STATE OF FLORIDA Pel ED AGENCY FOR HEALTH CARE ADMINISTRATION 2! NOV 14 py 3:08 DIMISiON of ADMIN Fhe STATE OF FLORIDA ERAT VE AGENCY FOR HEALTH CARE RINGS ADMINISTRATION, | Ol- 41S Petitioner, vs. AHCA NO: 09-01-0037 NH’ DARCY HALL, INC., d/b/a DARCY HALL OF LIFE CARE, Respondent. ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that after twenty one (21) days from the receipt of this Complaint the Agency for Health Care Administration (hereinafter referred to as the "Agency") intends to impose a civil penalty in the amount of Six Thousand Four Hundred ($6,400) Dollars upon Darcy Hall, Inc., d/b/a Darcy Hall of Life Care (hereinafter referred to as "Respondent"). As grounds for the imposition of this civil penalty the Agency alleges as follows: 1. The Agency has jurisdiction over Respondent by virtue of the provisions of Chapter 400, Part II, Florida Statutes. 2. Respondent is licensed to operate at 2170 Palm Beach Lakes Boulevard, West Palm Beach, Florida 33409, as a nursing home in compliance with Chapter 400 Part II Florida Statutes and Rule 59A-4, Florida Administrative Code. . 3. The Respondent has violated the provisions of Chapter 400, Part II, Florida Statutes, and the provisions of Chapter 59A-4, Florida Administrative Code, in that it failed to correct within the mandated time frame of immediately (Section 400.23(4)(c), er oe eggeeegee ore memes + rr Florida Statutes) (2) Class III, and (1) Class I deficiencies, cited during the survey of 2/21-24/00. These deficiencies, set forth below, were still uncorrected when a follow —up visit was made on 3/29-31/00. (a) Tag F224. Staff Treatment of Residents. The facility did not provide three resident with goods and services necessary to avoid physical harm and mental anguish. The residents were #10, #11, #12. The findings include: (1) On 9/07/99 at 11:30 am the nurses’ notes documented that resident #12, who was 98 years old and dependent for all care, “rolled off bed scale hitting head laceration to middle forehead, 2 cm. skin to upper left forearm other to left top hand. Skins tears cleansed. Gauze applied to laceration. Put call in to Doctor, __ orders to send to ___ E.R. for evaluation.” (Name of doctor and E.R. deleted by surveyor.) The nurses’ notes for 6 pm documented the resident received 11 staples to the forehead. Based on this documentation the facility staff did not provide adequate staff assistance and proper technique during the procedure to weight this resident and resultant harm occurred. The surveyor asked the Administrator and Director of Nursing for documentation of an investigation of this incident, but the facility could provide none. (2) Resident #11 suffers from Dementia and had a current physician’s order for a lactose free diet. The resident was observed to be given milk with lunch on 2/22/00 by the CNA. On the morning of 2/23/00 at 7:30 am, the surveyor was observing the resident’s skin condition with the CNA and the resident was at the same time being cleaned, as he/she had been incontinent of stool and had diarrhea. The resident was put on the toilet and did void. The care plans of 11/16/99 (reviewed 02/08/00) for prevention of skin breakdown documented toilet every two hours and after meals. At 8:45 am, after a merry walker tugging at his/her incontinent brief stating with alarm “hurry up, hurry up, I'm going.” The surveyor informed CNA (not assigned to the resident) that the resident STR oe Poe reer had to go to the bathroom. The CNA took the resident into his/her room, left the resident there, and did not toilet the resident. The CNA then proceeded to go to the room across the hall and took the breakfast tray of another resident. The CNA assigned to resident #11 was informed of the toileting need by the unassigned CNA. By the time the assigned CNA arrived in the room, as observed by the surveyor, the resident had diarrhea all over. The staff neglected to provide the lactose free diet and did not attend promptly to the resident’s urgent need for toileting. (3) Resident #10 had a diagnosis of dementia, he/she was admitted on 12/09/99 with a weight of 85 Ibs. (ideal body weight is 105 lbs.) The record documented on 02/03/00 that the resident weighed 79 Ibs. This is a 7% loss since admission. The resident was observed on the mornings of 02/21/00, 02/22/00 and 02/23/00 to be in constant motion ambulating freely all over the wing in a merry walker. On 02/22/00 at 11:45 am the CNA was observed to take the resident out of the merry walker and sit him/her in a chair and place their lunch tray in front on him/her. The CNA then left the room and closed the door. A few minutes later the resident came out of the room and was ambulating down the hall without the walker. The CNA stated to the resident you should go back and finish lunch. The resident is then taken to the room, placed back in the merry walker and leaves the room. The surveyors observed the lunch tray to be taken away with a few bites of potato and % slice of buttered bread eaten. The next morning from 7:30 am, the surveyor observed this same resident’s breakfast tray to remain on the food cart until 9:45 am when the cart was taken back to the kitchen. The resident was never given the food. Two surveyors then showed the Director of Nursing and Facility Consultant the food tray for the resident. This situation was an issue of neglect with no adequate dining assistance for dementia resident and no breakfast provided to the resident. This resident had a significant weight loss. The facility manager, after being informed, sent nurse managers to the unit to oversee the care provided. Correction date mandated was Immediate. ae (2a) This deficiency remained out of compliance at the time of the follow up survey conducted on 3/29-31/00. Based on observation and record review the facility did not provide four residents with necessary services to avoid physical harm, and a safe environment in which to reside. The residents were #5 and #13. In addition, the facility neglected to put adequate systems in place to prevent physical harm and mental anguish of residents who sustained 44 falls in the month of March 200. Of these 44 residents 39 sustained physical injuries of which 3 residents required hospitalization as a result of the injuries sustained. Findings include: qd) Resident #5 was admitted to the facility with a diagnosis of depression and dementia according to the clinical record. According to the comprehensive assessment dated 11/25/99 the resident was severely impaired for decision-making, was ambulatory with limited assistance and was noted to have adverse behavior of wandering on the comprehensive assessment. Review of the incident logs for February and March 2000 revealed this resident was a victim of resident to resident abuse as well as having a history of physical harm incurred by him/her as a result of his/her mental state and continuous behavior of wandering throughout the west wing. On 02/01/00 at 5 am the nurse’s notes stated “the resident was pulled out of bed by another resident, skin tear side of R. knee. Cleansed with and dry sterile dressing applied. Dr. and family notified.” On 02/03/00 the nurse’s notes stated the resident was “in his/her room when another resident hit him/her left hand with a cane Left hand is bruised, ice applied. Physician notified of situation.” On 02/05/00 the resident was noted to be found on the floor without injuries by the nursing staff. On 02/11/00 the resident was noted in the nurse’s notes and incident logs as sustaining a skin tear of unknown origin in the facility. Review of the investigation of the 02/03/00 abuse sustained with the cane revealed “Reported to State Agency: “NO”. Conclusions/further follow up: Avoidable: “NO”. Resident in own room wandering about ad lib in Merry Walker.” There was no documentation that the resident’s care plan was changed as a result of this incident to 4 Tr: apr cd =F ensure protection of this resident from physical harm in the future. The facility did not report the incident on 02/05/00 to the state agency as required until surveyor intervention on 03/30/00. Interview with the corporate Nurse consultant on 03/30/00 revealed the facility staff did not know who the resident was who hit resident #5 with a cane. He/she interviewed staff and determined through interview with staff aide that the resident was resident #6. This resident’s care plan was reviewed and stated “Reassure resident when other residents wander into his/her room. There was no documentation through the investigation or in resident #6’s record that this resident was instructed not to strike other resident’s with his/her cane. This resident was identified on the comprehensive assessment as being independent for decision making. (2) Resident #11 was documented on the incident log on 03/ 17/00 as being stabbed in the right thumb with a fork by another resident in the dining room at 12:20 pm. Results of the investigation of this incident revealed “Conclusion/further follow-up: Resident in dining room for lunch” “resident on west wing with diagnosis of Alzheimer’s and Dementia and behavior problems. Resident monitored frequently. Staffing appropriate. The incident report revealed, “Altercation with another resident, was stuck with a dinner fork. Three small lacerations noted to right thumb.” The facility Director of Nursing was interviewed on 3/30/00 at approximately 2:15 pm. This Director was unable to verify with staff interview, , which stuck the resident with a fork. After interviewing several staff on ‘duty a the resident who stabbed resident #11 with the fork was resident #13. There was no indication on the investigation of this incident that this resident was ever | ¢ for future recurrence of attempts to harm other residents. . - (3) Resident #13 was documented on the incident log as eloping from the facility on 3/25/00 at 3 pm. This resident was documented on the comprehensive assessment as being moderately impaired for decision making, with short-term memory problems. The assessment depicted the resident to be independent in ambulation. wore aera * Physician orders for this resident for March 2000 revealed an order for “Wander guard check for placement every shift and battery weekly on WEDNESDAY.” According to the incident log the resident had the wander guard on at the time of elopement. The nurse’s notes stated, “Found outside the facility wandering towards highway Palm Beach Lakes Blvd. No injury sustained. No evidence of fall. All alarms checked and were functional. Wander guard checked and functional. Resident brought back by evening supervisor-Stated to watch resident as resident was found outside and asked that the patient be medicated.” Interview with the maintenance man of 3/30/00 at 2 pm revealed the only door presently secured with the wander guard alarm is the lobby door. Further interview revealed the maintenance department did not test the alarms until asked by the surveyors because he/she was not notified of the resident elopement on 3/25/00. The Maintenance director then tested the alarms and found them to be functional on 3/30/00. The Director of Nursing stated that the staff felt the resident exited without staff noticing. The resident resides on the west wing where the facility houses most of the severely impaired for decision making residents. The facility has 6 exit doors. The 2 exit doors most proximal to the west wing do not have a wander guard alarm on the doors. The Administrator informed the survey team that the facility intends to make all exit doors compatible with the wander guard alarm system but this has not been done. Therefore, residents who reside and have the wander guard on the west wing remain at risk if they attempt to exit the facility. . This is in violation of section 400.022(1)(6), FS., carrying in this instance a $700 civil penalty. (6) Tag F 225. Staff ‘Treatmen ents. ‘There was no investigation by the facility for injury sustained during care ent #12 who suffered laceration to forehead for rolling off bed. Findings include: (1) — The surveyor interviewed the Director of Nursing, hire date 12/13/99, to ascertain what system was in place to identify alleged incidents of neglect 6 rome ome ere tt aod Troe rere ome aa and abuse, monitor that neglect does not occur, and determined what injuries of unknown origin need investigation. The D.O.N. stated since the middle of January all incidents and accidents were reviewed daily at the stand up meeting by the management team and that the Assistant Director of Nursing is responsible for monitoring the wing where the neglect occurred involving residents 10, 11, and 12. The Director of Nursing stated incident reports were sent to Corporate Headquarters. (2) The facility did not notify the AHCA or complete an adequate and thorough investigation of allegation of abuse of staff to resident that occurred on 01/06/00. Resident #32 admitted 9/02/98 discharged 01/31/00. Allegation was of physical abuse of resident by staff. The surveyor asked for the documentation of the investigation and was provided with the following 2 documents: 1) a letter written by a staff member regarding the incident (staff was no the alleged perpetrator); 2) notes dated 01/07/00 on sheet of lined paper that documented the resident was examined and diagnostic tests done. The note documented steps taken were: spoke to family, reported to APS, reported to police, pictures were taken, staff placed on suspension until incident resolved. There was no signature on these notes. The nurse’s notes for the resident contained no documentation of the incident; only the social service note documented the incident. This investigation was not thorough and did not meet the regulatory requirement. The investigation further did not follow the facility policy dated 6/99 given to the survey team by the director of nursing. Problems with the investigation were: a) The policy and procedure dated 6/99 did not have a requirement that the administrator be notified immediately. b) Notification of AHCA not done on 1/06/99 (#3 P&P facility) c) There was no documentation an incident report was completed as required by policy, no documentation in resident’s clinical record of exam by nurse, the hand written note in investigation file was not signed by a nurse. No documented interview by facility of perpetrator (#4 facility P&P). rt oemeery d) There was no conclusion by the facility as to whether abuse had taken place. e) The staff member who was the alleged perpetrator had no documentation in his/her personnel file of suspension or return to work dates. 3) The surveyor was given the names of two other residents of the facility where there were allegations of abuse/neglect and there was no thorough investigation completed in these cases either. 4) The facility policy for prevention of abuse/neglect lacked misappropriation of property and lacked immediate notification of administrator. 5) Resident #18 was noted in the medical record (nurse’s note) on 01/31/00, 6:00 pm, as having sustained a fall, “resident was found on floor next to bed in room.” A review of facility documentation revealed that there was no further investigation to determine how this resident who is unable to ambulate, unable to have bed mobility, and is in need of total assist to transfer, ended up on the floor with, “a hematoma on right forehead, ice applied, family and doctor notified.” A further note on 2/01/00 details a discussion with the resident’s daughter in law, in that the facility was attempting to contact the resident’s daughter who had passed away one yeat ago. The facility face sheet had not been revised to reflect current information. 6) When documentation regarding abuse/neglect occurrences was requested, there was no documentation regarding this resident contained in the file. A review of the facility incident and accident log revealed that the resident had sustained a fall. When asked for the incident/occurrence reports, the surveyor was informed that this documentation was to be sent to the corporate office and maintained in a confidential file, the facility was not allowed to keep copies of the reports in the facility. 7) It was determined through interview with the Director of Nursing that the facility had not responded to the occurrence as “injuries of unknown source” per the abuse/neglect protocol, and therefore, did not report the occurrence to any State agency or consider it abuse or neglect. A change in Administrator makes the determination as to whether the Administrator had been contacted a mute issue. The correction date given was immediately. (2b) This deficiency remained out of compliance at the time of the 3/29/00- 3/31/00 revisit survey. Based on interview, observation, review of facility policies, and review of documentation of abuse/neglect investigations, the facility did not 1) prevent neglect; 2) did not complete and document a thorough investigation of allegations of abuse and neglect; 3) did not notify the AHCA of all allegations of abuse and neglect in required 5 working days. The findings include: 1) There was no sufficient facility investigation for injuries sustained to resident #5 who received a hematoma on his/her hand by a cane from another resident and resident #11 who was stabbed in the hand by another resident with a fork in the dining room. Based on the policy of the facility the staff is to immediately notify the Administrator of any incidence of abuse, neglect, or mistreatment. There was no documentation that this was done. Section 4" of the policy states, “Any and all protective and/or remedial actions to prevent further harm to the patient/resident who had suffered physical or psychological harm from abuse, mistreatment, or neglect will be taken.” This was not done in all 3 of the cases. 2) Interview with the Director of Nursing as well as documentation for resident #5 and resident #11 revealed the facility did not report either case to the it i A i A ae ei ae ee abuse registry as required. Furthermore, the facility did not alter the care of the perpetrators but did revise the care plans of the resident who were abused to reflect that their behavior should be modified. The facility investigation did not reveal the perpetrators identity until 3/29/00 until the surveyor asked who the residents were. The perpetrators were not a part of the investigation relating to the abuse of resident #5 and Resident #11. This was confirmed upon interview with the Director of Nursing. 3) The facility did not ensure that all residents who had a wander guard in place was adequately safeguard. 4) Investigation regarding this resident did not conclude what measures would be instituted to prevent this recurrence by this or any other resident. Cross reference to example 3 at F 224 on the same date. This is in violation of sections 400.211 and 400.141(10), F.S., Class II deficiency, carrying in this instance a $700 civil penalty. (c) Tag F324. Quality of Care. The facility did not ensure that each resident receives adequate supervision and assistance to prevent accidents for 4 of 30 residents in the survey sample. The findings include: 1) Resident #9 is totally dependent on others for all activities of daily living (ADL’s). The resident was observed during the tour of the facility to have a resolving ecchymotic area and an abrasion over the left eye. Interviews with staff on 02/21/00 revealed that the resident had fallen from his/her wheelchair recently and suffered the injury. Review of the clinical record revealed that the resident is receiving an antianxiety and an antipsychotic medication for a diagnosis of dementia with psychosis. The comprehensive assessment revealed that the resident has impaired 10 } 3 standing balance, He/she was to wear a trunk restraint (Lap Buddy) while in the wheelchair. Review of the record revealed that the resident had suffered the following injuries at various times of the day: unexplained injury i.e. bump on the head while in bed on 01/05/00; found on floor 12/13, 01/11 and 02/04/00. On 12/13 and 02/04/00 the resident had been in the wheel chair with the lap buddy in place. During the survey the resident was observed in a recliner chair in his/her room. The resident was not supervised or checked by staff for extended periods of time during the survey. The resident had periods of restlessness while in the chair in his/her room. | 2) Resident #27 is totally dependent on staff for all ADL’s and at risk for falls due to cognitive impairment and an unsteady gait. The resident was observed during the survey to be in his/her wheelchair with a lap buddy in place. The resident was observed to be wandering into other resident’s rooms on 02/23/00. ‘The resident was no redirected by staff on that day. On 02/21 and 02/22/00 the resident’s wheelchair was locked as he/she sat in his/her room unattended for extended periods of time. Review of the resident’s record revealed that the resident was found on floor on 01/26, 01/30 and 01/31/00. The resident’s behavior was not supervised on 02/21. 02/22 and 02/23/00. 3) Review of the facility’s incident log revealed that in 01/2000 there were 95 incidents, 68 of the 95 incidents were identified as falls. Forty-eight percent of the incidents occurred on West Wing. Residents #9 and #27 reside on the West Wing. (4) Resident #33 was admitted to the facility on 5/26/98 with diagnoses of debility, musculoskeletal disease, and hypertension. Resident dependent on staff for assistance with bed mobility, transfers, bathing, and eating. On the first day of survey, 2/21/00, it was revealed that the resident was found on floor between the bed and 11 STREP em ge pee Trp RE oe Ce TORT oc RRP TREE Soepe eet camer oer it Ai il 4.) a a i a wtre nightstand at 8:30 am revealed that the family member at approximately 10:30 am revealed that the family member had spoken to facility staff about her concerns of not using side rails on the resident’s bed. The resident had had side rails but were recently discontinued. The facility administration at the time (December 1999) told the family member that the “state” considered side rails restraints and could not be on the resident’s bed. The family member has visited and found the resident near the edge of the bed with a leg hanging over the edge. (4) Record review revealed that several side rail screens were conducted. On 5/18/99, the screening assessment indicated that side rails were indicated for safety. On 11/01/99, side rails were changed to one side rail for mobility. A physician order was written 12/-7/99 for no siderailes, not needed for mobility. A side rail screen was not conducted at this time. The minimum data set (MDS) assessment on 11/04/99 and 02/20/00 indicated under section P. Devices and Restraints, the resident used “other types of bedrails used (e.g. half rail, one side).” (5) On 02/21/00, the resident developed a large (approximately 8 cm round) hematoma above the right eye. X-rays and neurochecks were ordered. In addition, a side rail screen was conducted and two half-side rails were ordered. (2c) This deficiency remained out of compliance at the time of the revisit survey conducted on 3/29-30/00. Based on record reviews, observations and interviews conducted it was determined that the facility did not provide adequate supervision to prevent accidents for 5 of 13 residents in the survey sample. Findings include: qd) Resident #11 was stabbed with a fork for another resident on 3/17/00 at 12:40 pm in the dining room. The resident sustained three small lacerations on 12 ee cree ep Sogpe rp reer + his/her right thumb. There was no documentation that the staff attempted to intervene at the time of the incident or that the staff was present. The social worker of the facility was the only witness listed on the occurrence report of’ the facility. There was no documentation that the staffing in the dining room was adequate on this day to provide adequate supervision of this and other residents. (2) Resident #5 was hit on the hand for wandering into another resident’s room on 02/23/00 at 12:30 pm with the other resident’s cane causing a hematoma to resident #5’s hand. This was not investigated until surveyor intervention on 3/30/00. Review of the unusual occurrence report identified no witnesses. The perpetrator was documented as striking out at staff with his/her cane on January 16, 2000. There was no revision of this perpetrator’s care plan or a plan in place to assure adequate Supervision of this resident to prevent further harm to other residents and staff. (3) Resident #13, a resident on the West Wing, and Resident #12, a resident on the East wing, both eloped the facility on 3/25/00 at 3 pm. There was no documentation that either of these elopements was witnessed by staff. There was no documentation that these resident received adequate supervision to prevent exit seeking by the resident. Resident #13 had been identified on more than one occasion by the nursing staff at attempting to exit. (4) Resident #12 was assessed as needing supervision for ambulation on the comprehensive assessment dated 12/28/99. This resident has a history of falls, unsteady gait and increased confusion according to the rap tri ggers used by the facility for this assessment. This resident was ambulating unsupervised on 3/30/00 at approximately 3 pm in the B wing hallway with his/her walker. The resident was heard crashing to the 13 wor pr oere = some floor. There was no staff present in the hallway at the time of the fall. The care plan coordinator and 2 surveyors were passing the hallway and heard the crash. The resident was observed to be bleeding above the right eye. The resident was moaning, Other residents were in their wheelchairs and one had observed the fall. The resident was sent 911 to the hospital and returned to the facility later that evening. The diagnoses from the hospital were Laceration to the right temple with sutures and head contusion. The resident was ordered to have neurochecks to be completed. Interview with the nurse caring for the resident on 3/31/00 at 2:30 pm revealed the resident did not receive his/her Ativan due to lethargy from the fall but that the neuro checks were “fine”. The staff did not adequately supervise this resident who had a history of falls. (5) Resident #12 was admitted to the facility on 11/99. The diagnoses according to the clinical record were heart disease, diabetes, morbid obesity, and hypertension. This resident was documented on the comprehensive assessment as being alert and oriented x3 with no evidence of delirium and mood problems. According to the incident log March 25, 000, the resident eloped the facility in his/her custom sized wheelchair to a local store. Review of the nurse’s notes for this date revealed the resident at 3 pm was observed by a staff member on break in the parking lot of the facility “saw patient wheel chairing to Walgreen’s pharmacy.” This staff member escorted the resident back to the facility. “Review of the investigation of this incident dated 3/217/00 revealed a conclusion/follow-up: Avoidable “no” _ is alert and oriented. He/she was found in Walgreen parking lot by staff member and returned to the facility. He/she understands now that he/she must follow rule for his/her safety. Interview with the Director of Nursing at 2 pm. on 3/30/00 revealed the resident occasionally sits out front of lobby 14 F door and no one saw him/her leave the premises and it was change of shifts. The facility did not implement a plan that would allow this resident to let the facility know his/her whereabouts. (6) Sixteen of 44 falls in the month of March 2000 resulted in injuries to the 16 residents. There was no effective plan in place by the facility to prevent reoccurrence. The facility stated that after each fall a resident is screened by physical therapy. The facility did screen these falls but the number of falls was 44 in March and 50 in February. The facility did not ensure adequate staff supervision to prevent their residents from falling. The lack of supervision by the facility has caused the residents to be at greater risk of injury and harm based on the above deficiencies. This is in violation of rule 59A-4.1288, F.A.C., Class II deficiency uncorrected, carrying in this instance a $5,000 civil penalty 4. The above referenced violations constitute grounds to levy this civil penalty . pursuant to Section 400.102(1)(c), Florida Statutes, in that the above referenced conduct of Respondent constitutes a violation of the minimum standards, rules and regulations for the operation of a nursing home. 5. Notice was given in writing to the respondent of each of the above violations and the time frame for correction. ELECTION AND EXPLANATION OF RIGHTS FORMS ATTACHED 7. RESPONDENT Is FURTHER NOTIFIED THAT FAILURE TO REQUEST A HEARING WITHIN TWENTY ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY, 15 I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Retum Receipt Requested to Brian Tenney, Administrator, Darcy Hall of Life Center, 2170 Palm Beach Lakes Blvd., West Palm Beach, Florida 33409, Darcy Hall, Inc., 3570 Keith Street, NW, Cleveland, TN 37312, and to CT Corporation System, 1200 South Pine Island Road, Plantation, Florida 33324 on AO, 2001. , Field Office Manager Agency for Health Care Administration 1710 East Tiffany Drive, Suite 100 West Palm Beach, Florida 33407 Copy to: Nursing Home Program Office Agency for Health Care Administration t 2727 Mahan Drive Tallahassee, Florida 32308 Alba M. Rodriguez, Assistant General Counsel Agency for Health Care Administration 8355 N.W. 53rd Street Miami, Florida 33166 Gloria Collins Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #14 Tallahassee, Florida 32308 SE eee NOTE: In accordance with the Americans with Disabilities Act, persons needing a special accommodation to participate in this proceeding should contact Alba M. Rodriguez no later than fourteen (14) days prior to the proceeding or hearing at which such special accommodation is required. Alba M. Rodriguez may be contacted at Manchester Building, 1st Floor, 8355 N.W. 53rd Str iami i Telephone: (305) 499-2165, me Stes; Miami, Florida 33166. 16 . ; b

Docket for Case No: 01-004413