STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

FILED

AHCA

AGENCY CLERK

RODRIGUEZ ALF NO. 2,

Petitioner,

V.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

                                                                              I

FINAL ORDER

211& AUG 31 A 52

Case No. 16-2900

AHCA No. 2016001371

License No. 11696

File No. 11967690

Provider Type: Assisted Living Facility

RENDITION NO.: AHCA- \l.t> -Du(pO -S-OLC

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

1. The Agency issued the attached Notice of Intent to Deny and Election of Rights form to the Respondent. (Ex. 1) The parties have since entered into the attached Settlement Agreement, which is adopted and incorporated by reference into this Final Order. (Ex. 2)

   
   

2. The parties shall comply with the terms of the Settlement Agreement.

   
   

3. The Petitioner granted a provisional license with a license expiration date of November 1,

   2016.

   
   

4. The Petitioner shall pay the Agency $2,000.00. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the "Agency for Health Care Administration" and containing the.AHCA ten-digit case number should be sent to:

Central Intake Unit

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 61

Tallahassee, Florida 32308

ORDERED at Tallahassee, Florida, on this _]J_ day of ,¥= ' 2016.

ecretary

Care Administration

Filed September 13, 2016 4:44 PM Division of Admi1nistrative 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

Richard J. Shoop, Agency

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

2

Docket for Case No: 16-002900

Orders for Case No: 16-002900