SEP-11-2087 14:52 Sep 11 2007 14:26 AHCA STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2007-09747 ROSE FENELON, R.N., RESPONDENT, a ADMINISTRATIVE Comp ENT COMES NOW, Petitioner, Department of Health (‘Department’), by and through its undersigned counsel, and files this Administrative Complaint before the Board of Nursing (“Board”) against Respondent, Rose Fenelon, R.N., and in Support thereof alleges: , 1. Petitioner is the state department charged with regulating the Practice of Nursing Pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes: and Chapter 464, Florida Statutes. 2. At all times material to this Complaint Respondent was a registered nurse CR.N.”) within the state of Florida, having been issued license number RN 9256909. Sep 11 2007 14:27 SEP-11-2087? 14:52 AHCA P.@3 3. Respondent is licensed pursuant to Chapter 464, Florida Statutes, and is a health care practitioner as defined in Section 456.001(4); Florida Statutes (2006). 4. Respondent’s address of record. is 1145 Kempton Chase’ Parkway, Orlando, Florida 32837. 2. On or about May of 2006, Respondent applied to the Florida: Board of Nursing for ticensure as 2 ragistered nurse through endorsamernt. | 6 Section 464.009(1}, Florida Statutes (2006), describes the: requirements for licensure a3 a registered nurse by endorsement and. _ provides that the department shall issue the appropriate license by: endorsement to practice professional or practical nursing to an applicant: who, upon applying to the department and remitting a fee set by the board. not to exceed $100, demonstrates to the board that he or she: a. Holds a valid license to practice professional or practical. nursing in another state or territory of the United States, : provided that, when the applicant secured his or her. original license, the requirements for licensure were | substantially equivalent to or more stringent than those wo existing in Fiorida at that time; DOH v. Rose Fenelon, RN Case Number: 2007-09747 3:\PSU\Nursing\Blancho, Megan\AC\License by Misrep\Fenelon, R.N..doc SEP-11-2087 14:53 of Nursing Application for Nursing Licensure CApplication”) and a: completed Nursing License Verification Form (‘NLVF”), 8. On or about May 8, 2006, Respondent signed an Application. indicating that she held a license to practice as a R.N. under license’ 9, Respondent indicated on her Application that she obtained the: licensure to practice as a registered nurse in Wyoming by examination in’ b. oo C. oo endorsement, an number RN 21399 in the State of Wyoming. -~ 2002. DOH v. Rose Fenelon, RN Case Number: 2007-09747 JA\PSU\Nursing\Blancho, Megan \AC\License by Misrep\Fenelon, R.N.:doc 7 In order to obtain licensure as a registered nurse b Sep 11 2007 14:27 @HCA P.@4 Meets the qualifications for licensure in Section 464.008," Florida Statutes, and has successfully completed a state;. regional, or national examination which is substantially equivalent to or more stringent than the examination: given by the department; or Has actively practiced nursing in another state,, a preceding 3 years without having his or her license acted: against py the licensing autnority of any jurisdiction. applicant must submit to the Department a Florida Boar : Sep 11 2007 14:28 SEP-11-2087 14:54 AHCA P.BS 10. On or about May 8, 2006, Respondent signed a NLVF indicating she held license number RN 21399 in Wyoming. 11. The NLVF was signed by Jenny N. Kalinas, MS, RN, identified ag the official of the Wyoming licensing board, indicating that Respondent held license number RN 21399 in the State of Wyoming, that Respondent license to practice as a registered nurse was obtained by examination i 2002, and that Respondent's licance wes in good standing. 12. On or about January 19, 2007, the Department issued: Respondent 2 license to practice af @ registered nurse, based on the Application and NLVF that Respondent submitted purporting tha Respondent was licensed to practice as a registered nurse in the State of: Wyoming. 13. On or about April 19, 2007, the Executive Director from the: Wyoming State Board of Nursing (‘Wyoming BON”) signed -a notarized affidavit indicating that Respondent was not licensed as a registered nurse « or as a licensed practical nurse in the State of Wyoming. 14. The affidavit submitted by the Executive Director fram the’ Wyoming BON indicated that the NLVF was not signed by any authorized .. person in the licensing office of the Wyoming BON. DOH v. Rose Fenelon, RN Case Number: 2007-09747 3:\PSU\Nursing\Blancho, Megan\AC\License by Misrep\Fenelon, R.N..doc SEP-11-2087 14:54 AHCA P. BE Sep 11 200? 14:29 15. The Application and/or NLVF submitted for Respondent conta ‘ misrepresentations. 16. Respondent does not hold a license to practice asa. registered nurse in the State of Wyoming. 17, Respondent did not meet the requirements for issuance of license to practice as a registered nurse in the State of Florida by: endorsement, 18. Saction 464.018(1){a), Florida Statutes (2006), provides tha that procuring, attempting to orocure, or renewing @ license to practice nursing by bribery, by knowing misrepresentations, or through an error of the department or the board constitutes grounds for disciplinary action b | the Board of Nursing. 19. Respondent obtained a license to practice nursing in. the Stat of Florida by knowing misrepresentations in her Application and/or NLVF by: indicating that she was licensed as a registered nurse in the State of Wyoming when she was not licensed as a registered nurse or licensed as a licensed practical nurse in the State of Wyoming. 20. Based on the foregoing, Respondent violated Section 464.018(1)(a), Florida Statutes (2006), by procuring, attempting to DOH v. Rose Fenelon, RN Case Number: 2007-09747 ° J:\PSU\Nursiig\Blancho, Megan\aAC\ License by Misrep\Fenelon, R.N_.doe Sep 11 200? 14:29 SEP-11-2087 14:55 AHCA Pa? procure, or renewing a license to practice nursing by bribery, by knowing: misrepresentations, or through an error of the department or the board. WHEREFORE, the Petitioner respectfully requests that the Board of Nursing enter an order imposing one or more of the following’ penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, macement of the Respondaat on srosation, corractive aqien, fafund oF fees billed or collected, remedial education and/or any other relief that the Board deams aooronrigt. /. Ao eg SIGNED this 2 a day of ¢ / Auf , 2007. Ana M. Viamonte Ros, M.D., M.P.H State Surgeon General DEPARTMENT OF HEALTH UTY CLERK Megan 'M. Blancho CLERK: adr Ret Adeistont General Counsel DATE tm DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar # 0860921 (850) 245-4640 (850) 245-4682 FAX PCP: 2/ef¢) PCP Members: Af, Cat /MB RP. Mbecl POH v, Rose Fenelon, RN Case Number: 2007-No747 ° J: ‘\PSU\Nursing\Blancho, Megan\AC\License by Misrep\Fenelon, R.N..doc Sep 11 2007 14:30 SEP-11-2087 14:56 AHCA P.88 NOTICE OF RIGHTS Respondent has the right to request a hearing to b conducted in accordance with Section 120.569 and. 120.57, Florida Statutes, to be represented by counsel or other qualified: representative, to present evidence and argument, to call an cross-examine witnesses and to have subpoena and subpoen duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred® costs related to the Investigation and prosecution of this matter Pursuant fo Section 456.072(4), Florida Statutes, the Board shal: assess costs réiated to the investigation amd prosecution of a. disciplinary matter, which may include attorney hours and Costs, on the Respondent in addition to any other discipline imposed. DOH \. Rose Fenelon, RN 7 Case Number: 2007-09747 ‘ J:\PSU\Nursing\Blancho, Megan\AC\License by Misrep\Fenelon, R.N..doc

Docket for Case No: 07-004114PL