87/23/2004 11:58 9413381233 DCF PAGE 82 ‘ :! , y .) DEPT OF HEALTH ORLA aehai BIT, | SERVICES - OTRETV rm JUL 23 239, | STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES O'STRICT COUNSti3 ortice een IN THE MATTES A Civil Penalty Aggai Freedom Bible 4 | ADMINISTRATIVE COMPLAINT { | | | prida 33054 \ } NATURE OF THE CASE 1. This ase arisés from the Respondent's failure to comply with Sections 402.301-402.3 1%) et seq.,\Florida Statutes with respect to licensure requirements, 2. This ® an administrative action for imposition of civil penalties per known incident(s) of odfurrence as authorized in section 402.310, Florida Statutes. 3. Petitifiner, State of Florida, Department of Children and Families is the administrative ajency of the State of Florida, charged with the duty to enforce and administer the § povisions of Chapter 402, Florida Statutes. 4. OnJ Freedom was i Florida Adminis bean provided Riuary 2, 2004, the facility was notified by certified mail that Camp iolationiof s.402.30 (2)(f), Florida Statutes and 65C-22.003 (7)(a), gative Code in that documentation of your director credential had not m the Department. The facility was given 10 business days from the date : bvide dotumentation (a copy) of the director credential certificate or ft. The facility was advised that failure to comply with documentation result it the Immediate issuance of a provisional license: for a period K months, training transcri requirements not to exceed sf ANuary 24, 2004, the Department had not received documentation of the Kcredential, therefore the facility was issued a provisional license for the period January, 2004 through July 2, 2004, As part of the corrective action, the Department req Hested monthly updates on the facility’s progress towards. earning a director credenj fal or hiring a director with the appropriate credential, to be given to the licensing repre@ntative by mail or telephonically. These updates were due by the 15" of each month, i | 6. On & ; 8 2, 2004, the facility was notified by certified mail advising the facility of the continue@ noncompliance and that documentation must be raceived by the Department or action to revoke the provisional license will be initiated. @7/23/2004 11:58 9413381233 DCF PAGE Therefore, youre here ny notified of the Department’s Intent to revoke your license ta ope 7 ie Camp Freedom. This decision Is4 “Puluant to Section 402.305 (2)(f), Florida Statutes, every child Wary 1, 2004, which consists of the foundational lave! or the ced level. As of January 1,2004, every applicant for a license erate a child care facility or a license for a change of ownership hild care faclilty must document that the facility director has a f lor credential prior to issuance of the license to operate the facility’. NOTICE OF RIGHTS This decision affected by it days from the 4 must also mea Monstitutes final agency action unless a person who is substantially wbmits a:written request for hearing that is received within twenty-one ate on which he or she first receives this notice. The request for hearing the requirements of Section 120.562, Florida Statutes (F.S.), and either Rule 28-106.284 or Rule 28-106.301, Florida Administrative Code, or else it will be dismissed as riquired by Section 120.569(2)(c), F.S. |: That law and pse rules require the written request for hearing to include the following information: ff 41. The name} d address of each agency affected and each agency's file or identifidfation number if Mjown; = | 2. The name, 1 hearing weddress, and telephone number of the petitioner's representative, if any; 4. An explang fon of how the petitioner's substantial interests are or will be affected by St of when and how the petitioner received notice of the agency decision; 6. A statern@at that the petitioner does not dispute the facts upon which the agency relied i i but that it i nts to ekercise the right to be heard anyway OR a statement that the petitioner (pes dispute the facts upon which the agency relied and a list of the facts in disputez}! 03 63/23/2004 11:58 3413381233 DCF PAGE sh lement of the facts as the petitioner perceives tham to be, including the ieet out by the agency that the petitioner wants the agency to reverse or 8. Astatemenfipf the specific rules or statutes that the petitioner believes requires the prse or modify its decision; and 9. Astatemen i pecifying what action the petitioner wants the agency to take in the Failure to requégt a hearing in writing and within the time frames required in this notice or failure to proide the information required by the law and rules governing requests for Chapter 120 hibrings constitutes a complete waiver of any right that a substantially ay have to chalienge this decision. | The request mit be received by the following persons at the following addresses on or qe (21) days of the date on which this notice was first raceived by the person reques tig the hearing: Eugenie Rémak, #255084 Paul Flounlacker, Agency Clerk District Legia Counsel Department of Children & Families Departmentipf Children & Families Office of the General Counsal Post Officaox 60085 1323 Winewood Bivd., Bldg. 1, Suite 407 Fort Myers YF 33906 Tallahassee, FL. 32301 STATE OF FLORIDA, DEPARTMENT OF CHILDREN AND FAMILIES | Michelle Molloy, Licensing Suan ad Qr/23/2004 11:58 9413381233 DCF PAGE 85 CERTIFICATION OF SERVICE FY that a true and correct copy of the fore cing has bean furnished by qU.S. Certified Mail #7202 /060 6405 3p U8 4, Bp urn Receipt equested, in ag Hordance with ss. 120.60(3), Florida Statutes, this _. day of. Cieza to Bank vargo. ll, Registered Agent for Freedom Bible Church, Inc.. 500 ab Street, Pd , Florida 33954 | STATE OF FLORIDA, DEPARTMENT OF CHILDREN & FAMILIES i” Karen Petersen

Docket for Case No: 04-002773