STATE OF FLORIDA © DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2017-13344 SHANQUEL S. MCCULLOUGH, C.N.A., ) RESPONDENT. ADMINISTRATIV! MP 'T Petitioner Department of Health (Department) files this Administrative -Complaint before the Board of Nursing (Board) agal nst Respondent Shanquel S. McCullough, C.N.A., and in support thereof alleges: 1. Petitioner is the state agency charged with regulating the practice of certified nursing assistants pursuant to Chapters 20.43, Florida Statutes (2017); Chapter 456, Florida Statutes (2017); and Chapter 464, Florida Statutes (2017). 2. At all times material to this Complaint, Respondent was certified to practice as a nursing assistant within the State of Florida, having been issued certification number CNA 152173. 3. At all times material to this Complaint, Respondent's address of record was 4111 9" Street East, Bradenton, Florida 34208. 4, In or around May 2017, Respondent was employed by Centerstone of Florida, a behavioral health clinic located in Brandenton, Florida. 5. Patient A.T., a 25-year-old female, was a patient at Centerstone of Florida. 6. On or about May 6, 2017, Respondent engaged in an altercation with Patient A.T. | 7. During the altercation, Respondent repeatedly punched, or hit, Patient A.T. 8. Section 464.204(1)(b), Florida Statutes (2016), authorizes the Board of Nursing to impose discipline against a certified nursing assistant for intentionally violating any provision of this chapter, chapter 456, or the rules adopted by the board. 9. Section 464.018(1)(h), Florida Statutes (2016), authorizes the Board of Nursing to impose disciple for engaging in unprofessional conduct as defined by board rule. - 10. Rule 64B9-8.005(13), Florida Administrative Code, defines unprofessional conduct to include using force against a patient, striking a Administrative Complaint ° Dept of Health v. Shanquel S. McCullough, CNA. DOH Case No. 2017-13344 patient, or throwing objects at a patient. 11. Respondent Intentionally used force against a patient and intentionally struck a patient by repeatedly punching, or hitting, Patient A.T. 12. Based on the foregoing, Respondent violated Section 464.204(1)(b), Florida Statutes (2016), by intentionally violating Section 464.018(1)(h), Florida Statutes (2016), by violating Rule 6489-8.005(13), Florida Administrative Code. WHEREFORE, Petitioner respectfully requests that the Board enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's certification, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. [Signature appears on following page] Administrative Complaint Dep't of Health v. Shanquel S. McCullough, C.N.A. DOH Case No. 2017-13344 SIGNED this 12%) day of WtobeY_, 2017. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary Npunniod Kristen M, Summers Assistant General Counsel FL DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 _ DePIDEPUTY CLERK - Florida Bar Number 112206 DATE mber tereene (T) (850) 558-9909 OCT 13 2017 - (F) (850) 245-4662 (E) Kristen.Summers@fihealth.gov PCP Meeting: October 13, 2017 PCP Members: Stone-Gale and Forst Administrative Complaint Dep't of Health v. Shanquel S. McCullough, C.N.A. DOH Case No. 2017-13344 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be In writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint | pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, Is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and: prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition any other discipline imposed. i { i ' \ Administrative Complaint Dep't of Health v. Shanquel S. McCullough, C.N.A. DOH Case No. 2017-13344

Docket for Case No: 18-002741PL