DES MOINES, Iowa — A southwestern Iowa disability treatment center was fined $40,000 and could lose its license to operate if problems aren’t solved, after an investigation revealed numerous cases of abuse, a state regulatory agency said Friday.

The Iowa Department of Inspections and Appeals said the cases included staff members striking patients on their heads with spoons and butter knives and taunting them with sexual conversations.

The Glenwood State Resource Center, operated by the Iowa Department of Human Services, serves 230 people with behavioral challenges, mental disabilities or severe medical conditions. The Department of Inspections and Appeals released the results of its investigation into a series of complaints of abuse at the center.

The department, which inspects, licenses and certifies health care providers in the state, found repeated violations of patient treatment regulations that occurred last year, with some of those placing patients in immediate jeopardy.

The agency said Glenwood staff failed to do the following: ensure patients were free from abuse and mistreatment, immediately report allegations of abuse, and provide adequate support to ensure policies were carried out.

As a result the agency fined the center and a letter on Jan. 13 informed it that a conditional license was being issued, which means failure to correct the problems could result in revocation of its license to operate. The letter also recommended the state terminate the facility’s federal Medicaid certification if corrections aren’t achieved by April 10.

About 90 percent of Glenwood’s $75.9 million budget comes from state and federal Medicaid funding.

The Department of Human Services announced Jan. 4 that six workers were fired, six resigned and five others were disciplined after its internal investigation found seven patients were physically abused and 13 others were subjected to verbal abuse or neglect.

DHS said Friday it cooperated fully with the inspections and appeals agency, disciplined those involved and has worked to ensure patient safety by increasing supervision on evenings and weekends, retraining staff and increasing middle and top management presence in the residential houses.

“Our top priority is the safety of our clients, and there is no tolerance at Glenwood or any state facility for the type of unacceptable behavior identified in DHS and DIA investigations,” said DHS Mental Health and Disability Services Administrator Rick Shults in a statement.

The agency said the mistreatment of clients was committed by a small number of the more than 770 staff at Glenwood.