard of care in
    disciplinary proceedings involving licensed nursing functions is to exercise
    the degree of “care which, under similar circumstances, would have
    10
    ordinarily been exercised by a competent registered nurse.” (Cal. Code Regs.,
    tit. 16, § 1442.) The Board’s findings of gross negligence and unprofessional
    conduct were based on the ALJ’s findings that plaintiff’s conduct was an
    “extreme departure from the standard of care in carrying out nursing
    functions in connection with the appraisal of J.N. . . . .”6 These findings were
    supported by the record, including expert testimony. (See Lattimore v. Dickey
    (2015) 
    239 Cal.App.4th 959
    , 969 [expert testimony is necessary to establish
    nursing standard of care and to evaluate alleged breaches, except where
    negligence is obvious to laypersons].)
    Plaintiff further argues that implying a different standard of care for
    resident appraisals performed by licensed nurses renders the California
    Residential Care Facilities for the Elderly Act (Health & Saf. Code, § 1569
    et seq.) impermissibly vague and uncertain. We agree with the Board that its
    decision does not imply a standard of care into the act. Rather, the Board’s
    decision is based upon its finding that plaintiff performed a nursing function
    and breached the standard of care for nurses set forth in the regulations
    applicable to nurses. (Cal. Code Regs., tit. 16, § 1442.)7
    6 Specifically, the expert witnesses testified that a nurse performing a
    resident appraisal should perform a functional, head-to-toe assessment,
    looking at all of the skin. The evidence supports the ALJ’s finding that
    plaintiff’s assessment of J.N. was inadequate because he failed to identify
    and fully describe her multiple wounds.
    7 Plaintiff also argues he had no duty to provide nursing services to
    J.N. because there was no nurse–patient relationship between him and J.N.
    Again, this argument is premised upon plaintiff’s position that his resident
    appraisal of J.N. was not a nursing function. Under the facts of this case,
    plaintiff’s premise is faulty and his related argument based on a purported
    lack of a nurse–patient relationship also fails.
    The ALJ decision, adopted by the Board, found that plaintiff had a duty
    to J.N. as a registered nurse and he was subject to the standard of care
    applicable to registered nurses. This finding implies the existence of a
    11
    To summarize, a licensed nurse may be subject to discipline by the
    Board when he or she agrees to assess a resident’s physical and mental
    condition; holds him- or herself out as a licensed professional while doing so;
    and knows that his or her assessment will be, and in fact is, relied upon to
    determine the level of care the resident needs in a new facility. Applying
    some undefined, lesser standard of care to plaintiff’s misconduct under these
    nurse–patient relationship, which is supported by substantial evidence. The
    Board’s registered nursing expert testified that the performance of an RCFE
    assessment by a nurse creates a nurse–patient relationship. Plaintiff’s own
    expert similarly acknowledged that performing resident assessments
    constitutes patient care.
    Plaintiff relies upon Keene v. Wiggins (1977) 
    69 Cal.App.3d 308
    , 313–
    314 (physician retained by workers’ compensation carrier to examine injured
    employee for purpose of rating injury “has no reason to believe the person
    examined will rely upon this report,” and is not liable to the person examined
    for negligence in making the report) and Felton v. Schaeffer (1991) 
    229 Cal.App.3d 229
    , 236–237 (no physician–patient relationship between
    physician hired to perform preemployment physical examination and
    prospective employee because the “physician’s sole function was to provide
    information to aid the employer’s decisionmaking process, not to serve the
    [prospective employee]”). Both cases are distinguishable because they
    address whether the physicians have civil liability for negligence as opposed
    to whether they are subject to discipline by a licensing board. (Keene, at p.
    310; Felton, at p. 234.) Further, in neither case was it foreseeable that the
    patient would rely upon the physician’s report. (Keene, at pp. 313–314;
    Felton, at pp. 236–237.) In contrast, here, J.N.’s assessment was performed
    to determine the level of care she needed when she was transferred from
    Nina’s. This was most certainly for J.N.’s benefit. Plaintiff even
    acknowledged as much when he testified that the reason for completing the
    assessment was to assist the residents in choosing their next home. It was
    foreseeable that J.N., through her conservator, would rely upon the
    assessment, and, in fact, she did so. Under these circumstances, plaintiff is
    subject to discipline by the Board. The issue whether plaintiff could be held
    liable in a civil action for his misconduct is not before us, and we express no
    opinion on this question.
    12
    circumstances is counter to the Board’s “highest priority” of public protection.
    (§ 2708.1.)
    III.   The Board was not required to plead a violation of the RCFE
    statutes.
    Plaintiff complains that he cannot be disciplined for failing to properly
    perform J.N.’s resident appraisal as required by RCFE statutes and
    regulations because (1) the Board did not plead violations of any specific
    RCFE regulations and (2) the Board does not have the power to discipline
    plaintiff for violations of the RCFE regulations. We address plaintiff’s latter
    argument first. The Board disciplined plaintiff for gross negligence and
    unprofessional conduct while engaged in nursing functions. This is well
    within the Board’s jurisdiction. (See Rand, supra, 206 Cal.App.4th at pp.
    581–582 [rejecting argument that Board of Psychology lacked jurisdiction to
    discipline licensed psychologist for unprofessional conduct while acting as
    court appointed special master].)
    Nor do we agree the Board was required to plead specific violations of
    RCFE regulations to discipline plaintiff for gross negligence under Business
    and Professions Code section 2761, subdivision (a)(1). The Board’s accusation
    alleged plaintiff was hired to assist with the closure of Nina’s and that he was
    grossly negligent in, among other things, failing to perform a complete
    assessment of J.N., failing to ensure that her service plan accurately reflected
    her needs and status, and failing to recommend a higher level of care. The
    Board further alleged incompetence and unprofessional conduct based upon
    the same alleged omissions. Although the Board did not specifically reference
    RCFE regulations, it did allege that the assessment was required by the CCL
    as part of the closing process. Finally, the Board alleged unprofessional
    conduct based upon plaintiff’s dishonesty during the Board’s investigation.
    The accusation detailed plaintiff’s alleged errors and omissions in conducting
    13
    J.N.’s assessment and asserted that each cause for discipline was based upon
    violations of Business and Professions Code section 2761, subdivision (a)(1).
    No more was required. (Gov. Code, § 11503, subd. (a) [requiring that
    agencies set forth in the accusation acts and omissions with which the
    licensee is charged and specify “statutes and rules that the [licensee] is
    alleged to have violated”].)8
    IV.   Plaintiff’s dishonesty during the investigation constitutes
    unprofessional conduct under section 2761.
    Plaintiff’s final contention is that he cannot be disciplined for
    dishonesty because section 2761 does not expressly list dishonesty as a type
    of unprofessional conduct.9 Plaintiff’s argument ignores that the plain
    8 Plaintiff’s reliance upon Linda Jones General Builder v. Contractors’
    State License Board (1987) 
    194 Cal.App.3d 1320
     is misplaced. In Linda
    Jones General Builder, the Contractors’ State License Board alleged a
    contractor was subject to discipline for a willful departure from “ ‘accepted
    trade standards in the absence of specific requirements in the plans or
    specifications,’ ” and then, at the hearing, the board argued the contractor
    should be disciplined for a willful departure from plans or specifications. (Id.
    at p. 1323, italics added.) The court found that because the board had not
    charged the contractor with a willful departure from plans or specifications,
    the contractor could not be disciplined on this ground. (Id. at pp. 1326–1327.)
    Here, plaintiff was charged with violating section 2761, subdivision (a)(1),
    and the disciplinary action was based upon this accusation.
    9 In making the legal argument that he cannot be disciplined for
    dishonesty under section 2761, plaintiff does not appear to dispute that
    substantial evidence supports the finding that he was dishonest. However,
    his brief also includes a section titled “Conclusion” which disputes that he
    was dishonest during his interviews with the Board investigator. We
    disregard this argument for three reasons. First, plaintiff’s argument is not
    under an appropriate heading. (See Cox v. Griffin (2019) 
    34 Cal.App.5th 440
    ,
    453–454 [argument contained in section headed “ ‘Introduction’ ” violates Cal.
    Rules of Court, rule 8.204(a)(1)(B) requiring separate headings summarizing
    argument and is forfeited].) Second, plaintiff fails to cite to the appellate
    record. (Sky River LLC v. County of Kern (2013) 
    214 Cal.App.4th 720
    , 741
    [Cal. Rules of Court, rule 8.204(a)(1)(C), requiring appellate briefs to cite to
    14
    language of section 2761, subdivision (a) provides a non-exhaustive list of
    what constitutes “unprofessional conduct.” It expressly states that
    unprofessional conduct “includes, but is not limited to,” the examples listed.
    (§ 2761, subd. (a); Moustafa v. Board of Registered Nursing (2018) 
    29 Cal.App.5th 1119
    , 1136 [recognizing that additional forms of conduct may be
    deemed unprofessional conduct because § 2761, subd. (a) provides that
    unprofessional conduct “ ‘is not limited to’ ” the examples given].) Courts
    have held that unspecified “ ‘unprofessional conduct’ ” must involve “conduct
    which indicates an unfitness to practice [the profession].” (E.g., Shea v.
    Board of Medical Examiners (1978) 
    81 Cal.App.3d 564
    , 575; Rand, supra, 206
    Cal.App.4th at p. 590 [“A professional who has shown dishonesty has
    demonstrated professional unfitness meriting license discipline”].)
    Plaintiff was found to have been dishonest with the Board investigator
    when he characterized his role in J.N.’s assessment as significantly more
    limited than what he explained in his earlier statement to the CCL
    investigator. We find that such dishonesty to the Board investigating
    plaintiff’s alleged malfeasance constitutes unprofessional conduct and
    demonstrates an unfitness to practice nursing.
    DISPOSITION
    The judgment is affirmed. Respondent is entitled to its costs on appeal.
    appellate record, applies to matter references at any point in the brief and
    not just to the statement of facts].) Third, he makes no reasoned argument
    that the Board’s finding is not supported by substantial evidence. (Okorie v.
    Los Angeles Unified School Dist. (2017) 
    14 Cal.App.5th 574
    , 600 [appellant is
    required to present cognizable legal argument in support of reversal of
    judgment], disapproved on other grounds in Bonni v. St. Joseph Health
    System (2021) 
    11 Cal.5th 995
    , 1012, fn. 2.)
    15
    _________________________
    Jackson, P. J.
    WE CONCUR:
    _________________________
    Needham, J.
    _________________________
    Burns, J.
    A159990/Clawson v. Bd. of Registered Nursing
    16
    A159990/Clawson v. Bd. of Registered Nursing
    Trial Court:      Superior Court of the City and County of San Francisco
    Trial Judge:      Ethan P. Schulman
    Counsel:          William Michael Clawson, in pro. per., for Plaintiff and
    Appellant.
    Rob Bonta, Attorney General, Carl W. Sonne, Assistant
    Attorney General, Joshua A. Room and Brett A.
    Kingsbury, Deputy Attorneys General, for
    Defendant and Respondent.
    17
    

Document Info

Docket Number: A159990

Filed Date: 12/17/2021

Precedential Status: Precedential

Modified Date: 12/17/2021