State of Florida Department of Business and Professional Regulation Division of Hotels and Restaurants DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. License Number 5603606 HOLLAND APTS dent License Type 2003 espondent. Case Number 2013021633 / Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against HOLLAND APTS, ("Respondent’), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 509, Florida Statutes. 2. Respondent is, and has been at all times material hereto, licensed by or subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 860 W JAMES LEE BLVD, CRESTVIEW, FLORIDA 32536.The mailing address of record is HOLLAND APTS, at 162 RAINBOW DRIVE, FORT WALTON BEACH, FLORIDA 32548. 3. Inspection of this establishment conducted pursuant to Sec. 509.032, Florida Statutes, revealed violations of the provisions of Chapter 809, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment. The violation(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit “B", incorporated herein by reference. WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penalties: administrative fine not to exceed $1,000 per offense, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the tules promulgated thereto, Signed May 20, 2013 Ken Hensdill, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Marc Drexler, Lead Attorney Florida Bar No, 0487058 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 Certificate of Service BY CERTIFIED U.S, MAIL, ARTICLE NUMBER: 7196 9008 9111 0766 7938 | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , 2013. Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2013021633 File Number: 84957 District Number: 06 License Number: 5603606 2003 Form revised 01.01.13 HOLLAND APTS Exhibit A License Number: 5603606 License Type: 2003 APARTMENT Case Number: 2013021633 Itis alleged that on March 11, 2013, May 13, 2013 Respondent was in violation of Florida Statute 509 (FS); the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC), and/or specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, as incorporated by Chapter 61C, FAC in the following particulars. Copy(s) of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. ** denotes a high priority violation. * denotes an intermediate priority violation. 4. 13-03-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed water damage on the wall (in kitchen area of office unit). 2. 13-03-4 61C-1.004(5) FAC Basic: Alll building structural components, attachments and fixtures shall be kept in good repair. Observed moid-like substance on wall (under A/C units behinde building). 3. 13-08-4 61C-1.004(5) FAC Basic: All ouilding structural components, attachments and fixtures shall be kept in good repair. Observed hole in the ceiling (small holes in ceiling of office unit #143) 4. 13-09-4 61C-1,004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. , Observed water damage on the ceiling (in kitchen area of office unit #143) 6. 13-12-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed hole in the soffit/fascia (between Apt. !40 & 141). 6. 13-23-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed door frame in disrepair (door frame into bathroom of office unit #143). 7. 13-28-4 61C-1.004(5) FAC Basic: All building structural components, attachments and fixtures shall be kept in good repair. Observed rotted woad on exterior of building (above Apt. 141). 8.25-07-4 509.221(7)FS Basic: The operator of any establishment licensed under this chapter shall take effective measures to protect the establishment against the entrance and the breeding on the premises of all vermin. Any room in such establishment infested with such vermin shall be fumigated, disinfected, renovated, or other corrective action taken until the vermin are exterminated. Observed discarded couch stored outside. Case Number: 2013021633 File Number: 84957 District Number: 06 License Number: 5603606 2003 Form revised 01.01.13 HOLLAND APTS

Docket for Case No: 13-002954

Orders for Case No: 13-002954