FILED September 3, 2020 STATE OF FLORIDA AGENCY FOR PERSONS WITH DISABILITIES Agency Clerk Agency for Persons with Disabilities AGENCY FOR PERSONS WITH DISABILITIES, Petitioner, v. License Number: 5654-6-GA. BURKE STREET GROUP HOME, OWNED AND OPERATED BY SANTA MARIA HOME CARE, INC., Respondent. / ADMINISTRATIVE COMPLAINT The AGENCY FOR PERSONS WITH DISABILITIES, (“Agency”), issues this Administrative Complaint against Burke Street Group Home, owned and operated by Santa Maria Home Care, Inc. (or “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, residential habilitation centers, and comprehensive transitional education programs pursuant to section 20.197 and Chapter 393, Florida Statutes. 2. At all times material to this complaint, Respondent has held a group home facility license issued by the Agency for the following address: 3134 West Burke Street, Tampa, Florida 33614. 3. Santa Maria Home Care, Inc. is a registered Florida for profit corporation. 4. Section 393.0673, Florida Statutes, sets forth the Agency’s authority for denial, suspension, or revocation of license; moratorium on admissions; and administrative fines. (1) The agency may revoke or suspend a license or impose an administrative fine, not to exceed $1,000 per violation per day, if: (a) The licensee has: 1. Falsely represented or omitted a material fact in its license application submitted under s. 393.067; 10. 2. Had prior action taken against it under the Medicaid or Medicare program; or 3. Failed to comply with the applicable requirements of this chapter or rules applicable to the licensee; or (b) The Department of Children and Families has verified that the licensee is responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult. COUNT I The Agency re-alleges and incorporates paragraphs one through four as if fully set forth herein. On or about April 25, 2020, K.T., a vulnerable adult female resident of Respondent’s Burke Street Group Home, left the group home and began walking away through the front yard. K.T. was followed by Respondent’s staff, Mary Gainous and Frances Tertulien, who attempted to physically restrain K.T. by tugging on her hair, hitting her, and putting an arm around her neck to try and keep her from walking away. On or about April 30, 2020, the Department of Children and Families (“DCF”) commenced an investigation involving allegations of abuse, neglect or exploitation of a vulnerable adult, resident K.T. On or about May 27, 2020, DCF closed their investigation with verified findings of abuse, neglect or exploitation of a vulnerable adult against the Respondent’s employee Frances Tertulien. The Agency may revoke a license or impose an administrative fine if the Department of Children and Families has verified that the licensee is responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult. § 393.0673, Fla. Stat. Based on the foregoing, Respondent violated section 393.0673, Florida Statutes, by being found responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult. COUNT II The Agency re-alleges and incorporates paragraphs one through four as if fully set forth herein. On or about April 25, 2020, K.T., a vulnerable adult female resident of Respondent’s Burke Street Group Home, left the group home and began walking away through the front yard. K.T. was followed by Respondent’s staff, Mary Gainous and Frances Tertulien, who ran after K.T. and attempted to physically 12. 13. 14. 15. 16. 17. restrain K.T. by tugging on her hair, hitting her, and putting an arm around her neck to try and keep her from walking away. Due to a lengthy history of engaging in highly intense maladaptive behaviors, resident K.T. receives behavior analysis services and requires a higher level of behavioral supports in her residential setting, including staff who are trained on her behavior analysis support plan and crisis management procedures. The Burke Street Group Home was not designated by the Agency as a group home capable of providing the level of behavioral support that K.T. required at the time of this incident on April 25, 2020. Respondent knew that K.T. required a higher level of behavioral supports in her residential setting when she agreed to provide residential facility services to K.T. K.T.’s behavior plan describes how staff are to respond when she elopes from the group home. Staff are to calmly follow K.T., without running after her or attempting to physically stop her and keep her in their line of sight. Staff Mary Gainous and Frances Tertulien failed to follow K.T.’s behavior plan by running after her and attempting to physically restrain her. Staff must be certified through an Agency-approved emergency procedure curriculum before being authorized or permitted to administer physical restraint procedures. Staff Mary Gainous was not certified or authorized to administer physical restraint procedures. Fla. Admin. Code R. 65G-8.002(3). When the DCF PI interviewed Mary Gainous on May 14, 2020, she stated to the PI she had taken the class 3 times but never passed. A letter from the PCM Association to Mary Gainous, dated May 7, /2020, stated she did not pass the certification training. Any physical crisis management technique that might restrict or obstruct an individual’s airway or impair breathing, including techniques whereby staff persons use their hands or body to place pressure on the client’s head, neck, back, chest, abdomen, or joints is prohibited. Fla. Admin. Code R. 65G-8.009(3). Physical or corporal punishment that includes but is not limited to hitting, slapping, smacking, pinching, paddling, pulling hair, pushing or shoving residents is strictly forbidden. Such actions constitute a Class I violation. Fla. Admin. Code R. 65G- 2.009(8)(d)1. Direct service providers shall be trained in responding to serious and spontaneous behavioral incidents requiring emergency intervention procedures. A violation of this paragraph shall constitute a Class II violation. Fla. Admin. Code R. 65G- 2.009(8)(b). 20. 21. 22. 23, 24, 25. 26. 27. The Agency may revoke a license or impose an administrative fine if the licensee has failed to comply with the applicable requirements of this chapter or applicable tules. § 393.0673, Fla. Stat. Based on the foregoing, Respondent, with full knowledge that Mary Gainous failed to certify for the emergency procedure curriculum, violated Rule 65G-2.009(8)(b), Florida Administrative Code, by failing to have properly trained direct service provider staff responding to serious and spontaneous behavioral incidents that require emergency intervention procedures. Respondent is in violation of section 393.0673, Florida Statutes, by being found responsible for the abuse, neglect, or abandonment of a child or the abuse, neglect, or exploitation of a vulnerable adult. COUNT III The Agency re-alleges and incorporates paragraphs one through four as if fully set forth herein. On or about January 10, 2019, Respondent was issued a non-compliance letter in response to verified findings of abuse and neglect of a vulnerable adult resident at the Burke Street Group Home on or about October 24, 2018. The Respondent was required to submit a corrective action plan to the Agency that included retraining of staff on the prevention of abuse, neglect, and exploitation; retraining of staff on crisis management intervention procedures; and retraining of staff on incident reporting requirements. The staff verified as responsible for the abuse and neglect of a vulnerable adult resident was Quintrell Warren. Although the Respondent was notified that Quintrell Warren was identified as the person responsible for abuse and neglect of a vulnerable adult, the Respondent has continued to employ Quintrell Warren as a manager at the Burke Street Group Home. Despite the corrective action plan submitted by the Respondent in 2019, a Class I violation of verified abuse, neglect, or exploitation of a vulnerable adult resident occurred again at the Respondent’s Burke Street Group Home on or about April 25, 2020. Respondent failed to ensure that all staff present at the Burke Street Group Home were properly trained and certified to implement emergency procedures of physical restraint during the incident on or about April 25, 2020. Critical incidents, which include when the Department of Children and Families has made a finding of verified abuse, neglect, exploitation, or abandonment by the provider or the provider’s employees, must be reported to the appropriate Regional Office by telephone or in person within | hour after facility staff become aware of the incident. Fla. Admin. Code R. 65G-2.010(5)(a). 28. 29. 30. 31. Respondent was notified of the verified finding of abuse, neglect, or exploitation by the DCF investigator on or about May 22, 2020 and was also notified of the same information by the Agency on or about May 28, 2020. On or about May 28, 2020 and May 29, 2020, APD staff Meisha Stewart verbally instructed Respondent to submit a critical incident report to the Agency for the verified findings of abuse, neglect, or exploitation but Respondent refused to do so. Pursuant to Rule 65G-2.0041(2), Florida Administrative Code, the Agency shall consider the following factors when determining the sanctions for a violation, to include the gravity of the violation; the lack of remedial action being taken by the licensee to correct the violation; whether the violation is a repeat violation; if the licensee willfully committed the violation; and the licensee’s cooperation with the Agency. Fla. Admin. Code R. 65G-2.0041. The Agency may revoke a license if the licensee has failed to comply with the rules applicable to the licensee. § 393.0673, Fla. Stat. Based on the foregoing, Respondent violated: Rule 65G-2.010(5)(a), Florida Administrative Code, by failing to report a critical incident to the Agency after being notified by DCF and instructed by APD to do so. Respondent committed a knowing and willful violation of the rule. Based on the foregoing and pursuant to section 393.0673, Florida Statutes, the Agency requests that a Final Order be entered that revokes the Respondent’s license or places any less penalty against Respondent’s license as proscribed by law. = | Dated September 3, 2020 eo a C _ Trevor Suter, Esq. Senior Attorney Agency for Persons with Disabilities 4030 Esplanade Way, Suite 380 Tallahassee, Florida 32399-0950 Attachments: Notice of Administrative Hearing Rights Copies furnished to: Marie Chery Michael Taylor Santa Maria Home Care, Inc. Regional Operations Manager 3808 North Lincoln Avenue APD Suncoast Region Tampa, Florida 33607 ago agency for persons with disabilities State of Florida Notice of Administrative Hearing Rights For Administrative Complaint You have the right to request a hearing to be conducted in accordance with sections 120.569 and 120.57, Florida Statutes (F.S.), and to be represented by counsel or qualified representative to challenge the administrative complaint. To obtain an administrative hearing, you must file a written request for hearing with the Agency Clerk by 5:00 PM Eastern Time within 21 days of the day that you receive the administrative complaint. Filed with the Agency Clerk means received by the Agency Clerk’s Office. If you fail to file the request for hearing within the 21 days, you waive the right to have a hearing. The request for hearing shall include: 1. Your name, address, e-mail address, telephone number, and facsimile number, if any, if you are not represented by an attorney or a qualified representative; 2. The name, address, e-mail address, telephone number, and facsimile number of your attorney or qualified representative, if any, upon whom service of pleadings and other papers shall be made; 3. A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (Pursuant to sections 120.569 and 120.57, F.S., a disputed issue of material fact entitles you to a formal hearing; if there are no disputed issues of material fact then you are entitled to an informal hearing); 4. A statement of when you received notice of the administrative complaint; and 5. A statement including the file number on the administrative complaint. You must file your request for hearing with the Agency Clerk by hand delivery, express delivery service, U.S. mail, facsimile transmission, or by email at the following address: Agency for Persons with Disabilities Attention: Agency Clerk Filed with the Agency Clerk means received in 4030 Esplanade Way, Suite 335 the Office of Agency Clerk by 5:00 pm on the Tallahassee, FL 32399 due date. APD.AgencyClerk@apdcares.org (850) 922-4556 (phone) Mediation under s.120.573, Florida Statutes, is (850) 410-0665 (fax) not available for this proceeding. Rev. OGC May 19, 2017 http://apdcares.org

Docket for Case No: 20-004473FL