Received: Oct 25 2007 11:39am _ 10/25/2087 10:56 7235315 CHILD CARE LICENSURE PAGE 082/87 STATE OF FLORIDA oa ; DEPARTMENT OF CHILDREN AND FAMILIES. ed Py IN THE MATTER OF Certified Mail 7005 1820 ora He, A Civil Penalty Against Retum Receipt Requested Anastasia Christian Teaching Services, Inc. RE: Anastasia Baptist Childcare Ministry D7 -\{ {0 % 1650 A1A South St. Augustine, Florida 32080 ADMINISTRATIVE COMPLAINT. YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of One Hundred Fifty Dollars ($150.00). As grounds for the impositian of this penalty, the Department states the following: 1. The Department of Children and Families, State of Florida, has jurisdiction over Respondent by virtue of the provisions of Chapters 402.301 — 402.319, Florida Statutes, 2. The Respondent, Anastasia Christian Teaching Services, Inc., is licensed to operate Anastasia Baptist Childcare Ministry located at 1650 A1A South, St. Augustine, Florida 32080 as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (F,A.C), Rule 65C-22. 3. During a complaint inspection on August 13, 2007, it was determined that the Respondent committed the following violation: FAC Chapter 65C-22.001(5)(a), in that; On August 9, 2007 direct supervision in the 2 year old group was inadequate in that an accident report documented that a 2 year old child had her underwear pulled down and was inappropriately touched by three (3) other students on her buttocks area. The child was also observed by staff to have a bloody lip as a result of being pushed down. The staff member was in the bathroom in the adjoining room and per staff statement, turned away only for seconds to clean a toilet. Similar violations were previously cited on December 11, 2000, Aprit 11, 2000 and October 10, 2006. An Intent to Impose Administrative Action was issued es a result of the violation on December 11, 2000. An Administrative Complaint (fine) was levied on April 12, 2000, in the amount of one hundred dollars ($100.00) for the violation on April 11, 2000. An Administrative Complaint (fine) was levied on November 3, 2006, in the amount of one hundred dollars ($100.00) for the violation on October 10, 2006. FAC 65C-22.001(5)(a) states, in part, that direct supervision means watching and directing children’s activities within the sarne room or designated Received: Oct 25 2007 11:39am 40/25/2807 10:56 7235315 CHILD CARE LICENSURE PAGE 83/87 Administrative Complaint-Anastasia Baptist Childcare Ministry Page 2 outdoor play area and responding to each child’s needs. Childcare personnel at a facility must be assigned to provide direct supervision to a specific group of children and be present with that group of children at all times. FAC Chapter 65C-22,006(2)(a}{q), in that: The Student Health Examination was no longer current for three (3) children enrolled more than 30 days. Similar violations were previously cited on March 29, 2004, July 21, 2004, December 15, 2004, April 28, 2005, August 14, 2006 and December 13, 2006. An Intent to impose Administrative Action letter was issued as a result of the violations on August 14, 200 and December 13, 2006. FAC Chapter 65C-22.006(2)(a)-(d), states in part, that within 30 days of enrallment, each child shall have on file and keep current a completed DH Form 680, Florida Certification of Immunization Part A-1, B, or C (July 2001), or DH Form 681, Religious Exemption from immunization (May 1989). If the custodial parents or legal guardians fail to provide the documentation required within 30 days of enrollment, the facility shall not allow the child to remain in the program. 4. The above referenced violation constitutes grounds to levy this Civil Penalty pursuant to ss.402.310(1)(a) and 402.310(4), Florida Statutes at the above referenced conduct of Respondent constitutes a violation of the minimum standards, rules and regulations for the aperation of a Child Care Facility, 5. Payment of this fine can be made directly to the Department of Children and Family Services. The mailing address is: P.O. Box 2417, Jacksonville, FL. 32231, Attention: Child Care Licensure. 6. Please be advised that you do have the right to contest this Civil Penalty through an administrative hearing pursuant to Section 120.57, Florida Statutes, but that you have no more than twenty one (21) days from the date the Administrative Complaint is received to initiate this formal review. To initiate this formal review process, a petition for formal hearing must be received by the following individuals within the twenty-one-day time frame: George P. Beckwith Gregory D. Venz, Agency Clerk Chief Legal Counsel . Department of Children & Famities Department of Children & Families Office of the General Counsel 210 N Palmetto Avenue, Ste, 412 1317 Winewood Blvd., Bidg. 2, Ste 204 Dayton Beach, FL. 32114 Tallahassee, FL. 32301 Received: Oct 25 2007 11:39am * 30/25/2007 18:56 7235315 CHILD CARE LICENSURE PAGE @4/07 Administrative Complaint-Anastasia Baptist Childcare Ministry Page 3 No later than fifteen (15) days after receipt of your written request for a formal haaring, the request for 2 hearing shall be granted or denied. Absent the consent of all parties, the hearing will not commence on fewer than fourteen (14) days notice. Finally, in accordance with s. 120.57(b)(4), Florida Statutes (2004), all parties to this cause have the opportunity to respond, to present evidence and argument of all issues of involved, to conduct cross-axamination and submit evidence, to submit praposed findings of facts and order, to file exceptions to any order of a hearing officer's recommended order, and to be represented by counsel (at your expense). In addition, you have the right to have subpoenas and subpoenas duces tecum issued. Your request for an administrative hearing must state what issues and material facts you dispute, or it will be dismissed. FAILURE TO DISPUTE MATERIAL ISSUES OF FACT IN YOUR REQUEST FOR A HEARING MAY BE TREATED BY THE DEPARTMENT OF CHILDREN AND FAMILY SERVICES AS AN ELECTION BY YOU FOR THE INFORMAL PROCEEDINGS UNDER s. 120.57(2), FLORIDA STATUTES (2004). NOTICE OF RIGHTS This decision constitutes final agency action unless a person who is substantially affected by it submits a written request for hearing that is received within twenty-one days from the date on which he or she first receives this notice. The request for hearing must also meet the requirements of Section 120.56, F.S., and either Rule 28-106.201 or Rule 26-106.301, F.A.C., or else it will be dismissed as required by Section 120.569(2)(c), F.S. That law and those rules require the written request for hearing to include the following information: 1. The name and address of each agency affected and each agency's file or identification number if known; 2. The name, address, and telephone number of the person who is asking for the hearing (the petitioner); 3. The name, address, and telephone number of the petitioner's representative, if any; 4. An explanation of how the petitioner's substantial interests are or will be affected by the agency decision; 5. A statement of when and how the petitioner received notice of the agency decision; 6. A statement that the petitioner does not dispute the facts upon which the agency relied but that it wants to exercise the right to be heard anyway OR.a statement that the petitioner does dispute the facts upon which the agency relied and a list of the facts In dispute; 7. Aconcise statement of the facts as the petitioner perceives them to be, including the Specific facts set out by the agency that the petitioner wants the agency to reverse or change; Received: Oct 25 2007 11:40am @5/87 * 10/25/2007 16:56 7235315 CHILD CARE LICENSURE PAGE + Administrative Complaint-Anastasia Baptist Childcare Ministry Page 4 8. A statement of the specific rules or statutes that the petitioner believes requires the agency to reverse or modify its decision; and 9. A statement specifying what action the Petitioner wants the agency to take in the matter, Failure to request a hearing in writing and within the time frames required in this notice or failure to provide the information required by the law and rules governing requests for Chapter 120 hearings constitutes a complete waiver of any right that a substantially affected person may have to challenge this decision. The request must be received by the following persons at the following addresses on or before twenty-one (21) days of the date on which this notice was first received by the person requesting the hearing: George P, Beckwith Gregory D. Venz, Agency Clerk Chief Legal Counsel Department of Children & Familles Department of Children & Families Office of the General Counsel 210 N. Palmetto Avenue, Ste, 412 1323 Winewood Blvd., Bidg, 1, Suite 407 Dayton Beach, FL. 32114 Tallahassee, FL. 32301 po erm Pameld Buckham Program Administrat STATE OF § RIDA, DEPARTMENT OF CHILDREN AN MILIES Lvl 4p Received: Oct 25 2007 11:40am 5/07 + % 10/25/2007 18:56 7235315 CHILD CARE LICENSURE PAGE @ CERTIFICATION OF SERVICE | HEREBY CERTIFY that a true and Correct copy of the foregoing has been furnished by U.S. Certified Mail, 7005 1820 0008 0152 1459, Retum Receipt Requested, in accordance with ss. 120.60(3), Florida Statutes (2005), this lay of September, 2007. Pamela\Buckham Program Administrator

Docket for Case No: 07-005103