STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR PERSONS WITH DISABILITIES, Petitioner, Vv. License Number: 13002264A CERTIFIED MAIL 7002 2410 o00b 449 Hestia House Group Home, Owned and ae Beha Operated by The ARC Sunrise of Central Florida, Respondent. / ADMINISTRATIVE COMPLAINT The AGENCY FOR PERSONS WITH DISABILITIES, ("Petitioner,” “Agency”, Or “APD’), issues this Administrative Complaint against Hestia House Group Home, owned and operated by The ARC Sunrise of Central Florida, (“Respondent”), and states the following as the basis for this complaint: 1. Petitioner is the state agency charged with regulating the licensing and operation of foster care facilities, group home facilities, and residential habilitation centers, pursuant to § 20.197 and § 393, Fila. Stat (2015). 2. At all times material to this complaint, Respondent has held a group home facility license issued by the Agency for the following address: 1312 Sumter Street, Leesburg, Florida 34788. The Respondent also has contracted with APD to provide the residents with Medicaid Waiver developmental disability services. 3. Fla. Stat. § 393.0673 (2015), sets forth the Agency’s authority for denial, suspension, or revocation of license; moratorium on admissions; and administrative fines. Fla. Stat. § 393.0673(2) (2015), provides that the Agency may deny an application for licensure submitted under §393.067 if the applicant has failed to comply with the applicable requirements of this chapter or rules applicable to the applicant. 4. Fla. Stat. § 393.13(3)(a) (2015), states that “[p]ersons with developmental disabilities shall have a right to dignity, privacy, and humane care, including the right to be free from abuse, including sexual abuse, neglect, and exploitation.” 10. Fla. Stat. § 393.13(3)(g) (2015), states “[p]lersons with developmental disabilities shall have a right to be free from harm, including unnecessary physical, chemical, or mechanical restraint, isolation, excessive medication, abuse, or neglect.” Fla. Stat. § 393.067(7) (2015), states that “[tihe agency shall adopt chapters establishing minimum standards for facilities and programs licensed under this section...” Fla. Admin. Code R. 65G-2.009(1)(d) (2014), provides in pertinent part, as follows: (d) The facility shall adhere to and protect resident rights and freedoms in accordance with the Bill of Rights of Persons with Developmental Disabilities, as provided in § 393.13, Fla. Stat. (2015). Violations of § 393.13(3)(a), Fla. Stat. (2015) relating to humane care, abuse, sexual abuse, neglect, or exploitation and all violations of § 393.13(3)(g), Fla. Stat. (2015), shall constitute a Class | violation. All other violations of § 393.13(3), Fla. Stat. (2015), shail constitute Class II! violations. All violations of §§ 393.13(4)(c)1.-2.,(f)-(g), Fla. Stat. (2015), shall constitute Class | violations. All violations of § 393.13(4)(h), Fla. Stat. (2015) shall constitute Class II violations. All other violations of § 393.13(4), Fla. Stat. (2015), shall constitute Class III violations. Pursuant to Fla. Admin. Code R. 65G-2.0041(4)(a) (2014), “[c]lass | statutory or rule violations are violations that cause or pose an immediate threat of death or serious harm to the health, safety or welfare of a resident and which require immediate correction.” Fla. Admin. Code R. 65G-2.0041(4)(a)2. (2014), provides that Class | violations may be penalized by a moratorium on admissions, by the suspension, denial or revocation of a license, by the nonrenewal of licensure, or by a fine of up to $1,000 dollars per day per violation. Pursuant Fla. Admin. Code R. 65G-2.0041(1)(d)-(e) (2014), ‘“fijn determining whether to pursue disciplinary action in response to verified findings by the Department of Children and Families of abuse, neglect, or exploitation involving the licensee or direct service providers rendering services on behalf of the licensee, the Agency will consider the licensee’s corrective action plan and other actions taken to safeguard the health, safety, and welfare of residents upon discovery of the violation. Considerations shall include the following: Whether the licensee took immediate and appropriate actions necessary to safeguard the health, safety, and welfare of residents during and after any investigations. Whether the occurrence is a repeat violation and the nature of such violation.” 11. 12. 13. 14. 15. 16. 17 Pursuant to Fla. Admin. Code R. 65G-2.0041(2)(a)-(c) (2014), “[t]he Agency shall consider the following factors when determining the sanctions for a violation: The gravity of the violation, including whether the incident involved the abuse, neglect, exploitation, abandonment, death, or serious physical or mental injury of a resident, whether death or serious physical or mental injury could have resulted from the violation, and whether the violation has resulted in permanent or irrevocable injuries, damage to property, or loss of property or client funds; The actions already taken or being taken by the licensee to correct the violations, or the lack of remedial action; The types, dates, and frequency of previous violations and whether the violation is a repeat violation.” Pursuant to Fla. Admin. Code R. 65G-2.009(1) (2014), “[rjesidential facility services shall ensure the health and safety of the residents and shall also address the provision of appropriate physical care and supervision.” Pursuant to Fla. Admin. Code R. 65G-2.009(1)(a)1. (2014), “[eJach facility shall facilitate the implementation of client support plans, behavior plans, and any other directions from medical or health care professionals as applicable.” Pursuant to Fla. Admin. Code R. 65G-2.009(1)(c) (2014), “[t]he treatment and care of residents shall be individualized and appropriate to differences in personal goals, abilities, sex, age, and special needs.” Pursuant to Fla. Admin. Code R. 65G-2.009(6)(a) (2014), “[e]Jach facility must provide the level of supervision necessary to ensure that residents are protected from harm and that a safe and healthy living environment is created and maintained. Direct service providers must be given specific information and strategies to provide such an environment for all of residents of the facility.” Pursuant to Fla. Admin. Code R. 65G-2.009(8)(d)1. and 3. (2014), Florida Administrative Code, “[t]he following responses are strictly forbidden: Physical or corporal punishment that includes but is not limited to hitting, slapping, smacking, pinching, paddling, pulling hair, pushing or shoving residents; Verbal abuse such as cursing at residents, using slurs or derogatory names, or screaming.” Count | On or about September 12, 2014, direct care staff Olivia Dacosta was working in the Hestia House group home. Resident 1, a vulnerable adult female, left her bedroom around 9:00 pm and went into the bathroom, turned on the hot water and got into the shower. Olivia Dacosta was assigned to supervise that portion of the house and residents in that area 18. 19. 20. 21. 22: 23. and conduct 15 minute bed checks. She was reportedly on the phone in the office and unaware that Resident 1 was in the shower. Other staff in the home eventually heard the water running and found Resident 1 sitting in the shower under the hot water, with reddened skin. The Department of Children and Families (“DCF”) commenced an investigation into this incident and closed their investigation with verified findings of inadequate supervision on the part of Olivia Dacosta. On or about September 18, 2014, direct care staff Olivia Dacosta was working in the Hestia House group home and reportedly shoved Resident 2, a vulnerable adult male, against the refrigerator, pinning him with her forearm against his chest. Resident 2 was holding a belt which she took from him and swung at him. She also reportedly taunted and provoked Resident 2 during her shift, causing him to become agitated repeatedly. According to the Respondent's Individualized Care Plan for Resident 2, he is diagnosed with intellectual disabilities, Type || diabetes, hypertension, and displays behaviors including inappropriate sexual behavior. The care plan states that he has a weak heart and physical techniques, such as T.A.C.T. (therapeutic aggression control techniques), cannot be used with him. The Department of Children and Families commenced an investigation into this incident, which was closed with verified findings of physical injury to Resident 2 by direct care staff Olivia Dacosta. On or about June 18, 2015, APD Central Region sent written correspondence from Regional Operations Manager Clarence Lewis to Mark Swain, President and CEO of SunriseARC, Inc. (doing business as The ARC Sunrise of Central Florida), describing the violations that occurred in September 2014 involving Residents 1 and 2. A corrective action plan in response to the verified findings of physical injury and inadequate supervision by the Department of Children and Families was requested within 10 days. The letter stated that the corrective action plan must include the following elements: a) Training for direct care staff on the specific medical and behavioral needs for each resident, as well as the level of supervision and are required for each resident b) Retraining for direct care staff and manager(s) of the home on the prevention, detection, and reporting of abuse, neglect, and exploitation c) How you intend to prevent the occurrence of similar incidents in the future. 24. 25. 26. 27. 28. 29. The letter sent to the Respondent advised that a repeated occurrence of this violation may result in disciplinary action which could include the imposition of an administrative fine or revocation/non-renewal of the facility's license. On or about June 25, 2015, a corrective action plan was submitted by John Riehm, VP of Programs for the Respondent, to the Agency. The plan stated that staff will receive the necessary training, and that management will report and terminate any issue related to abuse, neglect, and exploitation. The Health and Safety Policy submitted stated that the Respondent will, at no time, tolerate any form of client abuse under any circumstances and that the purpose of the policy is to protect clients from all forms of abuse/neglect. As to how they intended to prevent the occurrence of similar incidents in the future, the Respondent stated that “{t]hrough constant training and re-training we hope that this will not happen again.” The aforementioned incidents constitute violations of §§ 393.13(3)(a),(g) Fla. Stat. (2015), Fla. Admin. Code R. 65G-2.009(1)(d) (2014), Fla. Admin. Code R. 65G-2.009(1) (2014), Fla. Admin. Code R. 65G-2.009(1)(a)1. (2015), Fla. Admin. Code R. 65G-2.009(1)(c) (2014), Fla. Admin. Code R. 65G-2.009(6)(a) (2014), Fla. Admin. Code R. 65G-2.009(8)(d)1.and 3.(2014) are Class | violations. Count Il On or about November 29, 2015, direct care staff Deriya Harrison was working in Hestia House group home. When doing a routine room check, she observed that Resident 2’s door was closed and knocked on it with no answer. When she opened the door with the master key, she observed Resident 2 and Resident 3, also a vulnerable adult male, sitting next to each other on the bed, unclothed, with Resident 3’s hand on Resident 2’s genitalia. There were documented reports of previous similar incidents between Residents 2 and 3. Both of their Individualized Care Plans written by the Respondent noted a history of inappropriate sexual behaviors. On the incident report dated November 30, 2015, completed by Shelly Severance, Senior Residential Program Manager, it stated that both Resident 2 and 3 had been prescribed Estradiol for sexual tendencies but Resident 2’s Estradiol was discontinued in September 2015 due to side effects. The Department of Children and Families commenced an investigation into this incident at Hestia House group home. There was no safety or 30. 31. 32. 33. behavioral plan in place for either Resident 2 or 3, and their bedrooms were located directly next to each other. In the course of the investigation, it was determined that several direct care staff, including Deriya Harrison, worked as “pool” staff (working in the home on an as-needed, irregular basis) and were not made aware of the history of inappropriate sexual behaviors between Resident 2 and 3 or that Resident 2’s Estradiol had been discontinued in September 2015. In an email to the DCF investigator Lenea Carnes from Shelly Severance, Senior Residential Program Manager, dated December 3, 2015, Ms. Severance stated that it was ultimately her responsibility to make sure all staff have knowledge of discontinued medications and medication side effects. The training sheet dated September 10, 2015, for the discontinuation of Resident 2’s Estradiol, did not indicate that Deriya Harrison was made aware of the medication change. The investigation was closed with verified findings of inadequate supervision on the part of both Deriya Harrison and Shelley Severance. On or about July 1, 2014, APD Central Region Operations Manager Clarence Lewis sent written correspondence to Mark Swain, President and CEO of SunriseARC, Inc. (doing business as The ARC Sunrise of Central Florida), notifying him of violations that occurred in the Treasure Cay Group Home, operated by the Respondent. These violations occurred in June 2013 and a subsequent investigation by the Department of Children and Families was closed with verified findings of medical neglect on the part of Shelley Severance, Senior Residential Program Manager. The Respondent continued to employ Shelley Severance as a residential program manager, even after being notified on July 1, 2014, that she was responsible for the medical neglect of a vulnerable adult resident served by the Respondent. Ms. Severance was again found responsible for the neglect of vulnerable adult residents served by the Respondent on November 29, 2015. The Respondent failed to adequately safeguard the health, safety, and welfare of their residents and failed to protect their rights and freedoms. The aforementioned incident constitutes a repeat violation of § 393.13(3)(a), Fla. Stat. (2015), § 393.13(3)(g), Fla. Stat. (2015), Fla. Admin. Code R. 65G-2.009(1)(d), Fla. Admin. Code R. 65G-2.009(1) (2014), Fla. Admin. Code R. 65G-2.009(1)(c) (2014), Fla. Admin. Code R. 65G-2.009(6)(a) (2014), and is a Class | violation. WHEREFORE, based on the aforementioned violations of rules and laws applicable to the licensee as described above, and pursuant to s. 393.0673(2), Fla. Stat. (2015), the application for licensure renewal sought for the group home facility license held by Hestia House Group Home, owned and operated by The ARC Sunrise of Central Florida, is denied. Dated: April 4, 2016 \/ MO OD: Jeannette Estes Senior Attorney Office of the General Counsel 200 N. Kentucky Ave., Suite 422 Lakeland, FL 33801 Attachments: Explanation of Rights Election of Rights Form Copies furnished to: Mark Swain Clarence Lewis The ARC Sunrise of Central Florida Regional Operations Manager 35201 Radio Road APD Central Region Leesburg, FL 34788 CERTIFICATE OF SERVICE | HEREBY CERTIFY that a copy of this Administrative Complaint was sent to the above named individuals by U.S. Mail, facsimile, or electronic mail, this day of , 20lo. Jeannette Estes Senior Attorney 200 N. Kentucky Ave., Ste. 422 Lakeland, FL 33801 STATE OF FLORIDA AGENCY FOR PERSONS WITH DISABILITIES EXPLANATION OF RIGHTS FOR ADMINISTRATIVE COMPLAINT The enclosed Administrative Compiaint charges you with violating one or more provisions of Chapter 393, Florida Statutes, or the rules supplementing that Chapter. If you have questions regarding your response or best course of action, you may wish to seek the advice of legal counsel. Your receipt of this Administrative Complaint packet constitutes service upon you. Your rights under Florida law (Chapter 120, Florida Statutes) are as follows: You may elect to dispute the violations and alleged material facts in the Complaint and request a formal hearing with the Division of Administrative Hearings before an Administrative Law Judge, which is an administrative “trial”. You and the Agency may present evidence and witnesses to prove or disprove the facts alleged and submit a written proposed recommended order after the hearing for the Judge’s consideration. Based on the evidence and any proposed recommended orders submitted, the Judge will issue a Recommended Order containing Findings of Fact, Conclusions of Law, and Recommended Penalty, if any. Following review of the Recommended Order, the Agency will issue a Final Order. In the alternative, you may elect to not dispute the material facts alleged in the Complaint and request that an informal hearing be held to present testimony or documents you wish the Agency to consider in mitigation of the alleged violations prior to disposition of this case. Any penalty levied will be included in a Final Order. If a dispute of material fact is raised during the informal hearing, the hearing will be terminated and the case referred to the Division of Administrative Hearings for a formal hearing before an Administrative Law Judge. An Election of Rights form is included with the Administrative Complaint. The Agency must receive it within 21 days of your receipt of this Administrative Complaint packet. After the Agency determines whether a dispute of material fact exists, it will make arrangements on your behalf for the appropriate hearing. You will receive notice of the date, time, and place of hearing at the address designated by you on your Election of Rights. IMPORTANT: If the Agency does not receive a completed copy of the Election of Rights form, or any other written response from you, within the 21 days of your receipt of this Administrative Complaint, you will be considered to have waived your right to a hearing in this matter and the Agency may proceed against you in this matter without your participation. STATE OF FLORIDA AGENCY FOR PERSONS WITH DISABILITIES ELECTION OF RIGHTS FOR ADMINISTRATIVE COMPLAINT RESPONDENT: The ARC Sunrise of Central Florida | have read the accompanying Administrative Complaint and Explanation of Rights in this matter. | would like to request a hearing, and I elect for the following hearing option: 0 | dispute the material facts alleged in the Administrative Complaint and request that a formal evidentiary hearing be held before an Administrative Law Judge at the Division of Administrative Hearings, pursuant to Section 120.57(1), Florida Statutes. Specifically, | dispute the following material facts (attach additional sheets if necessary): O | do not dispute the facts alleged in the Administrative Complaint and wish to be heard on the issue of penalty or conclusions of law. | request an informal hearing pursuant to Section 120.57(2), Florida Statutes. | understand that at that hearing | will be permitted to submit written or oral evidence in mitigation of the charges or explain why the facts alleged do not constitute a violation of law. Please be advised this is a legally binding document and contains important information regarding your rights. Should you desire advice regarding your response, you may wish to seek legal counsel before proceeding. By signing this document, you represent that you are authorized to act on behaif of the establishment named herein and accept responsibility for compliance with any final order resulting from this action. Failure to complete, sign and return the election of rights form to the agency within 21 days of receipt will constitute a waiver of your right to be heard in this matter and the Agency may commence proceedings without your participation, which may result in penalties against your license. As provided in §393.063(1), Florida Statutes, penalties may include suspension, revocation or denial of licensure, and fines up to $1000 per day for each violation. Election of Rights page 1 Please fill out completely: Telephone number for contact: Fax Signature: Date: Print Name: Title: Business Location Address: +~—City.—=—s—“‘(‘é‘Stnte@:=S—“‘ éZipSCO~*# MailingAddress + City State || Zip Electronic mail for contact MAIL OR FAX BOTH PAGES OF THE COMPLETED FORM TO: David De La Paz, Esq., Agency Clerk Agency for Persons with Disabilities 4030 Esplanade Way, Suite 380 Tallahassee, Florida 32399-0950 Fax: (850) 414-5759 You are advised, per Section 120.573, Florida Statutes, that mediation is not available for this action. Please keep a copy of this document for your records. Election of Rights page 2 10

Docket for Case No: 16-002623FL