STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES To: Juliette Lewis Certified Mail: 7013 0600 0000 7498 4784 dibia Juliette’s Day Care Center Return Receipt Requested 6939 Como Road Jacksonville, FL. 32210 ADMINISTRATIVE COMPLAINT YOU ARE HEREBY NOTIFIED the Department has imposed a Civil Penalty in the amount of Two Hundred Dollars ($200.00). 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, to sanction Juliette Lewis d/b/a Juliette’s Day Care Center for violations of child care licensing standards in sections 402.301 — 402.319, Florida Statutes, and chapter 65C-22, Florida Administrative Code. 2. Juliette Lewis is licensed under chapter 402, Florida Statutes, and chapter 65C-22, Fiorida Administrative Code, to operate a child care facility known as Juliette’s Day Care Center License #C04DU0216 located at 6939 Como Road, Jacksonville, FL, 32210. The facility license is currently a REGULAR License. 3. During a Complaint Investigation on January 21, 2015 DCF Licensing Counseior Rosebud Hilliard, determined that: On January 14, 2015 one (1) or more children were not adequately supervised, which posed an imminent threat to a child which could have or did result in death or serious harm to the health, safety or well-being of a child. Staff member L.L., found a nine (9) month old child J.C., limp and gasping for air at the facility and did not call 911 for assistance. Instead L.L., called J.C.’s, Mom, Dad and Grandfather who came and transported the child to the hospital where he received medical care. 4. The foregoing facts violate Florida Administrative Code 65C-22.001(5)(a) which states: Direct supervision means actively watching and directing children’s activities within the same room or designated outdoor play area, and responding to the needs of each child. Child care personnel at a facility must be assigned to provide direct supervision to a specific group of children, and be present with that group of children at all times. When caring for school-age children, child care personnel shall remain responsible for the supervision of the children in care, shall be capable-of responding to emergencies, and are accountable for children at all times, including when children are separated from their groups. 5. The violation described above is a Class | violation of child care licensing standards. It is the facility's first (1) Class | violation of Child Care Facility Standards Classifications Summary #5 Supervision within a two-year period. The fine imposed for this violation is Two Hundred Dollars ($200.00). The facility was also cited with a Class 1 violation for #63 the owner, operator, employee or substitute, while caring for children, committed an act or omission that meets the definition of child abuse or neglect provided in Chapter 39, Florida Statutes. If you do not wish to contest the findings of this administrative complaint, please submit a cashier's check or money erder 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 2 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 Paul Sexton, Agency Clerk Chief Legal Counsel Office of the General Counsel Department of Children & Families Department of Children and Families P. O. Box 2417 1317 Winewood Blvd., Bldg 2, Room 204 Jacksonville, FL. 32231-0083 Tallahassee, Florida 32399-0700 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 shail 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) Avconcise statement of the ultimate facts alleged, including the specific facts the petitioner contends warrant reversal or modification of the agency's proposed action; E3 (g) Astatement of the specific rules or statutes the petitioner 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 (nh) 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. CERTI T RVICE | HEREBY CERTIFY that.a true and correct copy of the foregoing has been furnished by certified mail return receipt no. 7013 0600 0000 7498 4784 to Juliette Lewis d/b/a Juliette’s Day Care Center, 6939 Como Road, Jacksonville, FL, 32210 this /6:/tday of April 2015. f /)

Docket for Case No: 15-002645