l0-Fuvag STATE OF FLORIDA DEPARTMENTS ILDREN AND FAMILIES ae fi IN THE MATTER OF Certified Mail 7009 3410 0001 6528 3687 : A Civil Penalty Against 2010 OCT -} 2: Return Receipt Requested : Happy Care Bears, Inc. d/b/a CEVISIGH OF Kidz World Academy ADMINISTRATIVE 6265 Merrill Road HEARINGS Sep de: Jacksonville, Florida 32211 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penaity in the amount of Twelve Hundred Dollars ($1,200.00), and placed on Probationary Status not to exceed six (6) months, against Happy Care Bears, Inc., d/b/a Kidz World Academy. The license under ' which said Respondent operates its Child Care Facility. As grounds for the imposition of this penalty, the Department states the following: 1. The State of Florida, Department of Children and Families (DCF) has jurisdiction over this matter by virtue of the provisions of Sections 402.301 — 402.319, Florida Statutes. 2. The Respondent, Happy Gare Bears, Inc., is licensed to operate Kidz World Academy-License # CO4DU0692, located at 6265 Merrill Road, Jacksonville, Florida, 32211 as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (F.A.C), Rute 65C-22. Violation 3. During an inspection on May 12, 2010, a DCF Licensing Counselor determined that: On April 26, 2010, a child (L.B., DOB 1/27/07), reported to staff member T.R. that her back hurt because her mother hit her. Staff member S.T. was made aware of the child’s complaint on April 26, 2010, when staff member T.R. brought the child to the office after the child reported the incident. Staff members S.T. and T.R., reported that a third staff member K.N. was present in the office when the child repeated that her back hurt because she was struck by her mother. Staff member S.T. and T.R., acknowledge they observed a reddish bruise on the child’s back on April 26, 2010 and a report should have been made to the Florida Abuse Hotline. Staff member T.R. documented the incident in a health safety check book. Additionally, staff member J.G. was made aware of the allegation on April 27, 2010. A report was not made to the Florida Abuse Hotline as required until May 12, 2010. 4. FAC Rule 65C-22. 001 (11), states, as a mandated reporter, the owner, operator, employee or substitute failed to report suspected child abuse /negiect as required in section : 39.201, Florida Statues. Pursuant to the Florida Administrative Code Rule 65C-22.001 (11), this is a Class 1 violation. This same Class 4 violation was previously cited on December 23, 2009, for which the facility was levied a fine in the amount of $500.00 on February 12, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, item #63-Child abuse or neglect misrepresentation the fine for this second Class 1 violation is not less than $100.00 nor more than $500.00 per day. The Department may also impose other disciplinary sanction in addition to the fine. Due to child care personne! failing to report this incident for twelve (12) operational days, April 26, 2010 to May 11, 2010,the previous violation continued risk to the child and the seriousness of the incident, the fine for this second Class 1 violation is being assessed at $100.00 per day for each day the incident was not reported for a total of $1,200.00. Probationary Status In addition to the fine levied above the Respondent’s License will be placed on Probationary Status for a period not to exceed six (6) months. The terms of the Probation are as follows: a. There shall be no Class 1 violations. b. All staff members are required to re-read and sign the Abuse/Neglect Reporting Acknowledgement Form. The completed forms shall be forwarded to the Licensure Office within 10 (ten) operational days of the license being place on Probationary Status. 5. The above referenced violation constitutes grounds to levy this Civil Penalty pursuant to ss.402.310(1}(a) and 402.310(4), Florida Statutes as the above referenced conduct of Respondent constitutes a violation of the minimum standards, rules and regulations for the operation of a Child Care Facility. 6. Payment of money order or cashier’s check for this fine can be made directly to the Department of Children and Family Services. The mailing address is: 5920 Arlington Expressway, P.O. Box 2417, Jacksonville, FL. 32231, Attention: Child Care Licensure. 7. Failure to pay the fine imposed in this Administrative Complaint will result in an automatic non-renewal of the license referenced above. NOTICE OF RIGHTS NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES iF YOU BELIEVE THE DEPARTMENT'S DECISION IS IN ERROR, YOU MAY REQUEST AN ADMINISTRATIVE HEARING TO CONTEST THE DECISION. YOUR REQUEST FOR AN ADMINISTRATIVE HEARING MUST BE RECEIVED BY THE DEPARTMENT WITHIN 21 CALENDAR DAYS OF YOUR RECEIPT OF THIS NOTICE. FAILURE TO REQUEST AN ADMINISTRATIVE HEARING WITHIN THE 21 DAYS PROVIDED SHALL CONSTITUTE A WAIVER OF THE RIGHT TO A HEARING. You may submit your request for an administrative hearing to the Department at the following addresses: David Tucker Gregory D. Venz, Agency Clerk Chief Legal Counsel . Department of Children & Families Department of Children & Families Office of the General Counsel P.O. Box 2417 41323 Winewood Bivd., Bidg. 1, Suite 407 Jacksonville, FL. 32231-0083 Tallahassee, FL. 32301 Please note that a request for an administrative hearing must comply with section 120.569(2) {c), Florida Statutes, and Rules 28-1 06.201(2), Florida Administrative Code. Those provisions, when read together, require a petition for administrative hearing to include: (a) The name and address of each agency affected and each agency's file or identification number, if known; (b) The name, address, and telephone number of the petitioner; the name, address, and telephone number of the petitioner's representative, if any, which shall be the address for service purposes during the course of the proceeding; and an explanation of how the petitioner’s substantial interests will be affected by the agency determination; (c) A statement of when and how the petitioner received notice of the agency decision; (a) A statement of all disputed issues of material facts. if there are none, the petition must so indicate; (e) A concise statement of the ultimate facts alleged, including the specific facts the petitioner contends warrant reversal or modification of the agency’s proposed action; (f) A statement of the specific rules or statutes the petitioner contends require reversal or modification of the agency's proposed action; and (g) A statement of the relief sought by the petitioner, stating precisely the action petitioner wishes the agency to take with respect to the "_ agency’s proposed action. Section 120.569, Florida Statutes, and rule 28-106.201(4), Florida Administrative Code, require that a petition to be dismissed if it is not in substantial compliance with the requirements above. Pursuant to section 120.573, Florida Statutes, the Department advises that formal mediation is not available for this administrative complaint. However, the Department may consider proposals to resolve the complaint without a formal hearing. STATE OF FLORIDA, DEPARTME F CHILDREN AND FAMILIES Pamela Buckham Safety Program Manager CERTIFICATION OF SERVICE . | HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, 7009 3410 0001 6528 36 eturn Receipt Requested, in accordance with ss. 120,60(3), Florida Statutes (2005), this lay of August, 2010. STATE OF FLORIDA, DEPARTMENT OF CHILDREN & FAMIL| / é / Mre Pameia Buckham Safety Program Manager

Docket for Case No: 10-009420