riLeD MAR 2 1 2018 Docketed by CHIEF FINANCIAL OFFICER JIMMY PATRONIS STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES, DIVISION OF FUNERAL, CEMETERY, AND CONSUMER SERVICES, Petitioner, CASE NO.: 195915-16-FC 198401-16-FC Vis SIGNATURE MEMORIAL FUNERAL & CREMATION SERVICES, LLC, Respondent. / AMENDED ADMINISTRATIVE COMPLAINT The Department of Financial Services, Division of Funeral, Cemetery, and Consumer Services (Department), files this Amended Administrative Complaint before the Board of Funeral, Cemetery, and Consumer Services (Board) against Signature Memorial Funeral & Cremation Services, LLC (Respondent), and alleges: GENERAL ALLEGATIONS 1. The Department and Board have jurisdiction over Respondent’s license and the subject matter of this proceeding pursuant to section 20.121 and chapter 497, Florida Statutes (2015),! 2. Respondent is licensed in Florida as a funeral establishment, license number F090323. Respondent’s address is 3401 SE Hawthorne Road, Gainesville, Florida. 3. On May 13, 2016, the Department conducted an inspection of Respondent’s place 1 Unless otherwise indicated, all citations to Florida Statutes are to the 2015 version in effect at the time of the allegations. ATN 26991 ATN 27106 of business (the inspection). 4. The inspection disclosed major alterations or modifications to the physical structure of Respondent’s place of business that were made without notifying the Department. 5. The inspection disclosed that Respondent stored the embalmed remains of a deceased infant, C.D., on top of a black plastic tarp on a wooden plank supported by two workhorses while Respondent’s place of business was undergoing major alterations or modifications. COUNT | 6. The Department realleges and incorporates by reference the allegations set forth in paragraphs one through five as if fully set forth herein. 7. Section 497.152(1)(a), Florida Statutes, provides that “[vJiolating any provision of this chapter [497] or any lawful order of the board or department or of the statutory predecessors to the board or department,” constitutes grounds for discipline. 8. Section 497.152(1)(b), Florida Statutes, provides that “committing fraud, deceit, negligence, incompetency, or misconduct in the practice of any of the activities regulated under this chapter [497],” constitutes grounds for discipline. 9. Section 497.152(4)(h), Florida Statutes, provides that “[flailing to perform any statutory or legal obligation placed upon a licensee,” constitutes grounds for discipline. 10. Section 497.152(8)(a), Florida Statutes, provides that a “[vJiolation of any state law or rule or any municipal or county ordinance or regulation affecting the handling, custody, care, or transportation of dead human bodies,” constitutes grounds for discipline. ll. Section 497.386(4), Florida Statutes, provides that “all human remains transported or stored must be completely covered and at all times treated with dignity and respect.” 2 ATN 26991 ATN 27106 12. Based upon the foregoing, Respondent violated section 497.386(4), Florida Statutes, by storing the embalmed remains of C.D. on top of a black plastic tarp on a wooden plank supported by two workhorses while Respondent’s place of business was undergoing major alterations or modifications. Respondent is therefore subject to discipline pursuant to sections 497.152(1)(a), (b), (4)(h), and (8)(a), Florida Statutes. COUNT II 13. The Department realleges and incorporates by reference the allegations set forth in paragraphs one through five as if fully set forth herein. 14. — Section 497.152(1)(a), Florida Statutes, provides that “[v]iolating any provision of this chapter [497] or any lawful order of the board or department or of the statutory predecessors to the board or department,” constitutes grounds for discipline. 15. Rule 69K-21.002(4)(c), Florida Administrative Code, requires the owner of a funeral establishment to notify the Department at least ten days before making major alterations or modifications to the physical structure of a funeral establishment. 16. Based on the foregoing, Respondent violated Rule 69K-21.002(4)(c), Florida Administrative Code, by failing to notify the Department at least ten days before making major alterations or modifications to the physical structure of Respondent’s place of business, and Respondent is therefore subject to discipline pursuant to section 497.152(1)(a), Florida Statutes. WHEREFORE, the Department respectfully requests that the Board enter an order imposing one or more of the following penalties on Respondent: revocation or suspension of its license; imposition of an administrative fine not to exceed five thousand dollars ($5,000.00) for each count or separate offense; issuance of a written reprimand; placement of its license on probation; assessment of costs associated with the investigation and prosecution; imposition of 3 ATN 26991 ATN 27106 any or all penalties delineated within section 497.153(5), Florida Statutes; and any other relief that the Board is authorized to impose pursuant to the Florida Funeral, Cemetery, and Consumer Services Act. DATED and SIGNED this od [ I day of Mb , 2018. — fo r Chasity H. O’Steen General Counsel PC Found: 2/14/17 PC Found By: Al Hall, Jean Anderson, Richard Chesler ATN 26991 ATN 27106 NOTICE OF RIGHTS The Licensee has the right to request a proceeding to contest this action by the Board pursuant to sections 120,569 and 120.57, Florida Statutes (2015), and Rule 28-106, Florida Administrative Code. The proceeding request must be in writing, signed by a representative for the Licensee, and must be filed with the Department within twenty-one (21) days of receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written request. The request must be filed with the Department Agency Clerk, Julie Jones, Florida Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-0390. The Licensee’s written response must be received by the Department no later than 5:00 p.m. on the twenty-first day after receipt of this notice. Mailing the response on the twenty-first day will not preserve the right to a hearing. FAILURE TO RESPOND IN WRITING WITHIN TWENTY- ONE (21) DAYS OF THE RECEIPT OF THIS NOTICE WILL CONSTITUTE A WAIVER OF THE RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF SUSPENSION OR REVOCATION WILL BE ENTERED. If the Licensee requests a proceeding, information must be provided that complies with the requirements of Rule 28-106.2015, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, the response must contain: (a) The name, address, and telephone number, and facsimile number (if any) of the respondent (for the purpose of requesting a hearing in this matter the Licensee is the "Respondent”). (b) The name, address, telephone number, facsimile number of the attorney or qualified representative of the respondent (if any) upon whom service of pleadings and other papers shall be made. (c) A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. (d) A statement of when the respondent received notice of the administrative complaint. (e) A statement including the file number to the administrative complaint. If a hearing of any type is requested the Licensee has the right to be represented by counsel or other qualified representative at its own expense, to present evidence and argument, to call and cross-examine witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. If a proceeding is requested and there is no dispute of material fact, the provisions of section 120.57(2), Florida Statutes, apply. Oral or written evidence may be submitted in opposition to the action taken by the Board or a written statement challenging the grounds upon 5 ATN 26991 ATN 27106 which the Board has relied. While a hearing is normally not required in the absence of a dispute of fact, if the Licensee feels that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon request. However, if the Licensee disputes material facts which are the basis for the Board’s action, an adversarial proceeding must be requested pursuant to sections 120.569 and 120.57(1), Florida Statutes. These proceedings are held before a State Administrative Law Judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to the response to this notice may result in the request being denied. All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Mediation of this matter pursuant to section 120.573, Florida Statutes, is not available. No Department attorney will discuss this matter you or your representative during the time frame in which you have to request a hearing. ATN 26991 ATN 27106 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES OFFICE OF THE GENERAL COUNSEL DEPARTMENT OF FINANCIAL SERVICES, DIVISION OF FUNERAL, CEMETERY, AND CONSUMER SERVICES, Petitioner, CASE NO.; 195915-16-FC 198401-16-FC v. SIGNATURE MEMORIAL FUNERAL & CREMATION SERVICES, LLC Respondent. ELECTION OF PROCEEDING I have received and have read the Administrative Complaint filed by the Florida Department of Financial Services ("Department") against me, including the Notice of Rights contained therein, and J understand my options, I am requesting disposition of this matter as indicated below. (CHOOSE ONE) 1. [] I do not dispute any of the Department’s factual allegations and I do not desire a hearing. | understand that by waiving my right to a hearing, the Board of Funeral, Cemetery and Consumer Services (“Board”) may enter a final order that adopts the Administrative Complaint and imposes the sanctions sought, including suspending or revoking my license(s) as may be appropriate. 2. 1 do not dispute any of the Department's factual allegations and I hereby elect a proceeding to be conducted in accordance with Sections 120.57(2) and 497.153(4)(b), Florida Statutes. In this regard, I desire to: [1 Submit a written statement and documentary evidence to the Board in lieu of a hearing; or [1 Personally attend a hearing conducted by the Board at the location of a regularly scheduled Board meeting. 3. [] [ do dispute one or more of the Department's factual allegations. I hereby request a hearing pursuant to Section 120.57(1), Florida Statutes, to be held before the Division of Administrative Hearings. 1 have attached to this election form the information required by Rule 28-106.2015, Florida Administrative Code, as specified in subparagraph (c) of the Notice of Rights. Specifically, I have identified the disputed issues of material fact in the response attached hereto. TO PRESERVE YOUR RIGHT TO A HEARING, YOU MUST FILE YOUR RESPONSE WITH THE DEPARTMENT OF FINANCIAL SERVICES WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. THE RESPONSE MUST BE RECEIVED BY THE DEPARTMENT NO LATER THAN 5:00 P.M. ON THE TWENTY-FIRST DAY AFTER YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. The address for filing is: DFS Agency Clerk, Julie Jones, Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0390, Signature Print Name Date: Address: Date Administrative Complaint Received: If you are represented by an attorney or qualified — Phone No.: representative, please attach to this election form his or her name, address, telephone and fax numbers, Fax No.: \ ATN 26991 ATN 27106 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing AMENDED ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished by U.S. Certified Mail, return receipt requested, to Respondent at 3401 SE Hawthorne Rd, Gainesville, Florida 32601; and Christopher V. Butler, Esq., counsel for Respondent, at 200 E. Commercial St., Ste. 2, Sanford, FL 32771, and by e-mail to Christopher V. Butler, Esq., at crsbtIr@yahoo.com and cvbutlerlaw@gmail.com, on this pall St day of Vardi , 2018. J anfes A. Bossar Senior Attorney Fla. Bar No. 374598 Office of the General Counsel Florida Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-0333 (850) 413-4124 ATN 26991 ATN 27106

Docket for Case No: 18-002126