STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES IN THE MATTER OF Certified Mail 7011 0470 0002 3594 4308 A Civil Penalty Against Return Receipt Requested For Your Child Only, Inc. d/b/a For Your Child Only Victory Land 6101 Avenue B Jacksonville, Florida 32209 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED that the Department has imposed a Civil Penalty in the amount of Three Hundred Dollars ($300.00), against For Your Child Only, Inc. d/b/a For Your Child Only Victory Land. 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, For Your Child Only, Inc.., is licensed to operate For Your Child Only Victory Land - License #C04DU0019, located at 6101 Avenue B, Jacksonville, Florida 32209, 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 a complaint investigation conducted on July 11, 2011, a DCF Licensing Counselor, Rosebud Hilliard, determined that: ' The facility's use of seat belts was not appropriate, in that a two (2) year old child and a three (3) year old child were not transported using the required car seats. Children of this age should be properly restrained in car seats. 4. FAC Rule 65C-22.001(6)(d), states, the maximum number of individuals transported in a vehicle may not exceed the manufacturer’s designated seating capacity or the number of factory installed seat belts. When transporting, each child must be in an individual factory installed seat belt or federally approved child safety restraint, unless the vehicle is excluded from this requirement by Florida Statue. Pursuant to the Florida Administrative Code Rule 65C- Filed March 22, 2012 1:59 PM Division of Administrative Hearings 22.001(6)(d), this is a Class 1 violation. Pursuant to the Child Care Facility Standards Classifications Summary, CF-FSP Form 5316, Item #8-Seat Belts/Child Restraints, the fine for this first Class 1 violation is not less than $100.00, nor more than $500.00. Due to the fact that this is the facility's first Class 1 violation, this fine is being assessed at the amount of $200.00, $100.00 for each of the children who were not properly secured. Violation-ll 5. During a complaint investigation conducted on July 11, 2011, a DCF Licensing Counselor, Rosebud Hilliard, determined that: The Director, R.W., falsified transportation records. R.W. forged the initials of the driver, J.W., hired June 12, 2003 and the transportation monitor, S.B., hired January 5, 1995, on the transportation logs for the weeks of June 27, 2011 through July 1, 2011 and July 4, 2011 through July 8, 2011. Director forged the initials to make it appear to the Counselor that records had been accurately maintained for all children transported. R.W. admitted to signing J.W.’s initials on the log. 6. F,S. 402.319(1)(f), states, it is a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083, for. any person knowingly to make any other misrepresentation, by act or omission, regarding the licensure or operation of a child care facility or family day care home to a parent or guardian who has a child placed in the facility or is inquiring as to placing a child in the facility, or to a representative of a law enforcement agency, including, but not limited to, any misrepresentation as to the number of children at the child care facility or the family day care home; the part of the child care facility or family day care home designated for child care; the qualifications or credentials of child care personnel; whether a family day care home or child care facility complies with the screening requirements of s. 402.305; or whether child care personnel have the training as required by s. 402.305. Pursuant to Florida Statute 402.319(1)(f), this is a Class 1 violation. Pursuant to the Child Care Facility Standards Classification Summary, CF-FSP Form 5316, Item #63-Access/Child Abuse or Neglect/Misrepresentation, the fine for this second Class 1 violation is no less than $100.00, nor more than $500.00. This fine is being assessed at the amount of $100.00. 7. The above referenced violations constitute 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. 8. 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. 9. Failure to pay the fines 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 Winewood Blvd., 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, DEPARTMENT\OF CHILDREN AND FANILIES, Pamela fas Safety Program veal, CERTIFICATION OF SERVICE { HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, 7011 0470 0002 3594 4308 Return Receipt Requested, in accordance with ss. 120.60(3), Florida Statutes (2005), this May of December, 2011. STATE OF FLORIDA, DEPARTMENT OF CHILDREN & FAMILIES Parfela Buckham Safety Program Manager David Tucker/D04/DCF To Jeffrey Elliot/D04/DCF@DCF 02/09/2012 08:39 AM cc bec Subject Re: For Your Child Only Victoryland::} sufficient David G. Tucker Regional Counsel, Northeast Region Florida Department of Children and Families 5920 Arlington Expressway Jacksonville, FL 32211 (904)723-2172 (0) (904)534-8919 (c) david_tucker@dcf.state.fl.us This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If you are not the intended recipient, please notify the sender, delete this message, and do not use, disseminate, or copy its contents. Thank you. Jeffrey Elliot/D04/DCF Jeffrey Elliott/D04/DCF 02/08/2012 04:54 PM To David Tucker/D04/DCF@DCF ce Subject For Your Child Only Victoryland sufficient? Adm Complaint For Your Child Only Victory Land 12212011.doc thanks. 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Docket for Case No: 12-001069