STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES IN THE MATTER OF Certified Mail 7009 3410 0001 6527 9970 A Civil Penalty Against Return Receipt Requested Tiffany Thomas dibla Spellman Academy 10367 Monaco Drive Jacksonville, Florida 32218 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of Eighty Dollars ($ 80.00), against Tiffany Thomas d/b/a-Spellman Academy. 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, Tiffany Thomas, is licensed to operate Spellman Academy-License \ # C04DU0788, located at 10367 Monaco Drive, Jacksonville, Florida, 32218, as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (F.A.C), Rule 65C-22. | Violation-I 3. During a complaint investigation on September 2, 2010, a DCF Licensing Counselor | determined that: Upon Counselor's arrival staff members were not within sight and hearing of all children during naptime; one (1) staff member was in the kitchen and the 3 and 4 year olds were left alone napping. 4. FAC Rule 65C-22.001 (5) (a), states, Direct supervision means watching and directing children’s activities within the same room or designated outdoor play area and responding to the needs of each child. During nap time, supervision means sufficient staff in close proximity, within sight and hearing of all the children. Children who are up to 24 months of age, must be directly supervised at all times. Pursuant to Florida Administrative Code Rule 65C-22.001 (5) | (a-b), this is a Class 2 violation. This same Class 2 violation was previously cited on May 14, | 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #5-Supervision, the fine for this second Class 2 violation is $50.00. Violation-II 5. During a complaint investigation on September 3, 2010, a DCF Licensing Counselor determined that: Counselor determined that a minimum distance of 18” was not maintained around each child sleeping space. 6. FAC Rule 65C-22.002 (5) (b), ), states, a minimum distance of 18” inches must be maintained around individual napping and sleeping spaces, except a maximum of two (2) sides of a napping or sleeping space may be against a solid barrier, such as a wall. The solid side of a crib does not meet the requirement of a solid barrier. Pursuant to the Florida Administrative Code Rule 65C-22.002 (5) (b), this is a Class 3 violation. This same Class 3 violation was previously cited on January 14, 2010, April 28, 2010, and May 14, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #25-Nap/sleep space, the fine for this fourth Class 3 violation is $30.00 per day for each violation, violation was one day. 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 ADMINISTRATIVE HEARING MUST BE RECEIVED BY THE DEPARTMENT WITHIN 24 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 1323 Winewood Bivd., Bldg. 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 28-106.201(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; (d) 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, 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 6527 9970 Retumn Receipt Requested, in accordance with ss. 120.60(3), Florida Statutes (2005), this 7/ “day of February, 2011. STATE OF FLORIDA, Pamela Buckham Saféty Program Manager STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES IN THE MATTER OF Certified Mail 7009 3410 0001 6527 9727 A Civil Penalty Against Return Receipt Requested Tiffany Thomas d/b/a- Spellman Academy 10367 Monaco Drive Jacksonville, Florida 32218 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of Fifty Dollars ($50.00), against Tiffany Thomas d/b/a-Spellman Academy. 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, Tiffany Thomas, is licensed to operate Spellman Academy -License # C04DU0788, located at 10367 Monaco Drive, Jacksonville, Florida, 32218 as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (F.A.C), Rule 65C-22. Violation 3. During an inspection on September 7, 2010, a DCF Licensing Counselor determined that: The facility did not have evidence that a transportation log was maintained for all children being transported at this facility. 4. FAC Rule 65C-22.001 (6) (f) (g), states, a driver's log shall be maintained for all children being transported | the vehicle. The log shall be retained for a minimum of four (4) months. The log shall include each child’s name, date, time of departure and time of arrival, signature of second staff member to verify driver's log and the fact that all children left the vehicle. Pursuant to the Florida Administrative Code Rule 65C-22.001 (6) (f) (1), this is a Class 2 violation. This same Class 2 violation was previously cited on September 3, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #- Transportation, the fine for this second Class 2 violation is $50.00. 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 Counse!} Department of Children & Families Department of Children & Families Office of the General Counsel P.O. Box 2417 1323 Winewood Blvd., 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 28-106.201(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; (d) 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, DEPARTM OF CHILDREN AND FAMILI 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 6527 9727 Return Receipt Requested, in accordance with ss. 120.60(3), Florida Statutes (2005), this < y of February, 2011. STATE OF FLORIDA, DEPARTM FAMILIES Pamela Buckham Safety Program Manager STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES IN THE MATTER OF Certified Mail 7009 3410 0001 6528 4127 A Civil Penalty Against Return Receipt Requested Tiffany Thomas d/b/a- Spellman Academy 10367 Monaco Drive Jacksonville, Florida 32218 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of One Thousand Seven Hundred Ninety-Five Dollars ($ 1,795.00), against Tiffany Thomas dibla-Spellman Academy. The Department is recommending Revocation of 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, Tiffany Thomas, is licensed to operate Speliman Academy -License # C04DU0788, located at 10367 Monaco Drive, Jacksonville, Florida, 32218 as a Child Care Facility in compliance with Chapter 402, Florida Statutes (F.S.), and Florida Administrative Code (F.A.C), Rule 65C-22. Violation-l 3. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: There was a staff member J. Smith who stated her first day of employment at this childcare facility was September 2, 2010; however, this individual had no background screening documents on fite. This unscreened person was alone at when the Licensing Counselor arrived supervising twenty nine (29) children including one (1) infant. 4. FAC Rule 65C-22.004 (5) (a), direct supervision means watching and directing children’s activities within the same room or designated outdoor play area and responding to the needs of each child. Childcare personnel at a facility must be assigned to provide direct supervision to a specific group of children and be present with that group at all times. Pursuant to the Florida Administrative Code Rule 65C-22.001 (5) (a), this is a Class 1 violation. This same Class 1 violation was previously cited on February 25, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #-Supervision, the fine for this Class 1 violation is not less than $100.00 nor more than $500.00, in addition, the — Department may impose other disciplinary action in addition to the fine. This fine is being assessed in the amount of $500.00, due to this is the second Class 1 violation of this standard. Violation-H 5. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: There were twenty-nine (29) children observed with two (2) staff members. There were nineteen (19) children between the age of 3 and 4 in the VPK classroom and one (1) infant, two (2) one year olds and seven (7) two year olds in this mixed group class. For this ratio eight (8) staff were required for this group. 6. FAC Rule 65C-22.001 (4) (a) (b), states, that staff to child ratio, as established in 8.402.305 (4), F.S. is based on primary responsibility for the direct supervision of children and applies at all times while children in care. In groups of mixed age ranges where children under one (1) year of age are included, one (1) staff member shall be responsible for no more than four (4) children of any age group, at all times. Pursuant to the Florida Administrative Code Rule 65C-22.001 (4) (a) (60, this is a Class 2 violation. This same Class 2 violation was previously cited on January 14, 2010, February 4, 2010, April 28, 2010, September 2, 2010, and September 3, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #4-Ratio sufficient the fine for this fourth violation of one (1) day Is $75.00 per day, the fifth violation for one day is $100.00 per day, the sixth Class 2 violation is $100.00 per day for a total of $275.00. Violation-lll 7. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: Viotation-V 41. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: Staff member, J. Smith who stated her first day of work at this facility was September 2, 2010, did not have an Employment Application on file. 412. FAC Rule 65C-22.006 (4) (a), states, records shall be maintained and kept current on all childcare personnel, as defined by Section 402.302 (3), F.S., and household members if the facility is located in a private residence. These shall include: An employment application with the required statement pursuant to Section 402.3055 (1) (b), F.S. Pursuant to the Florida Administrative Code Rule 65C-22.006 (4) (a), this is a Class 3 violation. This same Class 3 violation was previously cited on January 14, 2010, February 4, 2010, April 28, 2010, September 3, 2010 and September 7, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #59-Personnel records, the fine for this fourth Class 3 violation is $30.00 per day for one day, for the fifth Class 3 violation is $40.00 per day for one day and the sixth Class 3 violation is $50.00 per day for a total of $120.00. Violation-Vi 13. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: Verification of Employment History Check for staff member J. Smith (who stated her start date was September 2, 2010) was not on file. 14. FAC Rule 65C-22.006 (4), states, Level 2 screening includes an Employment History Check that includes the previous two (2) years. An Employment History Check conducted under this rule shall include the applicant’s position description, confirmation of employment dates from previous job (s) and level of job performance. Pursuant to the Florida Administrative Code Rule 65C-22.006 (4), this is a Class 2 violation. This same Class 2 violation was previously cited on January 14, 2010, May 14, 2010, September 3, 2010 and September 7, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #60-Personnel records, the fine for this third Class 2 violation is $60.00 per day for one day, for this fourth Class 2 violation is $75.00 per day for one day, for this fifth Class 2 violation is $100.00 per day for one day, for a total of $235.00. Violation-VIl 15. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: Documentation of Level 2 Background Screening and Personnel File Requirements (CF-FSP Form 5131) was not on file for staff member J. Smith wha stated her start date was September 2, 2010. 16, FAC Rule 65C-22.06 (4), states, records shall be maintained and kept current on all childcare personnel, as defined by Section 402.302 (3), F.S., and household members if the facility is located in a private residence. These shall include Level 2 screening information documented on CF-FSP Form 5131, February 2004, Background Screening and Personnel File Requirements, which is incorporated by reference. Pursuant to the Florida Administrative Code Rule 65C-22.006 (4), this is a Class 2 violation. This same Class 2 violation was previously cited on January 14, 2010, September 3, 2010 and September 7, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #60-Background screening, the fine for the second Class 2 violation is $50.00 per day for one day, the third Class 2 violation is $60.00 per day for one day, the fourth Class 2 violation is $75.00 per day for one day for a total of $185.00. Viotation-Vill 17. During a complaint investigation on September 8, 2010, a DCF Licensing Counselor determined that: Documentation of the Affidavit of Good Moral Character was missing for staff member J. Smith who stated her start date was September 2, 2010. 18. FAC Rule 65C-22.006 (4) {d) (3}, states, records shall be maintained and kept current on all childcare personnel, as defined by Section 402.302 (3), F.S., and househoid members if the facility is located in a private residence. These shall include Level 2 screening information documented on CF-FSP Form 5131, February 2004, Background Screening and Personnel File Requirements, which is incorporated by reference. CF 1649A, January 2007, A Childcare Attestation of Good Mora! Character, which is incorporated by reference, must be completed annually for all childcare personne}. Pursuant to the Florida Administrative Code Rule 65C- 22.006 (4), this is a Class 3 violation. This same Class 3 violation was previously cited on January 14, 2010, May 14, 2010, September 3, and September 7, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #60-Attestation of Good Moral Character, the fine for the third Class 3 violation is $25.00, for the fourth Class 3 violation is $30.00 per day for one day, the fifth Class 3 violation is $40.00 per day for one day for a total of $95.00. Violation-IX 19. During a complaint investigation on September 8, 20140, a DCF Licensing Counselor determined that: Documentation of Level 2 Background Screening and Personne! File Requirements (FDLE, FBI and Local) was not on file for staff member J. Smith who stated she started her date of employment September 2, 2010. 20. FAC Rule 65C-22.006 (4) (1), states, a Level 2 screening as defined in Section 435.04, F.S., which includes at a minimum Federal Bureau of Investigations (FBI), Florida Department of Law Enforcement (FDLE) and Local Law Enforcement records checks. Pursuant to the Florida Administrative Code Rule 65C-22.006 94) (10, this is a Class 2 violation. This same Class 2 violation was previously cited on January 14, 2010, February 4, 2010, April 28, 2010 and September 7, 2010. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #60-Background screening the fine for the third Class 2 violation is $60.00 per day for one day, the fourth Class 2 violation is $75.00 per day for one day and the fifth Class 2 violation is $100.00 per day for one day for a total of $235.00. | REVOCATION In addition to the fine levied above, the Respondent’s License will be REVOKED for the following reasons: Violation Il-is the 6" violation of the same Class 2 standard within two (2) years. The Department sha!] Suspend, Deny or Revoke the license in such cases. Violation IV —is the 5" violation of the same Class 3 standard within two (2) years. The Department shall Suspend, Deny or Revoke the license in such cases. Violation V- is the 6" violation of the same Class 3 standard within two (2) years. The Department shall Suspend, Deny or Revoke the license in such cases. Violation VI - is the 5" violation of the same Class 2 standard within two (2) years. The Department shall Suspend, Deny or Revoke the license in such cases. 21. The above referenced violation constitutes grounds to levy this Civil Penalty including Revocation of the license. 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. 22. 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. 23. 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 1323 Winewocd 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 28-106,201(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; (d) A statement of all disputed issues of material facts. Sf 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, DEPARTMENT OF CHILDREN AND FAMILIES ho BK 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 4127 Return Receipt Requested, in accordance with ss. 120.60(3), Florida Statutes (2005), this 46: y of March, 2011. STATE OF FLORIDA, DEPARTMENT OF <)ILOREN & FAMILIES Pamela Buckham Safety Program Manager

Docket for Case No: 11-001738