STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES To: Lestey Holford dibla Certified Mail: 7012 0470 0000 1853 1688 Holford Family Day Gare Home Return Receipt Requested 862 Ashton Cove Terrace Jacksonville, FL 32218 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED the Department has imposed a Civil Penalty in the amount of One Hundred Dollars {$100.00). The Department’s authority and grounds to impase this sanction ara explained below: 1. The Department of Children and Familles is authorized by section 402.310, Florida Statutes, to sanction Lesley Holford d/b/a Holford Famlly Day Care Home for violations of chitd care licensing standards in sections 402.301 — 402.349, Florida Statutes, and chapter 65C-20, Florida Administrative Code. 2, Lestey Holford fs licensed under chapter 402, Florida Statutes, and chapter 65C-20, Florida Administrative Code, to operate a family day care home known as Holford Family Day Care Home License# F04DU0313 located at 862 Ashton Cove Terrace, Jacksonville, FL 32218, The license is currently a REGULAR license 3. During a Compiaint Investigation conducted on April 12, 2013 DCF Licensing Counsetor Paige Berse, determined that: A household member that has been disqualified by background screening has bean present in the home during the hours of operation of the family day care home. 4. The foregoing facts violate Florida Administrative Code 65C-22,008 (3) which states slt is also the intent of HB 7069 that all FDCH operators and their household members must be cleared through Background screening before having unsipervised direct contact with childreri. All new | | Please note that a request for an administrative hearing must comply with section 120.569(2)(c), Florida Statutes, and Rules 28-106.201(2), Florida Administrative Code. Those provisions require a petition for administrative hearing to include: (a) The name and address of each agency affected and each agency's file or identification number, if known; (b) The name, address, and telaphone number of the petitioner; the name, address, and telephone number of the patitloner’s representative, if any, which shall be the address for service purposes during the course of the proceeding; (c) An explanation of how the petitioner's substantial interests will be affected by the agency determination; (d) A statement of when and how the petitioner received notice of the agency decision; (e) A statement of afl disputed issues of material facts. if there are none, the petition must so indicate; (f) Acconcise statement of the ultimate facts alleged, Including the specific facts the petitioner contends warrant reversal or modification of the agency's proposed action; (g) Astatement of the specific rules or statutes the petitioner contends require reversal or modification of the agency’s proposed action, including an explanation of how the alleged facts relate to the specific rules or statutes; and (nh) A statement of the relief sought by the petitioner, stating precisely the action petitioner wishes the agency to take with respect to the agency’s proposed action. Section 120.569, Florida Statutes, and rule 28-106.201(4), Florida Administrative Code, require a petition fo be dismissed if it is not in substantial compliance with the requirements above. Mediation as described in section 120.573, Florida Statutes, may be available if agreed to by all parties, and on such terms as agreed to by all parties. The right to an administrative proceeding |s not affected when mediation does not result in a settlement. CERTIFICATE OF SERVICE { HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by certified mail return receipt no. 7012 0470 0000 1863 1588 to Lesley Holford d/b/a-Holford Family Day Care Home, 862 Ashton Cove Terrace, Jacksonville, FL 32218 this . Safety Program Manager household members must immediately complete a live scan screen upon arrival in the home. These household members shall not have unsupervised contact with children prior to being cleared through the background screening process. This includes household members living adjacent to or within a child care facility. Persons between the ages of 12 and 18 are not required to be fingerprinted but must be screened for delinquency records as usual. 5. The violation described above is a Class } violation of child care licensing standards. It is the facility's first (1°) Class ! violation of the Family Day Cara Home Standards Classification #3 Background Screening Requirements within a two-year period. The fine imposed for this violation is One Hundred Dollars ($100.00), If you do not wish to contest the findings of this administrative complaint, please submit a cashler’s check or money order made payable to the Florida Department of Children and Families, Child Care Regulation Office, 6920 Arlington Expressway, P.O. Box 2417, Jacksonville, FL 32231 if you wish to contest the findings of this administrative complaint and/or the sanctions imposed you may do so as provided in the notification of rights below. NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES IF YOU BELIEVE THE DEPARTMENT’S DECISION IS IN ERROR, YOU MAY REQUEST AN ADMINISTRATIVE HEARING TO CONTEST THE DECISION. YOUR REQUEST FOR AN ADMINISTRATIVE HEARING MUST BE IN WRITING AND MUST BE RECEIVED BY THE DEPARTMENT WITHIN 21 DAYS OF YOUR RECEIPT OF THIS NOTICE. FAILURE TO REQUEST AN ADMINISTRATIVE HEARING WITHIN THE 21 DAYS PROVIDED SHALL CONSTITUTE A WAIVER OF THE RIGHT TO A HEARING. You may submit your request far an administrative hearing to the Department at the following addresses: David Tucker Gregory D. Venz, Agency Clerk Chief Legal Counsel Department of Children & Families Department of Children & Families Office of the General Counsel P.O, Box 2417 1323 Winewood Blvd., Bldg. 1, Sulte 407 Jacksonville, FL. 32231-0083 Tallahassee, FL 32301

Docket for Case No: 13-002157