STATE OF FLORIDA

AGENCY FOR PERSONS WITH DISABILITIES

AGENCY FOR PERSONS WITH DISABILITIES,

Petitioner,

V.

License No. 15-1510

In Good Hands Group Home, owned and operated by Marie Volcy,

Respondent.

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ADMINISTRATIVE COMPLAINT

The AGENCY FOR PERSONS WITH DISABILITIES, ("Petitioner" or "Age ncy"),

issues this Administrative Complaint against In Good Hands Group Home, owned and operated by Marie Volcy (or "Respondent") , and states the following as the basis for this complaint:

1. Petitioner is the state agency charged with regulating the licensing and operation of foster care facilities, group home facilities, and residential habilitation centers, pursuant to Section 20.197 and Chapter 393, Florida Statutes .

   
   

2. At all times material to this complaint, Respondent has held a group home facility license issued by the Agency for the following address: 757 N.W. Bristol Street, Port St. Lucie, Florida, 34983 . The Respondent also has contracted with APO to provide the residents with Medicaid Waiver developmental disability services.

   
   

3. Section 393.0673(1)(a)(3), Florida Statutes, provides that the Agency may revoke a license, or impose an administrative fine if the licensee has failed to comply with the applicable requirements of Chapter 393, Florida Statutes, or the rules applicable to the licensee.

COUNT I

1. Rule 65G-2.012 (14)(e), F.A.C. requires that "Medications shall be kept in a locked enclosure."

   
   

   On May 6, 2011, APO Area 15 staff member Alisha Dawson observed prescription medications in the In Good Hands Group Home which were

   
   

   Filed July 12, 2011 10:17 AM Division of Administrative Hearings

   unlocked and accessible to the vulnerable adult residents of the group home.

   
   

   The aforementioned incident constitutes a violation of rule 65G- 2.012(14)(e), F.A.C.

   
   

   COUNT II

   
   

2. Rule 65G-2.012(12)(a), F.A.C. states, in relevant part:

   
   

   All poisonous and toxic compounds and potentially hazardous instruments shall be used with extreme caution.... Poisonous and toxic compounds shall not be stored in an area which may constitute a hazard to the clients. Such items shall be safeguarded and not commingled with food items in storage areas or elsewhere."

   
   

   On May 7, 2011, Area 15 Administrator Peter Karlan and observed an open one gallon container filled with used syringes within an unlocked bathroom closet of the In Good Hands Group Home. Mr. Karlan also observed an unsecured box containing bleach and other poisonous cleaning supplies on the floor of the facility's bathroom where the supplies would be accessible to clients of the facility.

   
   

   The aforementioned incidents constitutes a violation of rule 65G- 2.012(12)(a), F.A.C.

   
   

   COUNT Ill

   
   

3. Rule 65G-2.012(8)(I), F.A.C. requires the following:

   
   

   1. The facility shall maintain the interior and exterior of the building in a clean, safe, presentable and repaired condition.

   2. The grounds and all buildings on the grounds shall be maintained in a safe, sanitary and presentable condition.

On May 17, 2011, Area 15 Administrator Peter Karlan observed a large number of exposed wires running down a steel pole from the back of the house into a gas barbeque grill in the rear of the In Good Hands Group Home. A Notice of Noncompliance was previously issued to the Respondent on or about January 22, 2010, for exposed electrical wiring within the facility's bathroom.

The aforementioned incident constitutes a violation of rule 65G-2.012(8)(I), F.A.C.

COUNT IV

9. Rule 65G-7.005(2), F.A.C. requires:

A validated medication assistance provider must comply with the following requirements:

U) Record the date, time, dosage, and name of each medication in the MAR immediately following administration and sign the entries.

In addition, rule 65G-7.008(1), F.A.C. requires:

An up-to-date MAR [Medication Administration Record] shall be maintained for each client requiring assistance with medication administration, except when the client is off-site. The medication assistance provider must document the administration of medication or supervision of self­ administered medication immediately on the MAR, using either APD Form 65G7-00... or on an alternative MAR form that includes the following information:

1. The date that the medication was ordered and any date the medication was changed (including D/C date);

   
   

   1. The initials and signature of the medication assistance provider who assisted with medication administration;

During a monitoring review on May 6, 2011, APD Area 15 staff member Alisha Dawson observed that a Medication Administration Record (MAR) for a resident of the In Good Hands Group Home was not initialed to show that Seroquel had been administered on May 4, 2011, May 5, 2011, and on the morning of May 6, 2011, as was prescribed. Ms. Dawson also observed that a MAR did not indicate the date that the Seroquel had been ordered. A Notice of Noncompliance was previously issued to the Respondent on or about February 3, 2010, for insufficient medication administration records.

The aforementioned incidents constitute violations of rules 65G-7.005(2) and 65G-7.008(1), F.A.C.

WHEREFORE, Petitioner respectfully requests that an administrative fine of

$500 per count for Counts I, II, and IV, and an administrative fine of $250 per count for Count Ill, for a total fine of $1,750, be assessed to the In Good Hands Group Home, owned and operated by Marie Veley, in accordance with Section 393.0673, Florida Statutes.

Dated: June 9, 2011

Jon an Grabb

Sen or Attorney, Office of General Counsel Agency for Persons with Disabilities

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Cc/ APO Area 15 Administrator Peter Karlan Attachments:

Explanation of Rights Election of Rights Form

Copies furnished to:

Marie Volcy

In Good Hands Group Home 757 N.W. Bristol Street

Port St. Lucie, Fl 34983

APO Area 15 Administrator

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a copy of the above named individuals by U.S. Mail or electronic mail, this 9th day of June, 2011.

Percy W. Mallison, Jr., Agency Clerk Agency for Persons with Disabilities 4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

STATE OF FLORIDA

AGENCY FOR PERSONS WITH DISABILITIES ELECTION OF RIGHTS

RESPONDENT: In Good Hands Group Home, owned and operated by Marie Volcy, Port St. Lucie, Florida.

I have read the accompanying Administrative Complaint and Explanation of Rights in this matter, I would like to request a hearing, and I elect for the following hearing option:

□ I do not dispute the facts alleged in the Administrative Complaint and wish to be heard on the issue of penalty or conclusions of law. I request an informal hearing pursuant to Section 120.57(2), Florida Statutes. I understand that at that hearing I will be permitted to submit only written or oral evidence in mitigation of the charges or explain why the facts alleged do not constitute a violation of law.

D I dispute the material facts alleged in the Administrative Complaint and request an evidentiary hearing pursuant to Section 120.57(1), Florida Statutes. Specifically, I dispute the following material facts:

Please be advised this is a legally binding document and contains important information regarding your rights. Should you desire advice regarding your response, you may wish to seek legal counsel before proceeding. By signing this document, you represent you are authorized to act on behalf of the establishment named herein and accept responsibility for compliance with any final order resulting from this action. Failure to complete, sign and return the election of rights form to the agency within 21 days of receipt may constitute a waiver of your right to be heard in this matter and the Agency may commence proceedings without your participation, which may result in penalties against your license. As provided in §393.063(1), Florida Statutes, penalties may include suspension, revocation or denial of licensure, and fines up to $1000 per day for each violation.

Telephone number for contact:                                                  Fax      

Signature:                                                                         Date:                           -

Print Name:                                                                      Title:                                 _

MAIL OR FAX THE COMPLETED FORM TO:

Pete Mallison, Agency Clerk

Agency for Persons with Disabilities,

4030 Esplanade Way, Suite 380

Tallahassee, Florida 32399-0950

Fax: (850) 410-0665

You are advised, per Section 120.573, Florida Statutes, that mediation is not available for this action. Please keep a copy of this document for your records.

STATE OF FLORIDA

AGENCY FOR PERSONS WITH DISABILITIES EXPLANATION OF RIGHTS

The enclosed Administrative Complaint charges you with violating one or more provisions of Chapter 393, Florida Statutes, or the rules supplementing that Chapter. If you have questions regarding your response or best course of action, you may wish to seek the advice of competent legal counsel.

Your receipt of this Administrative Complaint packet constitutes service upon you. Your rights under Florida law (Chapter 120, Florida Statutes) are as follows:

You may elect to not dispute the violations alleged in the Complaint and request that a hearing be held to present testimony or documents you wish the Agency to consider in mitigation of the alleged violations prior to disposition of this case. Any penalty levied will be included in a Final Order. If a dispute of material fact arises, the hearing will be terminated and the case referred to the Division of Administrative Hearings.

You may elect to dispute the violations alleged in the Complaint and request a hearing before an Administrative Law Judge, which is an administrative "trial". You and the Agency may present evidence and witnesses to prove or disprove the facts alleged and submit a written proposed recommended order after the hearing for the Judge's consideration. Based on the evidence and any proposed recommended orders submitted, the Judge will issue a Recommended Order containing Findings of Fact, Conclusions of Law, and Recommended Penalty, if any. Following review of the Recommended Order, the Agency will issue a Final Order.

An Election of Rights form is included with the Administrative Complaint. The Agency must receive it within 21 days of your receipt of this Administrative Complaint packet. After the Agency determines whether a dispute of material fact exists, it will make arrangements on your behalf for the appropriate hearing. You will receive notice of the date, time, and place of hearing at the address designated by you on your Election of Rights.

IMPORTANT: If the Agency does not receive a completed copy of the Election of Rights form, or any other written response from you, within the 21 days of your receipt of this Administrative Complaint, you may have waived your right to a hearing in this matter and the Agency may proceed against you in this matter without your participation.

Please note, per Chapter 120.573, Florida Statutes, mediation is not available in this action.

Docket for Case No: 11-003381

Orders for Case No: 11-003381