FILED AUG 12-2016 Docketed CHIEF FINANCIAL OFFICER JEFF ATWATER STATE OF FLORIDA IN THE MATTER OF: DONALD PETER KOMA, CASE NO.: 169273-15-FC (License Number: F047107) / ADMINISTRATIVE COMPLAINT The Department of Financial Services, Division of Funeral, Cemetery, and Consumer Services (“Department”), files this Administrative Complaint before the Board of Funeral, Cemetery, and Consumer Services (“Board”) against Donald Peter Koma (“Respondent”) and alleges: GENERAL ALLEGATIONS 1. The Department and Board have jurisdiction over Respondent’s license and the subject matter of this proceeding pursuant to section 20.121 and chapter 497, Florida Statutes (2015). 2. At all times material to this complaint, Respondent was licensed as a direct disposer, having been issued license number F047107 (“License”). 3. At all times material to this complaint, Respondent was employed at Abbey Affordable Cremation and Funeral Services (“Abbey”), a licensed funeral establishment operating under license number F041472. 4. At all times material to this complaint, Abbey was located at 12541 B Ulmerton Road, Largo, Florida 33774. 5. At all times, material to this complaint, Clarence P. Wilson, Jr. (“Wilson”), a funeral director and embalmer having been issued license number F046664, was the funeral director in charge of Abbey. 6. Section 497.005(26), Florida Statutes, defines “direct disposer” as any person licensed under chapter 497 to practice direct disposition in this state. 7. Section 497.005(53), Florida Statutes, defines “practice of direct disposition” as the cremation of human remains without preparation of the human remains by embalming and without any attendant services or rites such as funeral or graveside services or the making of arrangements for such final disposition. 8. The practice of funeral directing is defined by section 497.372, Florida Statutes, to include, inter alia, selling or offering to sell funeral services, embalming, cremation, or other services relating to the final disposition of human remains on an at-need basis. The practice of funeral directing also includes the planning or arranging, on an at-need basis, of the details of funeral services, embalming, cremation, or other services relating to the final disposition of human remains. § 497.372, Fla. Stat. 9. Rule 69K-15.004, Florida Administrative Code, defines “at need” to mean after the individual for whom funeral arrangements are being made has died. 10. On or about February 8, 2013, R.L. died. 11. On or about February 11, 2013, R.L.’s daughter, V.L.L., met with Respondent to discuss funeral service arrangements and cremation services for her father and entered into an at- need services and merchandise contract with Abbey (“Contract”). 12. On or about February 11, 2013, Wilson was the only funeral director employed at Abbey and the only individual authorized to sign at-need contracts. 13. Wilson was not present at the meeting with V.L.L. but signed the Contract in advance of the meeting. 14. By meeting with V.L.L. to discuss funeral service arrangements and cremation services for her father and by completing the pre-signed Contract, Respondent engaged in the practice of funeral directing. COUNT 1] 15. Petitioner realleges and incorporates by reference the allegations set forth in paragraphs one through fourteen as if fully set forth herein. 16. Section 497.152(1)(a), Florida Statutes, provides that “[vJiolating any provision of this chapter or any lawful order of the board or department or of the statutory predecessors to the board or department” constitutes grounds for discipline. 17. Section 497.152(5)(a), Florida Statutes, provides that “[p}racticing or offering to practice beyond the scope permitted by this chapter [497] and rules adopted under this chapter for the type of licensure held or accepting and performing professional responsibilities the licensee knows, or has reason to know, the licensee is not competent to perform” constitutes grounds for disciplinary action. 18. Based on the foregoing, Respondent violated section 497.152(5)(a), Florida Statutes, by practicing beyond the scope of his direct disposer license when Respondent met with V.L.L. to discuss funeral service arrangements and cremation services and by completing the Contract and is therefore subject to discipline pursuant to section 497.152(1)(a), Florida Statutes. WHEREFORE, the Department respectfully requests that the Board enter an order imposing one or more of the following penalties on Respondent: revocation or suspension of his License; imposition of an administrative fine not to exceed five thousand dollars ($5,000.00) for each count or separate offense; issuance of a written reprimand; placement of his License on 3 probation; assessment of costs associated with the investigation and prosecution; requiring him to make restitution; imposition of any or all penalties delineated within section 497.153(5), Florida Statutes; and any other relief that the Board is authorized to impose pursuant to the Florida Funeral, Cemetery, and Consumer Services Act. DATED and SIGNED this | Stay of Aug USt 2016. J. Paul Whitfield Deputy Chief Financial Officer PC Found: March 24, 2015 PC Found By: Al Hall, Jean Anderson, Richard Chesler NOTICE OF RIGHTS The Licensee has the right to request a proceeding to contest this action by the Board pursuant to sections 120.569 and 120.57, Florida Statutes (2014), and Rule 28-106, Florida Administrative Code. The proceeding request must be in writing, signed by a representative for the Licensee, and must be filed with the Department within twenty-one (21) days of receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written request. The request must be filed with the Department Agency Clerk, Julie Jones, Florida Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-0390. The Licensee’s written response must be received by the Department no later than 5:00 p.m. on the twenty-first day after receipt of this notice. Mailing the response on the twenty-first day will not preserve the right to a hearing. FAILURE TO RESPOND IN WRITING WITHIN TWENTY- ONE (21) DAYS OF THE RECEIPT OF THIS NOTICE WILL CONSTITUTE A WAIVER OF THE RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF SUSPENSION OR REVOCATION WILL BE ENTERED. If the Licensee requests a proceeding, information must be provided that complies with the requirements of Rule 28-106.2015, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, the response must contain: (a) The name, address, and telephone number, and facsimile number (if any) of the respondent (for the purpose of requesting a hearing in this matter the Licensee is the "Respondent"). (b) The name, address, telephone number, facsimile number of the attorney or qualified representative of the respondent (if any) upon whom service of pleadings and other papers shall be made. (c) A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (d) A statement of when the respondent received notice of the administrative complaint. (e) | Astatement including the file number to the administrative complaint. If a hearing of any type is requested the Licensee has the right to be represented by counsel or other qualified representative at its own expense, to present evidence and argument, to call and cross-examine witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. If a proceeding is requested and there is no dispute of material fact, the provisions of section 120.57(2), Florida Statutes, apply. Oral or written evidence may be submitted in opposition to the action taken by the Board or a written statement challenging the grounds upon 5 which the Board has relied. While a hearing is normally not required in the absence of a dispute of fact, if the Licensee feels that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon request. However, if the Licensee disputes material facts which are the basis for the Board’s action, an adversarial proceeding must be requested pursuant to sections 120.569 and 120.57(1), Florida Statutes. These proceedings are held before a State Administrative Law Judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to the response to this notice may result in the request being denied. All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Mediation of this matter pursuant to section 120.573, Florida Statutes, is not available. No Department attorney will discuss this matter you or your representative during the time frame in which you have to request a hearing. STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF LEGAL SERVICES IN THE MATTER OF: DONAL PETER KOMA, CASE NO.: 169273-15-FC (License Number: F047107) ELECTION OF PROCEEDING J have received and have read the Administrative Complaint filed by the Florida Department of Financial Services ("Department") against me, including the Notice of Rights contained therein, and I understand my options. I am requesting disposition of this matter as indicated below. (CHOOSE ONE) 1. { ] Ido not dispute any of the Department’s factual allegations and J do not desire a hearing. 1 understand that by waiving my right to a hearing, the Board of Funeral, Cemetery and Consumer Services (“Board”) may enter a final order that adopts the Administrative Complaint and imposes the sanctions sought, including suspending or revoking my license(s) as may be appropriate. 2. I do not dispute any of the Department's factual allegations and I hereby elect a proceeding to be conducted in accordance with Sections 120.57(2) and 497.153(4)(b), Florida Statutes. In this regard, f desire to: | Submit a written statement and documentary evidence to the Board in lieu of a hearing; or [] Personally attend a hearing conducted by the Board at the location of a regularly scheduled Board meeting. 3. [ ] I do dispute one or more of the Department's factual allegations. I hereby request a hearing pursuant to Section 120.57(1), Florida Statutes, to be held before the Division of Administrative Hearings. I have attached to this election form the information required by Rule 28-106.2015, Florida Administrative Code, as specified in subparagraph (c) of the Notice of Rights. Specifically, f have identified the disputed issues of material fact in the response attached hereto. TO PRESERVE YOUR RIGHT TO A HEARING, YOU MUST FILE YOUR RESPONSE WITH THE DEPARTMENT OF FINANCIAL SERVICES WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. THE RESPONSE MUST BE RECEIVED BY THE DEPARTMENT NO LATER THAN 5:00 P.M. ON THE TWENTY-FIRST DAY AFTER YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. The address for filing is: DFS Agency Clerk, Julie Jones, Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390. Signature Print Name Date: Address: Date Administrative Complaint Received: If you are represented by an attorney or qualified Phone No.: representative, please attach to this election form his or her name, address, telephone and fax numbers. Fax No.: CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING FORM has been furnished by U.S. Certified Mail, return receipt requested, this Sa day of Ayus- , 2016, to: Donald Peter Koma, Respondent, at P.O. Box 4190, Seminole, Florida 33775. eirdre A-Farrington Assistant General Co, Division of Legal Set'vices Florida Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4269 Deirdre.Farrington@myfloridacfo.com Florida Bar No. 488690

Docket for Case No: 17-005191PL