STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES To: Partners In Education Certified Mail: 7012 3460 0002,3963 5830 Learning Center Incorporated Return Receipt Requested 5152 Vernon Road Jacksonville, FL 32209 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED the Department has imposed a Civil Penalty in the amount of One Thousand Five Hundred Ninety Dollars ($1,590.00). The Department's authority and grounds to impose this sanction are explained below: 1. The Department of Children and Families is authorized by section 402.310, Florida Statutes, fo sanction Partners In Education Learning Center Incorporated for violations of child care licensing standards in sections 402.301 ~ 402.319, Florida Statutes, and chapter 65C-22, Florida Administrative Code. 2. Partners In Education Learning Center Incorporated is licensed under chapter 402, Florida Statutes, and chapter 65C-22, Florida Administrative Code, to operate a child care facility known as Partners In Education Learning Center Incorporated License #C04DU0946 located at 5152 Vernon Road, Jacksonville, FL 32209. The facility license is currently a REGULAR License. 3. During a Renewal Inspection conducted on July 17, 2014 DCF Licensing Counselor Tracey Flanders determined: The CF-FSP 5337 Child Abuse and Neglect Reporting Requirements form expired for one staff member G.H. on May 1, 2014 and as of staff member last day of employment which was July 18, 2014 the form still had not been signed. 4. The foregoing facts violate Florida Administrative Code 65C-22.006(4)(c) which states: Records shall be maintained and kept current on all child care personnel, as defined by Section 402.302(3), F.S., and household members if the facility is located in a private residence. CF-FSP Form 5337, March 2009, Child Abuse & Neglect Reporting Requirements, which is incorporated by reference, must be signed annually by all child care personnel. 5. The violation described above is a Class Ill violation of child care licensing standards. It is the facility’s fourth (4") Class III violation of Child Care Facility Standards Classifications Summary #59 Personnel Records within a two-year period. The same violation was previously cited on October 30, 2012 at which time they received technical assistance, on July 19, 2013 they received an administrative warning and on March 18, 2014 they were fined $25.00. The fine imposed for this violation is One Thousand Five Hundred Ninety Dollars ($1,590.00) at $30.00 per day for 53 days from May 1, 2014 until July 18, 2014. If you do not wish to contest the findings of this administrative complaint, please submit a cashier’s check or money order made payable to the Florida Department of Children and Families, Child Care Regulation Office, 5920 Arlington Expressway, P.O. Box 2417, Jacksonville, FL 32231. If you wish to contest the findings of this administrative complaint and/or the sanctions imposed you may do so as provided in the notification of rights below. 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 IN WRITING AND MUST BE RECEIVED BY THE DEPARTMENT WITHIN 21 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 Blivd., 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 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; (c) An explanation of how the petitioner's substantial interests will be affected by the agency determination; (d) A statement of when and how the petitioner received notice of the agency decision; (e) A statement of all disputed issues of material facts. If there are none, the petition must so indicate; (f) Aconcise statement of the ultimate facts alleged, including the specific facts the petitioner contends warrant reversal or modification of the agency’s proposed action; A statement of the specific rules or statutes the petitioner > (g contends require reversal or modification of the agency’s proposed action, including an explanation of how the alleged facts relate to the specific rules or statutes; and (h) 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 a petition to be dismissed if it is not in substantial compliance with the requirements above. Mediation as described in section 120.573, Florida Statutes, may be available if agreed to by all parties, and on such terms as agreed to by all parties. The right to an administrative proceeding is not affected when mediation does not result in a settlement. CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by certified mail return receipt no. 7012 3460 0002 3963 5830 to Pa 5 In Education Learning Center Incorporated, 5152 Vernon Road, Jacksonville, FL 32209 this day of October 2014 Pamela Buckham Safety Program Manager

Docket for Case No: 14-005510