STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES _ ZF CU Pe IN THE MATTER OF Certified Mai! 7003-1680-0009-0592-1447 A Civil Penalty Against Re urpieceint Request All Faith Day Care, Inc. jy, oy ” 3133 Spring Glen Road “lol 45, Wy, : Jacksonville, Florida 32207 Kies ote ; 'S 4D, r, aoe ~ . ADMINISTRATIV TONG, YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of Seventy-five Dollars ($75.00). 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, All Faith Day Care Center, Inc., Is licensed to operate All Faith Day Care Center as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (FAC), Chapter 65C-22. 3. During an investigation on July 8, 2004, it was determined that the Respondent committed a violation of FAC Chapter 65C€-22.001(5)(a), in that: There was inadequate direct supervision of a child. After the complaint investigation was completed and the inspector was preparing to leave the Premises, a six-year-old child was observed unsupervised in the kitchen area holding a bottle of Prescription medication. The child stated he had been sent to the kitchen (from the school-age room) to get his medicine. When asked how he had obtained the medicine, he showed the inspector how he had climbed onto the kitchen counter top and retrieved his bottle from a shelf that contained other prescription medicine and over-the-counter medicine as wall. He stated he was taking it to a staff member, B.H., in the one-year-old dining area on the other side of the kitchen so that she could open the bottle for him. 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, Operation of a Child Care Facility. rules and regulations for the 61SS424+06 S@TTTWwe4 RB UEPTIUg adaqg dgt:so +0 91 AON Administrative Complaint - All Faith Day Care Center 2D ~ 4 September, 2004 / 4oNy. iy 10: Page 2 Heusisis , CAB RE . a4 a 4/1 5. Payment of this fine can be made directly to the Department of Children’agty / 7 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 unless 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 receives this notice. The request for hearing must also meet the requirements of Section 120.56, F.S., and either 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 law 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 received notice of the agency decision; 6. A statement that the petitioner does not dispute the facts upon which the agency relied but that it wants to exercisé the right to be heard anyway OR a statement that the petitioner does dispute the facts upon which the agency relied and a list 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. A statement 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. 619922406 satTtwe4 3 UaPTTyug Ideqg dgt?:sGO *O0 ST “ON Administrative Complaint — All Faith Day Care Center September, 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 Cierk Assistant General Counsel Department of Children & Families Department of Children & Families Office of the General Counsel P.O. Box 2417 1323 Winawood Bivd., Bldg. 1, Suite 407 Jacksonville, FL, 32231-0083 Tallahassee, FL. 32301 STATE OF FLORIDA, DEPARTMENT OF CHILDREN AND FAMILIES rr Linda. Smith Program Administrator S6T1SS422b06 satTtwe4 % UepTtyUg adeq dg1:so #0 ST ON i? Administrative Complaint - All Faith Day Care Center September, 2004 Page 4 CERTIFICATION OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail 7003-1680-0000-0502-1447, Return Receipt Requested, in accordance with ss, 120.60(3), Florida Statutes, this 44 day of September, 2004. STATE OF FLORIDA, DEPARTMENT OF CHILDREN & FAMILIES ui « Smith Program Administrator 61SS424+06 Set Iwe4 % uapTtug rdeq dgt:SO +0 ST SON

Docket for Case No: 04-004332