Case library / Applying with a record
She wrote her supervisor’s name on the hours forms
In short
The Associate Professional Clinical Counselor registration was revoked. The application for a subsequent associate regis
$3,000.00The Board revoked her registration, granted her a new one on three years’ probation, and cut the cost award from $10,650 to $3,000.
It is the rare case where the Board rejected its own administrative law judge’s proposed decision, decided the matter itself, and still gave a registrant who admitted forging a signature a supervised path back into practice.
What happened
The Board issued the respondent an Associate Professional Clinical Counselor registration on October 18, 2016. On June 7, 2021 it received her application for licensure as a professional clinical counselor, and on October 18, 2021 it received additional documents supporting that application, including an In-State Experience Verification form and Weekly Summary of Experience Hours forms signed by her former clinical supervisor.
Board staff concluded the documents were inadequate to establish the required supervised hours and sent a letter on July 2, 2021 describing the deficiencies. The respondent revised the forms and asked her former supervisor, who had by then left the agency and moved out of state, to sign them. The supervisor was on an extended vacation and returned the signed revisions in mid-August 2021. Staff then asked for a further revision. The respondent prepared a third set, sent it for signature, and afterward realized she had not obtained the supervisor’s signature on all of the documents staff had asked her to revise.
Rather than ask again, the respondent wrote the supervisor’s name on copies of the remaining documents and submitted them to the Board as if they bore the supervisor’s true signature. The supervisor had not authorized her to sign in her stead.
On November 22, 2021 Board staff emailed the supervisor to confirm the supervision and the signatures. The supervisor confirmed she had supervised the respondent but said the documents did not carry her signature. She texted the respondent the same day to say the Board had contacted her. That evening the respondent emailed Board staff admitting she had “made mistakes on my supervisor’s signature,” describing the anxiety and pressure she felt to be approved for the remaining licensure examination, and asking for a second chance.
The Board filed an Accusation on March 25, 2022. Her registration canceled on October 31, 2022 on reaching its six-year limit. The Board denied her August 2022 application for a subsequent associate registration on October 3, 2022, and on October 28, 2022 filed a combined first amended accusation and statement of issues. An administrative law judge heard the matter on February 2 and May 25, 2023. The Board rejected the proposed decision on August 24, 2023 and decided the case itself on the transcript and written argument under Government Code section 11517.
What it was charged as
Securing a license or registration by fraud, deceit, or misrepresentation on any application submitted to the Board — whether the person doing it is the applicant or a licensee acting in support of an application.
The commission of any dishonest, corrupt, or fraudulent act substantially related to the qualifications, functions, or duties of a licensee or registrant.
Expiration, cancelation, or surrender of a registration does not deprive the Board of jurisdiction to proceed — which is how a registration already canceled at its six-year limit could still be revoked.
Lets the Board place a registrant or applicant on probation instead of revoking or denying, where public welfare can be protected without keeping the person out of practice altogether.
Defines “substantially related” as conduct that to a substantial degree evidences present or potential unfitness to practice consistent with public health, safety, or welfare.
The rehabilitation criteria the Board applies to an applicant when the denial rests on professional misconduct rather than a completed criminal sentence.
The rehabilitation criteria on revocation, including how unintentional or immaterial a false statement was and whether the person tried to correct it or instead tried to conceal the truth.
Authorizes the Board to recover the reasonable costs of investigating and enforcing a case from a licentiate found to have violated the licensing act.
The outcome
The Associate Professional Clinical Counselor registration was revoked. The application for a subsequent associate registration was granted: the registration issues on completion of all requirements, is then immediately revoked, that revocation is stayed, and the respondent is on three years’ probation with weekly psychotherapy, two graduate semester units in law and ethics, supervised practice once she is licensed, and $1,200 a year in monitoring costs.
OAH No. 2022050774
$3,000.00ordered in cost recovery under B&P §125.3What the rule actually says
Every signature on a document you send the Board must be made by the person whose name it is. Business and Professions Code section 4999.90(b) reaches fraud, deceit, or misrepresentation on any application for licensure or registration or on the documents supporting it, and it binds two people at once — the applicant who submits the form and the licensee who signs in support of it. Subdivision (j) reaches any dishonest act substantially related to the license, whether or not it works. The supervisor’s signature on an experience verification form is the only independent confirmation the Board has that the hours are real, so what is being certified is the signature and not the arithmetic; it was no defense here that the numbers were accurate and identical to what the supervisor had already reviewed. The parallel provisions for the other Board licenses are sections 4982(b) and (k) for marriage and family therapists and 4992.3(b) and (l) for clinical social workers, and section 4990.33 means a registration that has expired or hit its six-year cap is still within reach.
Discussion
Analysis, not part of the decision
The Board was deciding two questions from a single act. First, whether to revoke a registration that had already canceled on its own at the six-year limit — section 4990.33 preserved jurisdiction, and the revocation matters because it stays in her license history permanently. Second, whether to grant the new registration she needed in order to work at all. It answered yes to both, which is why the order reads strangely: it revokes and grants in the same breath.
The mitigation analysis rewards close reading. The Board found a single act involving deliberate misrepresentation whose impact was minimal, because the documents she signed were identical to unsigned copies the supervisor had already seen and accurately reflected the experience the supervisor had in fact supervised. In the same decision it noted that the supervisor could not confirm the forms’ accuracy at hearing, because she no longer had access to the agency’s client records. The Board accepted that the harm was small while recording that nobody could any longer prove it — which is itself the argument for why the signature rule is absolute.
Procedurally, this is a reminder that a proposed decision is a proposal. The administrative law judge heard the witnesses over two days and wrote a decision; the Board declined to adopt it, ordered written argument, and issued its own decision on the transcript under Government Code section 11517. Either side can find the result changed after the hearing room empties.
Costs are the last turn. The Board established $10,650 in prosecution costs and found the figure reasonable. Under Zuckerman v. State Bd. of Chiropractic Examiners (2002) 29 Cal.4th 32, a board must consider the licensee’s good-faith belief in her position, whether she raised a colorable challenge, her ability to pay, and whether the investigation was disproportionate — so that a cost award does not punish people for asking for a hearing. Citing that she had been out of work since her registration canceled and that the misconduct was a single act with minimal impact, the Board reduced the award to $3,000.
Where insurance reaches, and where it does not
A forged signature is an intentional act, and every professional liability policy excludes intentional acts, dishonesty, and fraud from indemnity. There is nothing here for a policy to pay on the merits. Where a policy would have helped is the part of the case that actually cost money: the license-defense benefit, which reimburses the fee of a lawyer to answer the accusation, prepare the mitigation record, and appear at hearing. This matter ran to a two-day administrative hearing followed by written argument to the Board, and the respondent was represented by counsel throughout. Read the sublimit on your own policy and note that it is usually a fixed dollar cap, not a percentage — a contested two-day hearing can exhaust a small one.
What would have changed it
- Never sign, trace, type, or otherwise supply another person’s name on a Board document, even when you hold their signed original for identical content and are certain of what they would sign.
- When Board staff ask for revised forms, ask in writing exactly which documents need a fresh signature, then route every one of them back to the supervisor and wait. A supervisor on vacation is a scheduling problem, not an emergency, and no examination deadline is worth the alternative.
- At the end of any supervision relationship, get complete signed verification forms and keep copies. Supervisors leave, move states, and lose access to the records that prove your hours — which is exactly what happened here.
Questions
For a law and ethics seminar, or for yourself
- The Board called the impact of the misrepresentation minimal because the forged forms matched documents the supervisor had already reviewed. If the content was accurate, what exactly was the harm, and to whom?
- She admitted what she had done the same evening she learned the Board had contacted her supervisor. Title 16 section 1814 asks whether a person tried to correct a falsehood or tried to conceal it. Where on that line does a same-day admission after being caught fall, and how much weight should it carry?
- The Board rejected the administrative law judge’s proposed decision and decided the case on the written record without seeing the witnesses. What is gained and what is lost when the body that sets the discipline is not the body that heard the testimony?
Source. This write-up is drawn from the signed public decision in the case number above. Names, cities and employers have been removed — why. To pull the original, open the Board's quarterly newsletter archive, find the issue covering January 18, 2024, and match the case number in the Formal Disciplinary Actions section. Not legal advice.
