STATE OF FLORIDA fF DEPARTMENT OF CHILDREN AND FAMILIES/, « To: Children of Light Academy, Inc. Certified Mail Return 6140 Perrine Ranch Road Receipt No. New Port Richey, Florida 34655 7015 0640 0001 0004 1883 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department is imposing a Five Hundred Twenty-Five Dollars ($525.00) Administrative Fine. The Department's authority and grounds to impose this sanction are explained below. 1. The Department of Children and Families is authorized by section 402.310, Florida Statutes, to sanction Children of Light Academy, Inc., for violations of child care licensing standards in sections 402.301 — 402.319, Florida Statues, and Chapter 65C-22, Florida Administrative Code. 2. Children of Light Academy, Inc., is licensed under section 402, Florida Statues, and Chapter 65C-22, Florida Administrative Code, to operate a child care facility known as Children of Light Academy, at 6140 Perrine Ranch Road, New Port Richey, Florida 34655, The facility license was issued Certificate of License #CO6PA0264 which is currently a regular license. 3. During a routine inspection on November 3, 2014, the facility was found to be in violation of Child Care Licensing Standard #57 Children's Health/mmunization and Records (Parent's Acknowledgment - Influenza Guide), The licensing counselor found three of the children's records that did not have the custodial parents or legal guardians written acknowledgment of having been provided information detailing the causes, symptoms, and transmission of the influenza virus, annually, during the months of August and September as required. During a routine inspection on December 4, 2015, the facility was found to be in violation of Child Care Licensing Standard #57 Children's Health/immunization and Records (Parent's Acknowledgment - Influenza Guide). The licensing counselor found 34 of the children’s records that did not have the custodial parents or legal guardians written acknowledgment of having been provided information detailing the causes, symptoms, and transmission of the influenza virus, annually, during the months of August and September as required. CEnclosure During a re-inspection on February 24, 2016, the facility was found to be in violation of Child Care Licensing Standard #57 Children's Health/Immunization and Records (Parent's Acknowledgment - Influenza Guide). The licensing counselor found several of the children's records that did not have the custodial parents or legal guardians written acknowledgment of having been provided information detailing the causes, symptoms, and transmission of the influenza virus, annually, during the months of August and September as required. . 4. The acts and practices described in paragraph 3 above are violations of Rule 65C-22.006(3)(c)4, Florida Administrative Code, and Section 402.305(9)(b), Florida Statutes, which state in part: 65C-22.006 Record Keeping; (3) Enrollment Information. The facility operator shall obtain enrollment information from the child's custodial parent or legal guardian prior to accepting a child in care. This information shall be documented on CF- FSP Form 5219, March 2009, Child Care Application for Enrollment, which is incorporated by reference, or an equivalent form that contains all the information required by the department on CF-FSP Form 5219. CF-FSP Form 5219 may be obtained from the licensing authority or on the department's website at www.myflorida.com/childcare. (c) There shall be signed statements from the custodial parents or legal guardian that the child care facility has provided them with the following information: 4. Annually, during the months of August and September, the child care facility director must provide parents with information detailing the causes, symptoms, and transmission of the influenza virus. To assist providers the department developed a brochure, CF/P| 175-70, June 2009, Influenza Virus, Guide to Parents, which may be obtained from the department's website at www.myflorida.com/childcare. Section 402.305(9)(b), Florida Statutes: (9) ADMISSIONS AND RECORDKEEPING. (b) During the months of August and September of each year, each - child care facility shall provide parents of children enrolled in the facility detailed information regarding the causes, symptoms, and transmission of the influenza virus in an effort to educate those parents regarding the importance of immunizing their children against influenza as recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. 5. The violations described above in paragraph 3 are Class 3 violations of the child care licensing standards. It is the facility's third Class 3 violation of Child Care Licensing Standard #57 Children's Health/Immunization 2 and Records (Parent's Acknowledgment - Influenza Guide). On November 3, 2014, technical assistance was provided to the facility. On December 4, 2015, a Notice of Administrative Warning issued for this violation. On February 24, 2016, Notice of Administrative Notice of Administrative Action was issued for this violation. A Twenty-Five Dollar ($25.00) fine is hereby imposed for this Class 3 violation. 6. During the re-inspection on February 24, 2016, the facility was found to be in violation of Child Care Licensing Standard #63, Access/Child Abuse or Neglect/Misrepresentation (Fraudulent Information Provided _ Misrepresentation). In connection with the violation of Licensing Standard #57 that occurred on December 4, 2015, the licensing counselor gave the facility 30 days to obtain the custodial parent's or legal guardian's written acknowledgement of having been provided information detailing the causes, symptoms, and transmission of the influenza virus as required. On December 28, 2015, the director sent an email to the licensing counselor attaching a copy of allegedly written acknowledgements by the custodial parents or legal guardians. However, several of the signatures on the acknowledgements appeared to be the same or had very similar handwriting. During the February 24, 2016, on-site inspection the licensing counselor compared the written acknowledgments provided by the director on December 28, 2015, (the "December 28, 2015 Written Acknowledgements") to the enroilment packets in the children's files. During the re-inspection, on February 24, 2016, the licensing counselor observed that four (4) of the custodial parent's or legal guardian's name on the December 28, 2015 Written Acknowledgements, did not match the spelling of the custodial parent's or legal! guardian's name on the children’s enrollment forms. In one case, the first name of the custodial parent or legal guardian was spelled Kristine on the enroflment form for child, P.W. (date of enrollment August 18, 2014) but the name was spelled Kristin on the December 28, 2015 Written Acknowledgements. In a second case, the first name of the custodial parent or legal guardian was spelled Sylvia on the enrollment form for child, Y.S. (date of enrollment December 12, 2014); however, the name was spelled Selvia on the December 28, 2015 Written Acknowledgements. In a third case, the first name of the custodial parent or legal guardian was spelled Mariham on the enrollment form for child, S.H. (date of enroliment March 2, 2015) but the name was spelled Reham on the December 28, 2015 Written Acknowledgements. In the fourth case, the name of the custodial parent or legal guardian was spelled Christina Morcos on the enrollment form for child, C.A. (date of enrollment August 24, 2015) but the name was spelled Christin Samir on the December 28, 2015 Written Acknowledgements. During the re-inspection, on February 24, 2016, the licensing counselor observed that five (5) of the custodial parent's or legal guardian's names on the December 28, 2015 Written Acknowledgements, did not match of the names of the listed custodial parents or legal guardians on the children’s enrollment forms. 3 Margret Salahdeh and Michael Basily are listed as the custodial parents or legal guardians on the enrollment form for Me.B., date of enrollment April 16, 2015. The mother signed her name, Margret Salahdeh, on the enrollment packet forms, however the December 28, 2015 Written Acknowledgements, had the name Margo Basily, which did not match the signature or the name on the enrollment packet forms. Margret Salahdeh and Michael Basily are listed as the custodial parents or legal guardians on the enroliment form for Ma.B., date of enrollment April 16, 2015. The mother signed her name, Margret Salahdeh, on the enrollment packet forms, however the December 28, 2015 Written Acknowledgements, had the name Margo Basily, which did not match the signature or the name on the enrollment packet forms. Magdy Botros and Mariam Bortos are listed as the custodial parents or legal guardians on the enrollment form for A.B., date of enrollment May 31, 2015. The father, Magdy Botros, signed his name on the enrollment packet forms, however the December 28, 2015 Written Acknowledgements, had the name Anna, which did not match the signature or the names on the enrollment packet forms. Sandra Marcos and Ramy Marcos are listed as the custodial parents or fegal guardians on the enrollment form for P.M., date of enrollment August 18, 2014. The mother signed her name, Sandra, on the enrollment packet forms, however the December 28, 2015 Written Acknowledgements, had the name Yousef, next to the name D. Marcos (should have been P. Marcos) which did not match the signature or the names on the enrollment packet forms. Sherry Shnounda and Joseph Shnounda are listed as the custodial parents or legal guardians of MS., date of enrollment June 26, 2015. It is unknown who signed the December 28, 2015 Written Acknowledgements, which had the name Cinna, which did not match the signature or the names on the enrollment packet forms. During the re-inspection, on February 24, 2016, the licensing counselor also observed that eight (8) of the influenza acknowledgment forms had altered dates. The date on the influenza acknowledgement form was altered from November 6, 2014 to November 6, 2015 for the child, JAN. (date of enroliment August 18, 2014). The date on the influenza acknowledgment form was altered from June 8, 2015 to December 8, 2015 for the child, R.A. (date of enrollment June 8, 2015). The date on the influenza acknowledgement form was altered from March 2, 2015 to December 2, 2015 for the child, J.A. (date of enrollment March 2, 2015). The date on the influenza acknowledgement form was altered from April 30, 2015 to April 30, 2016 for the child, A.E. (date of enrolment April 30, 2015). The date on the influenza acknowledgement form was altered from August 18, 2014 to October 8, 2015 for the child, G. S. (date of enrollment August 18, 2014). The date on the influenza acknowledgement form was altered from August 18, 2014 to October 8, 2015 for the child, J.S. (date of enrollment August 18, 2014). The date on the influenza acknowledgement form was altered from October 3, 2014 to October 3, 2015 for the child, D.S. (date of enrollment October 14, 2014). The date on the influenza acknowledgement form was altered from November 12, 2014 to November 12, 2016 for the child, J.K. (date of enrollment September 24, 2014). The licensing counselor had reviewed these 4 forms during the inspection on December 4, 2015, and found that many of these records were not in compliance at that time. Now, during the February 24, 2016, inspection the forms with some alteration have a more current date and in two cases a future date. The licensing counselor spoke with the director about these various inconsistencies. The director initially advised that the custodial parents or legal guardians did sign the December 28, 2015 Written Acknowledgements, but later stated that some parents did not come to the facility and that the driver took the information and had the parent who picked up the children sign the December 28, 2015 Written Acknowledgements. During the inspection the licensing counselor called one of the legal guardians who advised the licensing inspector that she had not received the influenza virus information in December 2015 and that she did not sign an acknowledgment of having received such information in December 2015. The facility did not request additional time to comply with this requirement. The facility simply had another person sign instead of the parent or legal guardian. The requirement is clear, the parent or legal guardian is to be provided the influenza information annually during August and September, and the parent or legal guardian has to sign an acknowledgement that they have been provided this information. The Department had a meeting with the director and Father Aghathon Saleh on March 4, 2016, to address the seriousness of these misrepresentations to the Department. During this meeting the director stated that one parent picks up all the children and that the person who picked up the children at the bus stop was the individual who signed the December 28, 2015 Written Acknowledgements for the children being picked up. This confirmed that in some cases the custodial parent or legal guardian did not actually sign the December 28, 2015 Written Acknowledgements. The facility provided the licensing counselor with a document that misrepresented to the Department who actually signed for the children. This action by the facility not only fails to comply with the statutory and code requirements to have the custodial parent or legal guardian sign an acknowledgment that the facility provided them with information detailing the causes, symptoms, and transmission of the influenza virus, but also constitutes a misrepresentation by the facility to the Department. In addition to not having the custodial parent or legal guardian of each child sign the acknowledgment, some of the influenza acknowledgment forms had the alleged date of signature altered. !n at least two cases the alleged date signed was a date in the future. The Department relies on the facility and the director to follow the minimum standards set forth in the statutes and in the Florida Administrative Code each day it operates a child care facility. That trust and reliance is compromised when the facility provides the Department with a document that misrepresents the custodial parent's or legal guardian’s signature, and alters dates as to when the custodial or legal guardian signed the forms. Child Care 5 licensing standards have been developed for the health, safety and welfare of the children. . The facility's misrepresentation regarding those requirements to the ‘ Department places the health, safety and welfare of the children in care at risk. 7. The acts and practices described in paragraph 6 above are violations of Section 402.319 (f), Florida Statutes, which states in part: (f) Make any other misrepresentation, by act or omission, regarding the licensure or operation of a child care facility or family day care home to a parent or guardian who has a child placed in the facility or is inquiring as to placing. a child in the facility, or to a representative of the licensing authority, or to a representative of a law enforcement agency, including, but not limited to, any misrepresentation as to: 1. The number of children at the child care facility or the family day care home: 2. The part of the child care facility or family day care home designated for child care; 3. The qualifications or credentials of child care personnel; 4. Whether a family day care home or child care facility complies with the screening requirements of s. 402.305; or 5. Whether child care personnel have the training as required by s. 402.305. 8. The violations described above in paragraph 6 are Class 1 violations of the child care licensing standards, The February 24, 2016, violation is the facility's first Class | violation of Licensing Standard # 63,Access/Child Abuse or Neglect/Misrepresentation (Fraudulent information Provided Misrepresentation). A Notice of Administrative Action was issued to the facility. The facility was advised of the Department's intent to impose an administrative fine as a result of this violation. A Five Hundred Dollars ($500.00) fine is hereby imposed for this Class 1 violation. 9. If you do not wish to contest the findings of this administrative complaint, payment of the fine amount may be made directly to the Florida Department of Children and Families, Child Care Regulation (Attention: Mary Beth Wehnes), 9393 N. Florida Ave., Suite 500, Tampa, FL 33612. RIGHT TO ADMINISTRATIVE PROCEEDING IF YOU BELIEVE THE PROPOSED ACTION DESCRIBED IN THIS ADMINISTRATIVE COMPLAINT IS IN ERROR, YOU MAY REQUEST AN ADMINISTRATIVE HEARING IN ACCORDANCE WITH THE ENCLOSED “NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES” Certificate of Service { HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by certified mail return receipt to Fr Aghathon Saleh as president and registered agent of Children of Light Academy, Inc., at 6140 Perrine Ranch Road, New Port Richey, Florida 34655, this tb day of une , 2016. Mauprertr wenn Mary Beth Wehnes, CPM Regional Safety Program Manager CC: Alicia Gonzalez, DCF Legal Counsel Anna Walker, Family Services Counselor Enclosure NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES IF YOU BELIEVE THE DEPARTMENT'S DECISION iS IN ERROR, YOU MAY REQUEST AN ADMINISTRATIVE HEARING UNDER SECTION 120.569 AND 120.57, FLORIDA STATUTES, TO CONTEST THE DECISION. YOUR REQUEST FOR AN ADMINISTRATIVE HEARING MUST BE RECEIVED BY THE DEPARTMENT BY 5:00 P.M., NO LATER THAN 21 CALENDAR DAYS AFTER YOU RECEIVED THE DEPARTMENT'S ADMINISTRATIVE COMPLAINT. You must submit your request for an administrative hearing to the Department at the following addresses: Department of Children and Families Legal Counsel (Attention: Shane DeBoard) 9393 N. Florida Ave. Suite 900 Tampa, FL 33612 Department of Children and Families Agency Clerk (Attention: Paul Sexton) Office of General Counsel 1317 Winewood Blvd Building 2, Room 204 Tallahassee, FL 32399 IF YOUR REQUEST FOR AN ADMINISTRATIVE HEARING IS NOT RECEIVED BY THE DEPARTMENT BY THE ABOVE DEADLINE, YOU WILL HAVE WAIVED YOUR RIGHTS TO A HEARING AND THE DEPARTMENT'S PROPOSED ACTION WILL BE FINAL. ANY DENIAL, SUSPENSION, REVOCATION OR OTHER ACTION CONCERNING YOUR LICENSE OR REGISTRATION WILL BE EFFECTIVE ON THAT DATE OR ON ANY LATER EFFECTIVE DATE STATED IN THE ADMINISTRATIVE COMPLAINT AND ANY PENALTY OR FINE IMPOSED MUST BE PAID WITHIN 30 DAYS THEREAFTER OR ANY EARLIER TIME PROVIDED IN THE ADMINISTRATIVE COMPLAINT. If you disagree with the facts stated in the Department's administrative complaint, you may request a formal administrative hearing under section 120.57(1), Florida Statutes. At a formal hearing, you may present evidence and arguments on all issues involved, and question the witnesses called by the Department. You have the right to be represented by counsel or other qualified representative. If you do not disagree with the facts stated in the Department's administrative complaint, you may request an informal administrative hearing under section 120.57(2), Florida Statutes. At an informal hearing, you may present your 8 argument or a written statement for consideration by the Department. You have the right to be represented by counsel or other qualified representative. Your request for an administrative hearing must meet the requirements of Rule 28-106.2015(5), Florida Administrative Code, must be prepared legibly on 8 % by 11 inch white paper, and include all of the following items: (a) Your name, address, email address (if any) and telephone number. (b) The name, address, email address (if any) and telephone number of your attorney or qualified representative, if any. (c) A statement requesting an administrative hearing. (d) A statement of all facts in the administrative complaint with which you disagree. If you do not disagree with any of the facts stated in the administrative complaint, you must say so. (e) A statement of when and how you received the administrative complaint. (f) A statement identifying the file number of the administrative complaint, if shown on the administrative complaint. Section 120.569, Florida Statutes, and rule 28-106.201(4), Florida Administrative Code, require the Department to dismiss your request for hearing if it is not in substantial compliance with the requirements above. Mediation as described in section 120.573, Florida Statutes, is not available. However, other forms of mediation or informal dispute resolution may be available after a timely request for an administrative hearing has been received, if agreed to by all parties, and on such terms as agreed to by all parties. The right to an administrative proceeding is not affected when mediation or informal dispute resolution does not result in a settlement.

Docket for Case No: 16-004672