16/85/2684 14:21 723-2122 CRILD CARE LICENSURE PAGE 82 STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES IN THE MATTER OF Certified Mail 7003-1680-0000-0502-2499 Civil Penalty Against ‘ Return Recaipt Request 2. ot Daisy Bowers - 2 , Scott Mill Lane Schoo! - By Oe 2911 Scott Mill Lane (Ut > 7] 0 ry Boe Jacksonville, Florida 32223 ‘ EEG Fy Te Be N PLAINT 4 fo Q % 2 YOU ARE HEREBY NOTIFIED that the Department has Imposed a Clvil Penalty In the'Smount oP of Two Hundred Dollars ($200.00). As grounds for the Imposition of this penalty, the Department states the following: 1, The Department of Children and Families, State of Florida, has jurisdiction over the Respondent by virtue of the provisions of Chapters 402.301 - 402.319, Florida Statutes. 2. The Respondent, Daisy Bowers, is licensed to operate Scott Mill Lane School as a child care facility In compilance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (FAC), Chapter 65C-22, 3. During an investigation on August 18, 2004, it was determined that the Respondent committed a violation of FAC Chapter 65C-22.001(8)(a and b), In that: A method of discipline was used at the facility that was severe, humillating or frightening Lo children. Staff member, C.H., admitted to putting soap in a four-year-ald child’s mouth when he used “potty” language. She stated the child’s mother brought the soap to the facility and asked her to put it into the child’s mouth. This same four-year-old child was put In time out for approximately 10 minutes and was placed in time out in the kitchen of the facility. During an Interview with the licensing counselor, staff member C.H. admitted to cupping the same four-year-old child’s mouth to stop him from screaming. Medical Professional and personnel from other agencies interviewed the child. The child “pulled his lip back to reveal a blood blister on his Inner upper lip and then stated “Cynthia” at the day care “smacked me in the mouth real hard.” It was determined that the four-year-old child’s injury was “consistent with history, indicative of inflicted Injury.” 4. The above referenced violation constitutes grounds to levy this Civil Penalty pursuant to Chapter 402, 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 Child Care Facility. - 14/85/2684 18:21 f23-2122 CHILD CARE LICENSURE PAGE 43 ‘Administrative Complaint ~ Scott Mili Lane School August, 2004 Page 2 OV SSE 2, LA ne so “a “ Ne et 5. Payment of this fine can be made directly to the Departingat of Chila¥en and Families. The mailing address is: P.O. Box 2417, Jacksonville, FL. 32231, Attention: Child Care Licensure. NOTICE OF RIGHTS This decision constitutes final agency action untess a person who Is substantially affected by it submits a written request for hearing that is received within twenty-one days from the date on which he or she first recetves this notice. The request for hearing must also meet the requirements of Section 120.56, F.S., and elther Rule 28-106.201 or Rule 28-106.301, F.A.C.,, or else it will be dismissed as required by Section 120.569(2){c), F.S. That faw and those rules require the written request for hearing to include the following information: 1. The name and address of each agency affected and each agency's file or identification number if known; 2. The name, address, and telephone number of the person who is asking for the hearing (the petitioner); 3. The name, address, and telephone number of the petitioner's representative, if any; 4. An explanation of how the petitioner's substantial interests are or will be affected by the agency decision; 5. A statement of when and how the petitioner recewed notice of the agency decision: 6. Astalernent that the petitioner does not dispute the facts upon which the agency relled but that it wants to exercise the right to be heard anyway OR a statement that the petitioner does dispute the facts upon which the agency relied and a fist of the facts In dispute; 7. Aconcise statement of the facts as the petitioner perceives them to be, including the Specific facts set out by the agency that the petitioner wants the agency to reverse or change; 8. Astatement of the specific rules or statutes that the petitioner believes requires the agency to reverse or modify its decision; and 9, Astatement specifying what action the petitioner wants the agency to take in the matter, Failure to request a hearing in writing and within the time frames required in this notice or failure to provide the information required by the law and rules governing requests for Chapter 120 hearings constitutes a complete waiver of any right that a substantially affected person may have to challenge this decision. 14/@5/2084 18:21 #23-2122 CHILD CARE LICENSURE PAGE 64 ‘ee ‘Administrative Complaint - Scott Mill Lane School August, 2004 Page 3 The request must be received by the following persons at the following addresses on or before twenty-one (21) days of the date on which this notice was first received by the person requesting the hearing: Roger L.D. Williams . Paul Flounlacker, Agency Clerk Assistant General Counsel Department of Children & Families Department of Children & Families Office of the Genera! Counsel P.Q. Box 2417 1323 Winewood Bivd., Bldg. 1, Suite 407 Jacksonville, FL. 32231-0083 Tallahassee, FL. 32301 STATE OF FLORIDA, DEPARTMENT OF CHILDREN AND FAMILIES Linda alt Program Administrator 18/85/2064 16:21 723-2122 CHILD CARE LICENSURE PAGE B& — - ‘Administrative Complaint - Scott Mill Lane School August, 2004 Page 4 CERTIFICATION OF SERVICE T HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mall 7003-1680-0000-0502-2499, Return Recelpt Requested, In accordance with ss, 120.60(3), Florida Statutes, this _‘ 40 day of August, 2004, STATE OF FLORIDA, DEPARTMENT OF CHILDREN & FAMILIES Linda N. ith Program Administrator

Docket for Case No: 04-003702