= C) ‘ Ron DeSantis P| 3 State of Florida Governor 5 - Department of Children and Families % = Chad Poppell (Op § PS Secretary MYFLF RATES OM Revocation of Religious Exemption STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES April 16, 2019 Certified Mail # 7017 2400 0000 4405 9759 To: Return Receipt Requested Kim Holman Beautiful Angels Academy XO9O0R0086 800 W Central Bivd. Orlando, Florida 32805 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED the Department intends to revoke your religious exemption located at 800 W Central Blvd., Orlando, Florida. The Department's authority and grounds to impose this sanction are explained below. 1) 2) 3) 4) 5 6 Beautiful Angels Academy operates a child care facility located at 800 W. Central Blvd., Orlando, Florida 32805. The facility operates under a religious exemption pursuant to s. 402.316, Florida Statutes. Pursuant to s. 402.316, Florida Statutes, programs that are exempt from licensure “shall meet the screening requirements pursuant to ss. 402.305 and 402.3055. Failure by a facility to comply with such screening requirements shall result in the loss of the facility's exemption from licensure.” All child care personnel must be screened in accordance with ss. 402.305(2)(a) and (b), 402.302(3), 402.302(15), and 402.3055, Florida Statutes. The Department is authorized to deny, suspend, or revoke a license for failure to comply with this section, s. 402.3055(2), Fla. Stat. During a complaint investigation conducted at the facility on February 13, 2019, Licensing Counselor Erica Baker observed Vianca Oropeza enter the facility with children later determined to be enrolled at the facility. Licensing Counselor Baker learned that Ms. Oropeza was returning from a walking field trip where she had been alone with the children and no child care personnel with a current background screening were present. Ms. Oropeza is not background screened as required by ss. 402.305 and 402.3055, Florida Statutes. Additionally, during the investigation, Licensing Counselor Baker and Child Protective Investigator Jennifer Rodriguez discovered Casarah Henderson onsite and providing care to children at Beautiful Angels Academy. Upon being discovered at the facility, Ms. Henderson abandoned the children she was supervising alone in a parking lot and fled the scene. Staff onsite reported that Ms. Henderson was running the day to day operations of Beautiful Angels Academy. Ms. Henderson is the previous owner of a licensed child care facility operated at the same location under the name of Little Kings and Queens Learning Center. On May 5, 2017, and while Ms. Henderson owned Little Kings and Queens Learning Center, the license was issued an 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700 Mission: Work in Partnership with Local Communities to Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency administrative fine and the license was suspended for thirty days due to the accumulation of multiple violations of ss. 402.301-402.319, Fla. Stat. 7) Shortly thereafter, Ms. Henderson filed a notice for her child care facility at 800 W. Central Bivd., Orlando, Florida 32805, to be recognized as a religious exempt program pursuant to s. 402.316, Fla. Stat. On May 31, 2017, the Department issued a letter denying the request for exemption. “Once licensed, such facility cannot withdraw from the act and continue to operate”, s. 402.316(3), Fla. Stat. A copy of the letter has been attached hereto as Exhibit A and is incorporated by reference. 8 Following the denial of religious exemption, Ms. Henderson asserted to the Department that she was no longer associated with the child care facility and that she had sold her business to Kim Holden. Ms. Holden subsequently filed a notice to be recognized as a religious exempt program. Following the discovery of Ms. Henderson at the facility on February 13, 2019, Ms. Holden was discovered to be Ms. Henderson's mother. Ms. Holden failed to list Ms. Henderson on the facility's Affidavits of Compliance listing the names and background screening statuses of its child care personnel for 2017 and 2018. 9) Ms. Henderson continues to operate the child care facility with the assistance of Ms. Holden in deliberate defiance of the Department's previous denial of her application for religious exemption. Additionally, an individual that did not have background screening as required by statute was discovered onsite at the facility. Therefore, the Department has the authority to revoke the facility's religious exemption pursuant to s. 402.316, Fla. Stat. 10) An additional requirement to qualify for an exemption from licensure pursuant to s. 402.316, Florida Statutes, is that the child care facility must be an integral part of a church or parochial school. 11) Aside from the letter provided by the facility, the Department can find no documentation of the existence of Victory Christian Fellowship at 800 W. Central Bivd., Orlando, Florida 32805. It is a misdemeanor of the first degree to operate or attempt to operate a child care facility without a license or without registering with the Department, pursuant to s. 402.319(1) (c) Florida Statutes. If the Department determines you are operating a child care facility without _a license, the Department _may petition the circuit court to issue _an_ injunction against you under section 402.312, Florida Statutes, and may refer the matter to the State Attorney under section 402.319 Florida Statutes. 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” Should you have any questions regarding this notification, please contact the Child Care Program Office at (850) 488-4900. Sincerely, Shelley Tinney Operations and Management Consultant II CC: Samantha Wass de Czege, Director, Office of Child Care Regulation Richard Forrester, Regional Safety Program Manager Christina Bryant and Avida Rosa, Licensing Supervisors Erica Baker, Licensing Counselor Stefanie Camfield, Assistant General Counsel Darlene Jones, ELC of Orange County Joe Gibilisco, Florida Coalition of Christian Private Schools Accreditation, Inc. Enclosure: Notification of Rights Under Chapter 120, Florida Statutes Ww 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 SECTIONS 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: Agency Clerk Department of Children and Families 1317 Winewood Blvd, Bldg. 2, Rm. 204 Tallahassee, FL 32399-0700 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 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, 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. - 9 x 4; Rick Scott 2 Oo ce) 0 State of Florida Governor 4 2 Department of Children and Families % & Mike Carroll %, cy Secretary &, A MYFLFAMILIES.COM May 31, 2017 Certified Mail No. Return Receipt Requested Little Kings and Queens Learning Center 7014 2120 0002 9127 8675 800 W Central Blvd. Orlando, Florida 32805 License # CO9OR1047 Dear Ms. Henderson: This letter is to advise you that the Department of Children and Families intends not to recognize your request to operate the child care program, Little Kings and Queens Learning Center, located at 800 W. Central Blvd., under the religious exemption allowance pursuant to s. 402.316, Florida Statutes (F.S.). This decision is based on the following: a) The Department considered the licensure history of Little Kings and Queens Learning Center, which included an extensive list of violations. Little Kings and Queens Learning Center was first licensed as a child care facility on October 30, 2014, and located at 800 W Centra! Blvd., in Orlando, Florida. Since 2014, the violations at this location included: eighteen class II violations (7 of those aforementioned violations were from insufficient staff to child ratios), and eighteen class III violations. Additionally, a certified letter from Green Apple Accreditation revoking your accreditation dated 5/9/2017 has been issued. b) Section 402.316(3), F.S. clearly states a child care facility which is covered by exemption contained in Section 402.316 (1), F.S. may submit itself to the licensing provisions of Florida Statute 402 and that once the program is licensed, the program cannot withdraw from the act and continue to operate. It was not the intent of the legislature to allow child care facilities whose licenses are in jeopardy, due to continued violation of minimum standards, to use the exemption to continue operating in violation of the law. An Administrative Complaint has been issued 5/5/2017 by the Department to Little Kings and Queens Learning Center assessing an Administrative Fine and a 1 (one) year suspension for ratio and supervision violations. RI 0. AD) TIVE PROCEEDIN: 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” Should you have any questions regarding this notification, please contact the Child Care Program Office at (850) 488-4900. 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700 Mission: Work in Partnership with Local Communities to Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency Singprely, Linda Halpin, Operations and Management Consultant II Office of Child Care Regulation Copy: Richard Forrester, Regional Safety Program Manager Daphne Harvey, Program Analyst Avida Rosa, Licensing Supervisor Paul Sexton, Office of General Counsel Shane DeBoard, Regional Counsel 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 SECTIONS 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: Agency Clerk Department of Children and Families 1317 Winewood Bivd, Bidg. 2, Rm. 204 Tallahassee, FL 32399-0700 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 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 * iS x % Rick Scott 3 OQ (e) ° State of Florida Governor » Department of Childr ili % Z P en and Families Mike Carroll Dp > Secretary MYFLFAMILIES.COM July 7, 2017 Certified Mail No. Return Receipt Requested Little Kings and Queens Learning Center 7014 2120 0002 9127 8323 800 W Central Blvd. Orlando, Florida 32805 License # CO9OR1047 Dear Ms. Henderson: This letter is to advise you that the Department of Children and Families intends not to recognize your request to operate the child care program, Little Kings and Queens Learning Center, located at 800 W. Central Blvd., under the religious exemption allowance pursuant to s. 402.316, Florida Statutes (F.S.). This decision is based on the following: a) The Department considered the licensure history of Little Kings and Queens Learning Center, which included an extensive list of violations. Little Kings and Queens Learning Center was first licensed as a child care facility on October 30, 2014, and located at 800 W Central Bivd., in Orlando, Florida. Since 2014, the violations at this location included: eighteen class II violations (7 of those aforementioned violations were from insufficient staff to child ratios), and eighteen class III violations. Additionally, a certified letter from Green Apple Accreditation revoking your accreditation dated 5/9/2017 has been issued. b) Section 402.316(3), F.S. clearly states a child care facility which is covered by exemption contained in Section 402.316 (1), F.S. may submit itself to the licensing provisions of Florida Statute 402 and that once the program is licensed, the program cannot withdraw from the act and continue to operate. It was not the intent of the legislature to allow child care facilities whose licenses are in jeopardy, due to continued violation of minimum standards, to use the exemption to continue operating in violation of the law. An Administrative Complaint has been issued 5/5/2017 by the Department to Little Kings and Queens Learning Center assessing an Administrative Fine and a 30 (thirty) day suspension for ratio and supervision violations. GHT TO AD TIVE PR EDING 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” Should you have any questions regarding this notification, please contact the Child Care Program Office at (850) 488-4900. 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700 Mission: Work in Partnership with Local Communities to Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency Sinogrely, } NY ; iV Va) 4 -4inda Halpin, Opefations and Management Consultant II Office of Child Care Regulation Copy: Richard Forrester, Regional Safety Program Manager Daphne Harvey, Program Analyst Avida Rosa, Licensing Supervisor Ivory Avant, Assistant General Counsel, Office of General Counsel David Tucker, Chief Legal Counsel 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 SECTIONS 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: Agency Clerk Department of Children and Families 1317 Winewood Blvd, Bidg. 2, Rm. 204 Tallahassee, FL 32399-0700 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 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) Astatement requesting an administrative (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. 04/21/2019 To: whom is may concern, My name is Marcia Ravelo, | am an employee at Beautiful Angels Academy. | was hired by Miss Kim Holman, to be the lead teacher in the infant classroom. . Ms. Holman is in charge and controls daily activities. Ms. CaSarah Henderson does not work at Beautiful Angels Academy, she is a parent. | asked her to open the door for me on 2/13/2019 because | was changing a baby and she was going to be leaving soon. When Ms. Henderson left with her children, | was in the baby room with the babies. | opened the patio door to let fresh air in, and that’s when | saw Ms. Henderson leave with her children. The other teacher Ms. Fleming, and the DCF worker were on the patio when she left. The children were not left unsupervised DEBBIE ANN BATTLE Sincerely, hs Notary Public - State of Florica /] Se Commission + GG 274606 \ [/ RSE wy Comm. Exaires Nov 5. 2022 \ | t Boncec through Nationa: Notary Assn. 9 \ Vo fF Ww Marcia Ravelo laoblb- fr 04/15/2019 To: whom is may concern, My name is Tacoria Fleming | am an employee at Beautiful Angels Academy. | was hired in by Kim Holman, to be the lead teacher in the preschool classroom. Ms. CaSarah Henderson does not work at Beautiful Angels Academy. She was picking up her children on 02/13/2019 when DCF first came about the complaint. When Ms. Henderson left with her children, | was on the patio with the DCF worker Jennifer Rodriguez, the children were not left unsupervised. Ms. Holman is in charge and controls daily activities. Sincerely, Tacoria Fleming ¢ F} Cerer— — DEBBIE ANN S3ATTLE Notary Public - State of Florida Commission + GG 274606 My Comm, Exsires Nov 5. 2022 Bonded through Nationa: Notary Assn. 9 04/21/2019 To: whom is may concern, My name is Vianca Oropeza, I am not an employee at Beautiful Angels Academy. I am a parent. On 2/14/2019 I was asked by a couple parents to walk there children from school since I have to pass that way. I was not asked by the staff at Beautiful Angels Academy, this is something that was set up by the parents. I was not aware parents had to be fingerprinted just to walk the children, I did this as a favor so the kids would not have to walk by themselves. I went and got my fingerprints done since I found out that this was a problem, per DCF. Sincerely, DEABIE ANN 3AT Fo ae (op | Mi leCieng— Janca Oropeza 4/22/2019 AHCA BGS - Background Screening Result Provider Name: Beautiful Angels Academy , % , 3 Printed by: PATRICIA GREEN OCA Number: 074835602 Department of Children Background Screening Result and Families This individual's eligibility status as of 4/22/2019 is provided below. The employer must retain a hard copy of this result in the individual's employee file. If we become aware of a change in an individual's eligibility status, an email notification will be sent to the most recent employer of record in the Clearinghouse or the last provider to submit a screening request through the Clearinghouse. It is recommended health care and/or service provider employers check the screening results of staff regularly as an individual's status may change based on information received. If you become aware of an event that may change the employee's eligibility please contact your specified agency, Department of Children and Families, at 888-352-2842. The employer must take the appropriate action when a change in status occurs in accordance with Section 435.06, Florida Statutes. Applicant Name: SSN: Date of Birth: Race: Sex: VIANCA GLARIMAR OROPEZA XXX-XX-5420 2/6/1996 WHITE FEMALE Retained Prints Expiration Date: 1/31/2024 Clearinghouse Screening Available?: Yes Department of Children and Families Eligibility The Department has reviewed child welfare records for the State of Florida. This search was conducted in Florida's Automated Child Welfare Information System {(SACWIS). wv There is no record of the applicant being listed as the caregiver responsible for a verified finding of abuse, abandonment or neglect of a child. The individual may request additional information pursuant to s.39.202. Florida Statutes. Item Status Eligibility Determination Date DCF General Eligible 2/18/2019 DCF Child Care Eligible 2/18/2019 DCF Substance Abuse - Adult Only Eligible 2/18/2019 DCF Summer Camps Agency Review Required DCF Menta! Health Agency Review Required APD General Agency Review Required APD Developmental Disability Centers Agency Review Required APD CDC Agency Review Required Employment History (as reported to Florida's Background Screening Clearinghouse by provider employers.) Provider Position Hire Date End Date No records to display. Print Event: 192295405 Print Date: 4/22/2019 https://apps.ahca.myflorida.com/bgsweb2/Profile/PrintVerificationForm/2295405 1/1 OEPAR?, Religious Exempt Facility Information o> te Name: Beautiful Angels Academy Inc. GB oc stancaras = ‘-, 1D Number: X09OR0086 GHB] 0c sr stancars & ) ~ Address: 800 W Central Blvd, Orlando FL 32805-1809 = ~ Phone Number: (407) 307-5336 Capacity: 36 [ERR 8 standards ia . Owner/Director/Staff Responsible: Kim Holman C — . . s + Inspection Information 7 “A sr Type: Complaint Date: 02/14/2019 Arrival/Departure Time: 11:30 AM to 03:36 PM 2 P; “a Staff Present: 2 Children Present: 10 Onsite Visit: Yes N AND * [School Readiness Inspection] [ INSPECTION CHECKLIST GENERAL REQUIREMENTS 01. Capacity (Form OEL-SR-6202, Section 1 - Capacity, Page 10) Compliance 02. Minimum Age Requirements (Form OEL-SR-6202, Section 2 Minimum Age Compliance Requirements, Page 13) 03. Ratios (Form OEL-SR-6202, Section 3 Ratios, Page 13) Compliance Ratio: Infants- 3:1, Twos/Fours- 7:4 04. Supervision (Form OEL-SR-6202, Section 5 Supervision, pages 16-17) FALSE Noncompliance i Deaed 04-01 Supervision of children in the [Mixed aged] group was inadequate in that (the children were left alone while child care personnel! opened the door]. (Section 5, numbers 1 - 17) [SR] Somments. At time of inspection, counselor observed children being left alone inside the classroom Bue Date Completed at time of inspection Violation Level Class 2 04-03 Children in the outdoor play area were not adequately supervised in that [they were left alone on the playground]. (Section 5, number 4) [SR] Due Date Completed at time of inspection : Violation Level Class 2 04-12 In addition to the staff required to meet staff-to-child ratios, one additional adult was not present during a field trip. (Section 5. number 15) [SR] True Rue Date Completed at time of inspection Violation Level Class 2 04-14 The individual(s) responsible for children on a field trip did not have a telephone or other means of instant communication available. (Sector's, Nitaper TS) 188) False. A cellular phone was ready for use. Due Date Completed at time of inspection Violation Level Class 2 Page 1 of 14 Name: Beautiful Angels Academy Inc. License #: XO9OROO86 Address: 800 W Central Blvd, Orlando FL 32805-1809 Type: Complaint Date: 02/14/2019 Hien Gomolance't ' | False — 04-18 An unscreened individual was left alone to supervise children in care. (Section 19.5) [SR] A parent that does not work for Beautiful Angels Academy, was asked by another parent to walk children from school Comments At time of inspection, counselor observed an unscreened individual conducting a walking field trip alone with the children. Due Date Completed at time of inspection Violation Level Class 1 05. Driver's License, Physician Certification & First Aid/CPR Training (if Noncompliance applicable) (Form OEL-SR-6202, Section 6 Transportation, Page 17-19) False 05-01 The programs driver did not have [any transportation documents]. 1. A valid Mote drivers license. len Pe } There was no driver, or vehicle use to walk children from school 2. An annual physical examination which grants medical approval to drive . 3. Valid certificate(s) of course completion for first aid training and infant and child cardiopulmonary resuscitation (CPR) procedures. (Section 6.2, numbers 1 and 2) [SR] Comments At time of inspection, counselor did not observe any transportation documents. n/a Due Date Completed at time of inspection Violation Level Class 2 06, Vehicle Insurance and Inspection (If Applicable) (Form OEL-SR-6202, Section 6 Noncompliance Transportation, Page 17-19) -Compli D ' 06-01 A vehicle(s) used to transport children did not have the required insurance coverage. (Section 6.1, number 6) [SR] Gomments At time of inspection, counselor did not observe insurance coverage Due Date Completed at time of inspection Violation Level Ciass 2 06-03 A vehicle(s) used to transport children did not have an annual inspection by a mechanic to ensure it was in proper working order. (Section 6.1 number 1) [SR] There was no vehicle used to transport children.02/13/2019. DCF observed a parent picking up her children, they we misinformed. Comments At time of inspection, counselor did not observe an annual inspection. Due Date Completed at time of inspection Violation Level Class 2 07. Seat Belts/Child Restraints (If Applicable) (Form OEL-SR-6202, Section 6 Not Monitored Transportation, Pages 17-19) The vehicte used for transportation was not available during inspection. 08. Transportation (If Applicable) (Form OEL-SR-6202, Section 6 Transportation, Pause’ Noncompliance Pages 17-19) Non-Compliance Description 08-02 The program did not maintain a log for all children being transported in a vehicle. (Section 6.2, number 3) [SR] No vehicle was used to transport children. Comments P At time of inspection, counselor did not observe a transportation log. Rue Date Completed at time of inspection Violation Level Class 2 09. Planned Activities (Form OEL-SR-6202, Section 7 Planned Activities, Pages Compliance 19-20) 10. Field Trip Permission (Form OEL-SR-6202, Section 8 Field Trip Activity, Pages = a) ce Noncompliance 20-21) Field trip permission is signed for all children on the parent handbook at the bottom of page. Paee 2 of 14 Name: Beautiful Angels Academy Inc. License #: XOSORO086 Address: 800 W Central Blvd, Orlando FL 32805-1809 Type: Complaint Date: 02/14/2019 ‘FALSE — 10-04 Documentation of custodial parent or legal guardians permission for field trips was not on file for the child(ren). (Section 8, number 5) [SR] parents required to sign has signed a permission field for field trip Comments. At time of inspection, counselor did not observe permission slips for the walking field trips for school age children Due Date 04/29/2019 Violation Level Class 3 10-06 The program operator/staff did not have emergency contact information for the children on a field trip, or any other activity away from the facility. (Section 6.1, number 4) [SR] The operator/staff has child's contact info on phone and on paper. Comments. At time of inspection, counselor did not observe emergency contact information for the walking field trips for schoo! age children Due Date 04/29/2019 Violation Level Class 3 11, Child Discipline (Form OEL-SR-6202, Section 9 Child Discipline, Pages 21-22) Compliance PHYSICAL ENVIRONMENT 12. Facility Environment (Form OEL-SR-6202, Section 10 Physical Environment, TRUE — Noncompliance Pages 22-23) Additional training has been facilitated to statf Non-Compliance Descripti 12-01 Areas of the program facility were found to be in need of cleaning. (Section 10, number 1) [SR] Comments At time of inspection, counselor observed the air vents not cleaned. Due Date 04/29/2019 Violation Level Class 3 Non-c Descripti 12-02 An area(s) of the program facility was observed to not be in good repair. (Section 10, number 1) [SR] True this has been corrected Comments At time of inspection, counselor observed the baseboards are separated from the wall, the paint is peeling off of the wall. Due Date 04/29/2019 Violation Level Class $ 12-08 During the programs operating hours, an activity occurred in a portion of the building which endangered the health and/or safety of children in care. (Section 10, number 11) [SR] Comments True At time of inspection, counselor observed inside of the infant room, a child's knee being stuck between the bars of the cribs. This has been addressed, additional training has been provided to staff. Due Date Completed at time of inspection Violation Level Class 2 13. Toxic Substances, Hazardous Materials and Weapons (Form OEL-SR-6202, Section 10 TRUE Noncompliance Physical Environment, Pages 22-23) This has been fixed 13-03 The programs storage of harmful items including cleaning supplies, flammable products, poisonous, toxic, and hazardous materials were accessible to children in care. (Section 10, number 4) [SR] Somments At time of inspection, counselor observed chemicals accessible under the sink in the infant room. Due Date 04/29/2019 Violation Level Class 2 Page 3 of 14 ce Name: Beautiful Angels Academy Inc. License #: XO9ORO086 4 Were rere Address: 800 W Central Bivd, Orlando FL 32805-1809 Type: Complaint Date: 02/14/2019 13-04 Knives and/or sharp tools were accessible to children in care. (Section 10, number 4) [SR] all knives are kept in the kitchen behind a locked door, in above cabinents Comments At time of inspection, counselor observed inside the unlocked kitchen, knives accessible. Due Date 04/29/2019 Violation Level Ciass 2 14. Lighting, Temperature and Ventilation (Form OEL-SR-6202, Section 10 Physical Compliance Environment, Pages 23-24) 15, Indoor Floor Space (Form OEL-SR-6202, Section 1.1 Indoor Floor Space, Pages Compliance 11-12) 16. Outdoor Play Area/Fencing (Form OEL-SR-6202, Section 10.7 Outdoor Play Area Compliance and Section 10.8 Fencing, Pages 25-26) 17. Bedding and Linens (Form OEL-SR-6202, Section 12.4 Bedding and Linens, Page Compliance 29) 18. Nap/Sleep Space Requirements (Form OEL-SR-6202, Section 10.4 Nap and Sleep ge Noncompliance Space(s)/Safe Sleep Practices, Page 24) additional training has been provided to Non-Compl Descripti 18-02 A minimum distance of 18" was not maintained around each napping/sleeping space. {Section 10.4, number 3) {SR] Comments At time of inspection, counselor observed during naptime the mats were not 18” apart Due Date 04/29/2018 Violation Level Class 3 19. Crib Requirements (Form OEL-SR-6202, Section 10.4 Nap and Sleep Space(s)/Safe TRUE Noncompliance Sleep Practices, Page 24) = Teacher has been retrained 19-03 The program used cribs that did not meet current federal guidelines for construction regulations as outlined in Title 16, Parts 1219 & 1220 Code of Federal Regulations. (Section 10.4, number 6) [SR] Comments At time of inspection, counselor observed an infant using a crib dated from 2009. Due Date 04/29/2019 Violation Level Class 2 20. Restrooms and Bath Facilities (Form OEL-SR-6202, Section 10.6 Bathrooms and = True Noncompliance Sinks, Page 25) 20-03 The program facility did not have the number of toilets and/or sinks required for its designated capacity. {Section 10.6, number 2) (SRI This has been fixed. The toilet was not working properly at the time and Beautiful Angels Academy was waiting on additional funding at the time of inspection. However, a new toilet was purchased and installed At time of inspection, counselor observed the toilet inside of the boys restroom is not working. Due Date 04/29/2019 Violation Level Class 3 21. Operable Phone (Form OEL-SR-6202, Section 14.2 Fire Safety, Page 33) Compliance 22. Fire Drills & Emergency Preparedness (Form OEL-SR-6202, Section 14 Fire FALSE Noncompliance Safety and Emergency Preparedness and Response, Pages 32-34) Page 4 of 14 5 Name: Beautiful Angels Academy Inc. License #: XO9OROO86 Sd tear Ram Address: 800 W Central Bivd, Orlando FL 32805-1809 Type: Complaint Date: 02/14/2019 22-08 The written record of the fire drills was incomplete and did not include the following: [month of January]. (Section 14.3, number 2) [SR] Emergency Preparedness is on the wall. Fire Drills and Physical environment forms were presented at the time of inspection Lomments At time of inspection, counselor observed the fire inspection log incomplete. Due Date 04/29/2019 Violation Level Class 3 23. Food Preparation Area (Form OEL-SR-6202, Section 17.1 Food Preparation Area False Noncompliance and Section 17.2 Food Storage, Pages 37-38) flon-Combilance Heacricti 23-02 Preparation of food occurred in an area that is not a designated food preparation area. (Section 17.1) [SR] Comments At time of inspection, counselor observed inside the infant room, bottles being prepared. Yes they were prepared but there is a sinck in the baby room for handwashing, and parents provide bottled water for babies. Due Date 04/29/2019 Violation Level Class 3 Non-Compliance Description True 23-20 Open packages of perishabie or leftover foods were not (stored in a container or labeled.]. (Section 17.2, number 4) [SR] Comments Staff has been retrained At time of inspection, counselor observed an opened package of ground beef stored inside of the refrigerator without label. Due Date 04/29/2019 Violation Level Class 3 24. Health and Sanitation (Form OEL-SR-6202, Section 12 Health and Sanitation, Compliance Page 28) 25. Diapering (Form OEL-SR-6202, Section 12.3 Diapering, Pages 28-29) Compliance 26. Indoor Equipment (Form OEL-SR-6202, Section 11 Equipment and Furnishings, Compliance Pages 26-27) 27. Outdoor Equipment (Form OEL-SR-6202, Section 11 Equipment and Furnishings, Compliance Pages 26-27) TRAINING 28. Training Requirements (Form OEL-SR-6202, Section 18 Training Requirements, Noncompliance Pages 26-27) 28-06 The facility did not have documented proof that all staff were trained and knowledgeable in the use of fire extinguishers within 30 days of employment. (Section 14.2, number 3) [SR} This has been fixed. Comments At time of inspection, counselor did not observe fire extinguisher training inside of the personnel file. Due Date 04/29/2019 Violation Level Class 3 28-07 Program personnel did not complete training requirements prior to unsupervised contact with or care of children, or if supervised, within 90 days of beginning employment or service with the program. (Section 18.1) [SR] Comments At time of inspection, counselor did not observe inside of personnel file, completed School Readiness Training. Bue Date 04/29/2019 Violation Level Class 3 Paee S of 14 CY Name: Beautiful Angels Academy Inc. License #: XO9ORCO86 ww swttes Address: 800 W Central Blvd, Orlando FL 32805-1809 Type: Complaint Date: 02/14/2019 HEALTH REQUIREMENTS 29. Communicable Disease Control (Form OEL-SR-6202, Section 13 Health-Related Compliance Requirements, Pages 30-31) 30. First Aid Requirements (Form OEL-SR-6202, Section 13.4 First Aid and Compliance Cardiopulmonary Resuscitation Pages 31-32) 31. CPR Requirements (Form OEL-SR-6202, Section 13.4 First Aid and Compliance Cardiopulmonary Resuscitation Pages 31-32) 32. Emergency Telephone Numbers (Form OEL-SR-6202, Section 15 Emergency Compliance Procedures and Notification, Pages 34-35) 33. Accident/incident Notification and Documentation (Form OEL-SR-6202, Section 15 Noncompliance Emergency Procedures and Notification, Page 35) Non-Compliance Description 33-05 Pros y of the accident/incident form to the individual authorized to pick up child on the day the incident occurred. (Section 15.1, number 4) [SR] no such incident occurred. Comments At time of inspection, counselor did not observe personnel informing parent of incident. Due Date 04/29/2019 Violation Level Class 3 34, Medication (Form OEL-SR-6202, Section 16 Medication, Pages 35-36) Not Applicable Facility does not administer medication. FOOD AND NUTRITION 35, Meals and Snacks (Form OEL-SR-6202, Section 17 Food and Nutrition Services, Compliance Pages 3642 36. Bottles, Breastmilk, Formula and Infant Food (Form OEL-SR-6202, Section 17.4 Noncompliance Breastmilk, Infant Formula and Food, Pages 40-41) Se> Non-Compliance Description 36-02 Bottles and/or sippy cups brought Mi es were not labeled with childs first and last name. (Section 17.6, number 5} [SR] Gomments At time of inspection, counselor observed bottles without the label. Que Date 04/28/3019 Violation Level Class 3 ’ RECORD KEEPING 37. Immunization Records (Form OEL-SR-6202, Section 19.2 Record False Noncompliance Keeping/Childrens Files, Page 47) - 37-01 Child(ren) did not have a Florida Certification of Immunization (DH Form 680) or a Religious Exemption from Immunization (DH Form 681) on file within 30 days of enrollment. (Section 19.2, number 2) [SR] i ; ‘i and switched to new centers before the day in question. Which child were you referring to, since several children have left the daycare Comments At time of inspection, counselor did not observe inside of the children files, Immunization Records. Due Date 04/29/2019 Violation Level Class 3 Page 6 of 14 cr Name: Beautiful Angels Academy Inc. License #: XO9OR0086 ww eB fame Address: 800 W Central Blvd, Orlando Fi 32805-1809 Type: Complaint Date: 02/14/2019 38. Student Health and Records (Form OEL-SR-6202, Section 19.2 Record Keeping/Childrens Files, Page 46) 38-01 Child(ren) did not have a Student Health Examination (DH Form 3040) or an equivalent health statement on file within 30 days of enrollment. (Section 19.2, number 1) [SR] Which child? Comments At time of inspection, counselor did not observe inside of the children files, Student Health Exam. Due Date 04/29/2019 Violation Level Class 3 39, Enrollment Information (Form OEL-SR-6202, Section 19.2 Record Keeping/Childrens Files, Page 47) x i False 39-06 A signed statement from the custodial parents or legal guardian attesting the program had provided their written expulsion policy was not on file for child(ren). (Section 19.2, number $) [SR] All files have expulsion forms in parent hand book Comments At time of inspection, counselor did not observe a signed Expulsion Policy inside the child's file. Due Date 04/29/2019 Violation Level Class 3 40. Personnel Records (Form OEL-SR-6202, Section 19.4 Record Keeping/Personnel Compliance Records, Page 48) 41, Background Screening Documents (Form OEL-SR-6202, Section 19.5 Record Keeping/Background Screening, Page 49) False Non-Compliance Description 41-05 Rescreening was not completed every five years after the initial screening. (Section 19.5, number 1) [SR] who are you referring to? Staff members at the center have no breaks over 90 days Comments At time of inspection, counselor did not observe inside of the personnel file, the background rescreening wasn't completed after 90 days of being out of the industry. Due Date 04/29/2019 Violation Level Class 2 41-06 A five year employment history verification was not completed and on file prior to hire for the operator, program personnel, volunteers and substitutes. (Section 19.5, number 2) [SR] Which staff? Comments At time of inspection, counselor did not observe the 5 year employment verification inside the personnel files. Rue Date 04/29/2019 Violation Level Class 3 42. Daily Attendance (Form OEL-SR-6202, Section 19.3 Record Keeping/Attendance, False — Page 48) 42-01 There were no daily attendance records or they were unavailable for review by the inspection authority. (Section 19.3, number 1) [SR] i Comments At time of inspection, counselor did not observe completed daily attendance. Due Date 04/29/2019 Violation Level Class 3 ENFORCEMENT 43. Access/Child Safety (Form OEL-SR-6202, Section 20 Access and Section 21 Compliance Child Safety, Page 50) Page 7 of 14 Noncompliance Noncompliance Noncompliance Noncompliance EXAMPLE- REGISTRATION FORM Adsstston tata COOL L7bi w ia Hours in Care: Full day Part-time Deane Arey \s Readem) i DAY CARE CENTER ISTRATION INFORMATION Chita's Name XN Con WIGAN Nickname Address TS S, lee Ave ACVAKAS ECL B250S Home Phone/Cell Phone/Pager D21 eq qQ- lwo & ee = = Birthdate Le (2. | (ue Birthplace Cc) AQAAAG EL Sex t Race/Ethnicity LY. Father or Guardian’s Name 7 ») ee €, a a\\ NO Cc Sy CH : Living: ats No Natural Father/Stepfather/Guardian SS# Who has legal custody? Father or Guardian’s Employment Position (Faculty, Staff or Student —undergrad or grad.) ‘Telephone number at work Work/School schedule Email Address Mother or Guardian’s Name L ‘ ( \ x < OXY WEN ACG: Ces : No. Natural Mother/Stepmother/Guardian? SS# Who has legal custody? Mother or Guardian’s Employment BAce Ae Position (Faculty, Staff or Student —undergrad or grad.) YaeAsxnan ‘ CO Wreca? } is Telephone number at work Work/School schedule Email Address Child lives with: (Check one) Both parents vl Mother Father Legal Guardian If legal guardian, list name, address, phone number if other than above: = ” List the name and inti te of all children living in your home: “AX ¢ \ ON) ¢ yLes j Ne Ss \ Cun ott Q P) wari COW Ye ay BN, 6 iO Ovi» / Family Doctor VCC \ QA an ye x \ ep) Address Telephone In the event I cannot be reached, please call (these individuals are also authorized to pick-up my child): z= Relation to the Child Address ; Phone : 1 OO ren desSa) (421) 4712- | 833 2 Ay WendacrCSson 90773 -woea4 List any serious allergies (such as insect bites, food allergies, etc.) ‘al Rx YAR List any disabilities or special needs EXAMPLE - REGISTRATION FORM rg CL\.\n \ OC \ AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTION FOR (Child’s Name) \__ X\ \ \ Ci \ ) UE Aen In the event that | cannot be reached to make arrangements for emergency medical attention, | authorize the facility director or person in charge to take my child to Name of Licensed Physician SS Telephone No. a Or to (name of hospital or clinic) Telephone No. \ © TRANSPORTATION INFORMATION Child will most frequently be picked up by Ww ( XN ‘\ Auto make and color \ VY *« WO C WAC License number Other individuals authorized to pick up my child: Name Relationship Driver’s License Number Car Model/Tag Noraiie Peon A | AR COCOA Ooo 06 ZO oe DAY CARE CENTER INFORMATION PACKET This is to acknowledge that astaff member has provided me with an information packet and discussed it’s contents. Cet » 05 7:\% Parent or Guardian’s Signature - Date FIELD TRIPS pastes mai(c Ar I, the parent of ¢ i\ ( We \Nes\ CJ Sontracted the transportation services of the Day Care Center for extra curricular field trips. I fully understand that the Day Care Center is liable for transportation services only and not for accidents/inj uring such activities when the children are under the supervision of other adults at other locations. pate 1 | | 7 | \X Parent’s signatufte CHANGES : In the event any of this information changes, please notify us immediately. Thank you.

Docket for Case No: 19-002344