STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES To: Super Sub 1 Trading Group Corp Certified Mail: 7016 2140 9000 8293 3808 dibfa ivy League Academy Return Receipt Requested 2350 Market Dr Flaming stand, Ft. 32003 Case 2018-CO4CL0115-2 INISTRAT T YOU ARE HEREBY NOTIFIED the Department has imposed 4 Civi! Penalty In the armaunt of Five Hundred Fifty Dollars ($550.00). The Department's authority and grounds to impose this sanction are explaines below 4. The Department of Calldren and Families js authorized by saction 402.310, Florida Statutes to wanction Super Sub 1 Trading Group Corp d/b/a ivy League Academy fcr violations of chid care Ecensing standatds in sections 402.301 ~ 402.319, Florida Statutes. and chapter 65C-22, Florida Adminiatrative Code. 2: Super Sub 4 Trading Group Corp is ‘icensed under chapter 402, Florida Statutes, and chapter 65C-22. Flonda Administratve Code, to operate a ciiid care facility known ag ivy League Academy Lcense #O04C01.01 15 locatec at 2380 Market Dr, Fleming Isiand, FL 32003. The facility's iicense is currently a REGULAR Licersa. Violation #1 3. During 2 Re-nspaction on June 11, 2019 OCF Licanaing Counselor Hannan MeGiothin, cetarminad that The facility did net maintain a log for all children being transported in a vehicle. The program was cited for this same standard on May 23, 204%, They were given & corrective action deadline of June §, 2018, as of this re-inspection dated June 11, 201% the program has not submitted a corrective action for this standard. The program has bean given a new due date of June 24, 2018 to receive the corrective action. 4, Tne foregoing facts violate CCF Handbook, Section 2.5.2 A-E which states: A log must b¢ maintained for all childrer beng transconed in e vehicie or on foot away from tha premises of the chid care facility. The jog must be retained on file at the facility for a minimum of 12 months and availabia for review by the licensing authority. The log must include: t. Each child's name, 2. The date and time of departure, 3. Tims af arrival at the destination, 4. Tre signature of the driver (or in the case of travelling on foot. the signature of the child care personnel), and &. The s'gnature of a second staff member or person(s) authorized by the provider to verify ihe transponaton log and thet all chikdren have arved safely and leis tre vehicle @f apolicabic}. 8. Por to transporting chidren the transportation log must be recorded, s.gned, and dated immediately, verifying that all children were accounted for and that the log Is complete. ©. Upon arrival at the destination by vehicle or by foot, the chid care personnel must record, sijn and date the transportation joa immectately, veciving [hat ail children were acocunted for. The same must oecur immediately upon returning to the faciity premises. D. Upon artiva! at ihe destination by vehicle, the driver of the vehicle must 7. Mark each child off the cog as the child departs the vehicle: 2. Conduct 4 physica’ inspection and visual sweep af the vehicle interior to ensure that ne chid is feft in the vehicle; and 3. Record, sign. and date the trangportatian log immadiately, verifying that all children were accounted for. and that the visual aweep was conducted. 4. Ensure nat a second staff member signs and dates the transportation Log verifying that all childran ware accounted for, and that the jog is Compote. E. Upon arrivat at the destination by vehicle. a second and differant stalt mamber must: 1. Conduct a physical imspection and visual sweep of the vehicle tc ensure that no child ss left in the veticie: and 2. Sign, date and record the transportation Jag immediately verliying that all chidran ware accounted for, ang that the log is complete. §. Tne violation described above is a Class ll violation of child care licensing standards. itis the facility's second (2°%) Class Hl violation of Child Care Facility Standards Classifications Summary 405-02 Transportation within a two-year period, The same violation was previously cited on May 23 2519. The fine wnposed for this volation is Fifty Dollars ($50.00). ve Violation #2 3. During a Re-inspection on June 11, 2019 DCF Licensing Counselor, Hannah MeGisthlin, determined that Child care personne! misrepresented information, impersonated or provided fraudulent information related to the child care facility to a parent/guardian, licensing authority or law enforcement that could or did result in the death or serious harm to the health, safety or well-being of a chifd, During a field visiticomplaint investigation on May 29, 2019, Counselor observed staff membar R.H. arrive at the program with children at 3:06 p.m. Counselor then reviewed the transportation log at 3:27 p.m. which Was fer ine tracaperting ef abildvan tar inal day May 06, 4048. The erhagaration jag was Hat maintained in that there was not an arrival or departure time documented, children were not marked off as getting on the vehicle and/or off the vehicle, nor were there driver initials ar second staff initials verifying a physical inspection ware conducted. The only information pravided on the iog for May 29, 2019 at the time of inspection was an “ON” tima of "2:35" for Thundarboilt Elementary schoai, a dash through “GROUP TIME ON/OFF" for St, Johns Elementary School. an “X" through every child's box for St, Johns and the mileage start (79492) mileage end (79502) was documented. Counselor reviewed the transportation log missing the necessary Information at 3:27 p.m. On June §, 2018, counselor received transportation logs from the provider, for the corrective action that was due, for the violation incurred under standard #05-02 during the routine inspection on May 23, 2019. A transportation log was submitted for the week of May 28, 2079 to May 34, 2049. For the data of May 29, 2049, the transportation log is filled out completely with times: in the “GROUP TIME ON/OFF,” all children were marked off [signified by a check mark) with the total numbar of children transported written, and the river initials [RH] and second staff initials [SH] verifying physical inspections were conducted. The tims off for “Swimming” [elementary school] and "Patterson" {slemontary school] was listed as 3:00 PM. This is not accurate information in that the counsalor observed stalf member R.H. arrive at the facility at 3:06 PM. The initials/signatures verifying the physical inspection was conducted are nat accurate information in that there were no physical inspections, of the vehicle used to transport the children, until roughly 3:20 PM when counselor entered tha program and instructed staff member R.H. that a physical Inspection of the vehicle needed to be conducted. At that time, with counselor present, the driver R.H. conducted a physical Inapection of the vehicle: there was not 4 second physical inspection hy individual §.H., as it appears on the transportation lag that was submitted to the counselor via email on June §, 2019. Counselor discussed the impartance of accurately filling out the iranspertation logs and providing truthful information to the Heensing authority. 4. The foregcing facts viclate Florida Statute 402.319 (1A-F 1-5}{2) which states: (1) It is a misdemeanor of the first degree, pun’shable as provided in s. 77£.082 of s. 775.083. for any person knowirgly io: {a} Fail, by faise statement. misreaprasentaton, impersonation, or ather fraudulent means, to disclose in any application for voluntary of paid employment or licensure regulated under ss. 402.301-402.318 ail i.formation required under those sections or a material fact used in makirg a determination ag to such person's qualiicatians to be child care personne’, as defined ins. 402.302. In a child care facihly, family day care home. ur atner child care program. (b) Operate or attempt to operate a child care facility without having procured 2 ioense as required by this act. (c) Operate or atempt to operate a farnily day care home withaut a license or without registering with the department, whichever |s applicable. {d} Operate or aitempt to operate a chiid care facility or fenuly day care home under a jicanse that is suspended, revoked, or terminated. (e) Misrepresent, by act oF onuss'on, a child care facility or family day care home to be duly licansed pursuant to this act without being so icensed. (f}) Make any other overapresentation, by act of omiss ‘or, fegarcing the licensure or opération of a child care faciily or family day care home to a parent of guardian wno nas a child placed in the facility cr is inquiring as to placing a cmid in ine facility, or to a representative of the licensing authority, or to a rapresertative of a law enforcement agency, including, fut not limited to, any misreprasentation as ic 1. The number of children ai the child care facility or the family day care home: 2. The part of the child care facility or farmdy day care home designated for child care; 3. The qualifications or credentials of cid care personnel 4. Whether a family day care home or child care facility complies with the screening requirements of s. 402.305, or §. Whether child care personnel have the training as required by s. 402.305. (2) tf any chifd care personne! makes any misrepresentation in violation of this section to a parent or guarcian who has placed a child wy the child care facility or family day care home, and the parent or guardian relied upen the sisrepresentation, and the child suffers great bodily harm, permanent disfigurement, permanent disabsity. or death as ¢ result of an intentional act or negligence by the child care personnel, then the child care personne! commits a felony of the second degree, punishable as provided in s. 775.082, ¢. 775.083, or $. 775.084. 5. The violation described above is a Class | violation of child care licensing standards. |t is the facility's firet (1“} Clase f violation of Chitd Care Facility Standards Classifications Summary #47-07 AccessiCnhild Safety within a two-year period. The fine imposad for this violation is Five Hundred Dollars ($500.00). if you do not wish to contest the findings of this administrative complaint, made payable to the Florida Department of Children and Farnilies, Child Care Regulation Office, P.O. Box 2417, Jacksonville, Fi. 32231. RIGHT TO ADMINISTRATIVE PROCEEDING iF YOU BELIEVE THE PROPOSED ACTION DESCRIBED IN THIS ADMINISTRATIVE COMPLAINT !5§ IN ERROR, YOU MAY REQUEST AN ADMINISTRATIVE HEARING IN ACCORDANCE WITH THE ENCLOSED “NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES" we NOTIFICATION OF RIGHTS UNDER CHAPTER 120, FLORIDA STATUTES iF YOU BELIEVE THE DEPARTMENT'S DECISION iS IN ERROR. YOU MAY REQUEST AN ADMINISTRATIVE HEARING UNDER SECTIONS 120,569 AND 420.87, FLORIDA STATUTES, TO CONTEST THE DECISION. YOUR REQUEST FOR AN ADMINISTRATIVE HEARING MUST BE RECEIVED BY THE DEPARTMENT BY 5.00, P.M.. NO LATER THAN 21 CALENDAR DAYS AFTER YOU RECEIVED NOTICE OF THE DEPARTMENT'S DECISION. You must submit your request for an administrative hearing to the Department at the following addresses: David Tucker Chief Legal Counsel Department of Chitdren & Families P.O. Box 2417 Jacksonville, FL. 32234-0082 IF YOUR REQUEST FOR AN ADMINISTRATIVE HEARING (S NOT RECEIVED BY THE DEPARTMENT BY THE ABOVE DEADLINE, YOU WILL HAVE WAIVED YOUR RIGHTS TO A HEARING AND THE DEPARTMENT'S PROPOSED ACTION WILL BE FINAL if you disagree with the facts stated in the Department's decision, you may request a forma’ administrative hearing under section 120.57(1), Florida Siatuies. Ata formal hearing, you may present evidence and arguments on all issues involved, and question the witnesses called by the Department. If you do not disagree w'th the facts stated in the notice, you may request an informa administrative hearing under section 120.57(2), Fiorida Statutes. At an informa; heanng. you may present your argument ar a written statement for consideration by the Department. Wheiher you requesting a formal hearing or an informa! hearng. your request for an edminisirative hearng must meei the requirements of Rule 28-106.201(2) or Ruie 28- 106.301(2}, Florida Administrative Code. in aither eveni, your request for an administrative hearing must: 4. include a copy of the decisicn received from the Deparimant; 2. Be prepared legibly on 814 by 11 Inch white paper, and 3. inchide ail of the following items: (a) Tre Department's file or identification nurnber, if known: ib} Your name. address, email address (if any) and telephone number and the name, address ornail address { if any) and g telephone number of your representative, # any; {c) An explanation of how your rights or interests will be affected by the action described in the notice of the Department's decision; {d} A statement of when and how you received notice of fhe Department's decision: (e} A statement of all facts in the notice of the Department's dacision with which you disagree. if you do not disagree with any of the facts stated in the notices, you must say so: if} A statement of the facts you belleve justify a change in the Department's decision: (g) A statement of the specific rules or statutes you believe require reversal or modification of the Departmen?’s proposed action: {h) A statement explaining how the facts you have alleged above relate to the specific rules or statutes you have identified above: and (i) A statement of the relief you want, including precisely the action you want the Departmant to take. Section 120.569(2\c), Florida Statutes, requires the Department to dismiss your request for hearing if it is not in substantial compliance with the requirements above. Mediation as described in section 120.573, Florida Siatules, is not available. However, other forms of mediation or informal dispute resolution may be available after a timaty request for an administrative hearing has been received, if agreed to by all parties, and ar. such terms as agreed to by all parties. The right to an administrative proceeding is not affected when mediation or informal dispute resolution doss not resull ina settlement. CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by certified mail reiumn receipt no. 7016 2140 0000 8293 3808 to Super Sub 1 Trading Group Corp dib/a ivy League Academy, 2350 Market Dr, Fleming island, Fi. 32003 this ok day of June 2019. d _ bhi Ma'a Ramoutar Safety Program Manager USPS.com® - USPS Tracking® Results Page | of 3 U S P S Tr a cki n g FAQs > (https://www.usps.com/faqs/uspstracking-faqs.htm) Track Another Package -+ Remove X Tracking Number: 70162140000082933808 Expected Delivery on MONDAY 15 220 s00pmo Y Delivered July 15, 2019 at 9:05 am Delivered, To Original Sender JACKSONVILLE, FL 32203 yoeqpee4 Get Updates \v Text & Email Updates Tracking History July 15, 2019, 9:05 am Delivered, To Original Sender JACKSONVILLE, FL 32203 Your item has been delivered to the original sender at 9:05 am on July 15, 2019 in JACKSONVILLE, FL 32203. https://tools.usps.com/go/TrackConfirmAction?tRef=fullpage&tLc=2&text28777=&tLabe... 7/23/2019 USPS.com® - USPS Tracking® Results Page 2 of 3 July 13, 2019, 3:16 pm Available for Pickup JACKSONVILLE, FL 32203 July 13, 2019, 11:32 am Arrived at Unit JACKSONVILLE, FL 32203 July 12, 2019, 1:31 am Departed USPS Regional Facility JACKSONVILLE FL DISTRIBUTION CENTER July 10, 2019, 10:14 am Unclaimed/Being Returned to Sender ORANGE PARK, FL 32065 June 26, 2019 In Transit to Next Facility yoeqpee4 June 20, 2019, 11:08 pm Arrived at USPS Regional Facility JACKSONVILLE FL DISTRIBUTION CENTER Product Information See Less ~ Can’t find what you’re looking for? Go to our FAQs section to find answers to your tracking questions. https://tools.usps.com/go/TrackConfirmAction?tRef=fullpage&tLe=2 &text28777=&tLabe... 7/23/2019 Interdepartment Delivery NOTE - CROSS OUT ENTIRE LINE WHEN RECEIVED AND RE-USE UNTIL ALL LINES ARE FULL DELIVER TO DEPARTMENT SENT BY DEPARTMENT David Tucker Rebekah Harris | 404 599 0774 DEPARTMENT od gor oo WM" aign a0 Pent? DEPARTMENT sje D =| ns we s D é) = F) 5 o) o D — DELIVER TO

Docket for Case No: 19-004016