State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs, License Number 5603606 HOLLAND APTS dent License Type 2003 espondent. Case Number 2013030047 / Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS|AND RESTAURANTS, (“Petitioner’), files this Administrative Complaint against HOLLAND APTS, (‘Respondent’), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 509, Florida Statutes. 2. Respondent is, and has been at all times material hereto, licensed by or subject to the jurisdictidn of the Division of Hotels and Restaurants. The respondent's business address of record is 162 RAINBOW DRIVE, FORT WALTON BEACH, FLORIDA 32548.The mailing address of record is HOLLAND APTS, at 162 RAINBOW DRIVE, FORT WALTON BEACH, FLORIDA 32548. ; 3. Inspection of this establishment conducted pursuant to Sec. 509.032, Florida Statutes, revealedjviolations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment. The violation(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit “B”, incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penalties: administrative fine not to exceed $1,000 per offense, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, jor the rules promulgated thereto. Signed July 24, 2013 Ken Hensdill, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Marc Drexler, Lead Attorney Florida Bar No. 0487058 ; Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 Certificate of Service BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7196 9008 9111 0766 8362 THEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , 2013. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2013030047 File Number: 84957 District Number: 06 License Number: 5603606 2003 Form revised 01.01.13 HOLLAND APTS Exhibit A License Number: 5603606 License Type: 2003 APARTMENT Case Number: 2013030047 itis alleged that on May 13, 2013, July 16, 2013 Respondent was in violation of Florida Statute 509)(FS); the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC); and/or specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, as incorporated by Chapter 61C, FAC in the following particulars. Copy(s) of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. * denotes a high priority violation. * denotes an intermediate priority violation. 4. 13-04-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures kept in good repair. shall be Observed moid-like substance on wail (exterior back wall of Apt. 140). Observed mold-like substance on ceiling (in storage closet next to bathroom). Observed ceiling bulging/hanging down (in front Apt 140). room of 2.13-12-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed hole in the soffit/fascia (outside, back corner & front corner of Apt 140). 3. 13-22-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed door in disrepair (interior of front door of Apt 140, damaged at bottom). Observed door frame in disrepair (front door of Apt 140). 4. 13-28-4 61C-1.004(5) FAC Basic: Alll building structural components, attachments and fixtures shall be kept in good repair. Observed rotted wood on exterior of building. (along front eave of Apt. 140) 5. 13-32-4 61C-1.004(5) FAC Basic: Alll building structural components, attachments and fixtures shall be kept in good repair. Observed light fixture (attached to building) not functioning (Missing at entrance to Apt. 140). 6.39-05-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept clean. Observed dust/dirt/stain on the ceiling. (ceiting tile soiled throughout Apt. 140) Case Number: 2013030047 File Number: 84957 District Number: 06 License Number: 5603606 2003 Fonm revised 01.04.13 HOLLAND APTS

Docket for Case No: 13-003384

Orders for Case No: 13-003384