STATE OF WASHINGTON DEPARTMENT OF HEALTH ‘Olympia, Washington 98504 RE: — William John Kipp Jr. Master Case No. M2021-788 Document Statement of Charges Regarding your request for information about the above-named practitioner; attached is, a true and correct copy of the document on file with the State of Washington, Department of Health, Adjudicative Clerk Office. These records are considered Certified by the Department of Health Certain information may have been withheld pursuant to Washington state laws. While those laws require that most records be disclosed on request, they also state that certain information should not be disclosed. The following information has been withheld The identity of the complainant if the person is a consumer, health care provider, or employee, pursuant to RCW 43.70.075 (Identity of Whistleblower Protected) and/or the identity of a patient, pursuant to RCW 70.02.020 (Medical Records - Health Care Information Access and Disclosure) If you have any questions or need additional information regarding the information that was withheld, please contact Customer Service Center P.O. Box 47865 Olympia, WA 98504-7865 Phone: (360) 236-4700 Fax: (360) 586-2171 You may appeal the decision to withhold any information by writing to the Privacy Officer, Department of Health, P.O. Box 47890, Olympia, WA 98504-7890.STATE OF WASHINGTON + DEPARTMENT OF HEALTH. oe SECRETARY OF HEALTH ‘Adjudicatve Clerk Office In the Matter of . No, M2021-788 ‘ WILLIAM JOHN KIPP JR. STATEMENT OF CHARGES Credental No NAR NA 60704749 ‘The executve director of the Nursing Assistant Program (Program), on designaton by the Secretary of Health (Secretary), makes the Atlogatohs below, which are supported by the evidence contaned in case no 2021-6301 , The patient referred to in this Statement of Charges 1s identfied m the attached Confidential Schedule 4, ALLEGED FACTS . 11 On October 11, 2016, the State of Washington issued Respondent a credental to practice as a nursing assistant-registered Respondent's oredeniel 1s currently actve 12 On several occasions between 1985 and 1996, Respondent engaged in nion-consensual sexual contact with Vico A, @ minor 13 On several occasions between March 2003 and March 2005, Respondent ‘engaged in non-congensual sexual contact with Victim B, a minor 2, ALLEGED VIOLATIONS . 21 Based on the Alleged Facts, Respondent has committed unprofessional conduct in violation of RCW 18 130 180(1) which provides in part ° RCW 18.130.180 Unprofessional conduct. The following conduct, acts, oF conditions constitute unprofessional conduct for any license holder under the junsdicton of this chapter (1) The commission of any act involving moral turpitude,-dishonesty, or corruption relating to the practice of the person's profession, whether the act constitutes a cnme or not: If the act constitutes a cnme, ‘conviction in a cnminal proceeding 1s not a condition precedent to disciplinary.action Upon such a conviction, however, the judgment and ‘sentence is conclusive evidence at the ensuing disciplinary heanng of the guilt of the-license holder of the cnme descnbed In the indictment Cr information, and of the person's violation of the statute on which itis based - ‘STATEMENT OF CHARGES: PAGE 10F 3 NO M2021-768 (0c -my 9198For the purposes of this section, conviction includes all instances in which a plea of guilty or nolo contendere 1s the basis for the conviction and all proceedings in which the sentence has been deferred or suspended Nothing in thie section abrogates'nghts guaranteed under chapter 996A RCW, 22 The above violation provides grounds for imposing sanctions under RCW 18 130 160 3, NOTICE TO RESPONDENT ‘The charges in this document affect the pubic health, safety and welfare Tha « ‘executive director of the Program directs that a notice be issued and served on Respondent es promded by law, giving Respondent the opportunity to defend against these charges. If Respondent fails to defend against these charges, Respondent shall be subject to disciple and the imposition of sanctions under Chapter 18 130 RCW pateo March:25, 2022 om ‘STATE OF WASHINGTON . DEPARTMENT OF HEALTH ‘sf ‘SECRETARY OF HEALTH TRINA CRAWFORD EXECUTIVE DIRECTOR SOP MAIA CRAWFORD-BERNICK, WSBA #54001 : PROGRAM REPRESENTATIVE ‘STATEMENT OF CHARGES PAGE 2 OF 3 NO M2021-788 0-rey 1420CONFIDENTIAL SCHEDULE the Individual or individuals named herein. RCW: Patient A : Patent B ‘ This information Is confidential and Is NOT to be released without the consent of '42.56.240(1) ‘STATEMENT OF CHARGES | a PAGE 3 OF, 3 NO M2021-788 =eey