STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

J'S FAMILY HOME, INC.,

Petitioner,

FiLED

AHCA ,

AGEHCY CLERK

2016 DEC \ 3 A \\: 20

V.

ST ATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

                                                                                 I

FINAL ORDER

DOAH No. 15-6971

AHCA No. 2015003062

Having reviewed the Notice of Intent to Deny and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:

1. The Agency issued the Petitioner, an initial applicant for licensure, the attached Notice of Intent and Election of Rights form. (Ex. 1) The Election of Rights form advised of the right to an administrative hearing pursuant to Sections 120.57(1) and 120.57(2), Florida Statutes. The Petitioner received the Notice of Intent and Election of Rights form and later voluntarily withdrew the application for licensure. (Ex. 2)

   
   

   Based upon the foregoing, it is ORDERED:

   
   

2. The Petitioner's application for licensure is WITHDRAWN.

   
   

3. The Notice oflntent is withdrawn.

ORDERED at Tallahassee, Florida, on this day of                        , 2016.

Justi Age

erim Secretary

are Administration

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Filed December 14, 2016 2:11 PM Division of Administrative Hearings

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is entitled to judicial review, which shall be instituted by filing one copy of a notice of appeal with the Agency Clerk of AHCA, and a second copy, along with filing fee as prescribed by law, with the District Court of Appeal in the appellate district where the Agency maintains its headquarters or where a party resides. Review of proceedings shall be conducted in accordance with the Florida appellate rules. The Notice of Appeal must be filed within 30 days of rendition of the order to be reviewed.

CERTIFICATE OF SERVICE

I CERTIFY that a true and correc y of_fu_is Final 0..1,was served on the below-named persons by the method designated on this j.?    t>-f.rayof ,           Ce                                     ,2016.

Richard J. Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

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Docket for Case No: 15-006971

Orders for Case No: 15-006971