(M-le aD STATE OF FLORIDA 04 APR 12 PM 4:27 AGENCY FOR HEALTH CARE ADMINISTRATION Ane pial cP AGENCY FOR HEALTH CARE Hees VE ADMINISTRATION, mee Petitioner, AHCA No.: 2004001393 Return Receipt Requested: v. 7002 2410 0001 4237 4704 KAREN LEGALL, OWNER/OPERATOR d/b/a KAREN LEGALL, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Karen Legall, Owner/Operator d/b/a Karen Legall (hereinafter “Karen Legall”), pursuant to Chapter 400, Part VII, and Section 120.60, Florida Statutes, (2003), and alleges: NATURE OF THE ACTION 1. This is an action to impose a revocation of license pursuant to Section 400.6194(5), Florida Statutes for the protection of the public health, safety and welfare. JURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57 Florida Statutes, Chapter 28-106, Florida Administrative Code. 3. Venue lies in Broward County pursuant to Section 120.57 Florida Statutes, Rule 28-106.207, Florida Administrative Code. PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing adult family home care facilities pursuant to Chapter 400, Part VII, Florida Statutes (2003) and Chapter 58A-14, Florida Administrative Code. 5. Karen Legall operates a 5-bed adult family care home located at 2903 N. W. 115 Terrace, Pompano Beach, Florida 33065. Karen Legall is licensed as an adult family care home under license number 6905583. Karen Legall was at all times material hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes. COUNT I KAREN LEGALL FAILED TO PROPERLY MANAGE HER OWN FINANCIAL AFFAIRS AS THE ADMINISTRATOR AND PLACED PERSONAL CHARGES ON THE oe dp ame RESIDENT’S CHARGE CARD. : LE C 1) SECTION 400.6194(5), FLORIDA statutes 94 APR 12 PM 4:27 DIVISION £ (RESIDENT CARE STANDARDS) ADMINISTRATIVE HEARINGS CLASS II VIOLATION 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. Karen Legall was cited with one (1) Class II violation as a result of a complaint investigation conducted onsite on November 19, 2003 through November 21, 2003. This investigation continued by phone interview and in-office review until January 27, 2004. 8. Based on a complaint investigation conducted from November 19, 2003 through November 21, 2003, continued by phone interview and in-office review until January 27, 2004 and based on interview and record review, one of seven residents in the sample (Resident #2) did not manage her own financial affairs as the Administrator placed personal charges on the resident's charge card. The findings are as follows. 9. An interview with the Administrator was conducted on 11/19/03 at 9:50 AM. The Administrator stated Resident #2 wanted her name on two of the resident's credit cards (American Express and maybe a Visa/Mastercard) to make it easier to make purchases and return items. When shopping, she sometimes would put some of her purchases on the resident's credit card and then repay her portion with a money order. Based on record review, resident #2 wag admitted 5/15/02. The health assessment showed diagnoses of psychosis and paranoid schizophrenia. Adult Protective Services completed their investigation and found the case verified for exploitation. 10. Based on the foregoing, Karen Legall violated Section 400.6194(5), Florida Statutes, herein classified as a Class If violation, which warrants revocation of license. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 1. Enter a judgment in favor of the Agency for Health Care Administration against Karen Legall on Count I. 2. Assess a revocation of license against Karen Legall on Count I for the violation cited above. 3. Assess costs related to the investigation and prosecution of this matter, if the Court finds costs applicable. 4. Grant such other relief as this Court deems is just and proper. Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2003). Specific options for administrative action are set out in the attached Election of Rights and explained in the attached Explanation of Rights. All requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Julfen, Esq. al Counsel Agency for Health Care Administration 8350 N.W. 52 Terrace - #103 Miami, Florida 33166 Copies furnished to: Diane Reiland Field Office Manager Agency for Health Care Administration 1710 E. Tiffany Drive - Suite 100 West Palm Beach, Florida 33407 (U.S. Mail) Jean Lombardi Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) Home Care Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Karen S. Legall, Owner/Operator, 2903 N. W. 115 Terrace, Pompano Beach, Florida 33065 on this laf day of INF , 2004.

Docket for Case No: 04-001265