STATE OF FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES, Petitioner, v. JC INSPIRES INTERNATIONAL INC Agency Clerk No.: B22960 D/B/A JC INSPIRES INTERNATIONAL INC Food Entity No.: 391531 27455 S. DIXIE HWY UNIT 119 Settlement Amount: $5,000.00 HOMESTEAD, FL 33032 Respondent. ADMINISTRATIVE COMPLAINT Petitioner, the Department of Agriculture and Consumer Services, Division of Food Safety (“Department”), pursuant to Chapters 500 and 581, Florida Statutes, and Rule Chapter 5K-4, Florida Administrative Code, states that it is the licensing and regulatory authority as defined therein; that it has statutory jurisdiction over Respondent and this matter; and alleges: 1. On January 15, 2020, the Department conducted a food inspection at Redland Ranch, located at 14655 SW 232™ Street, Miami FL 33170, a permitted food entity pursuant to Chapter 500, Florida Statutes. Products containing hemp extract were collected for analysis to determine compliance with Chapter 500, Florida Statutes, section 581.217, Florida Statutes, and rule SK- 4.034, Florida Administrative Code. One or more samples collected, for which Respondent is the responsible party, were analyzed by the Department’s lab and found to be misbranded in violation of rule 5K- 4.034(6), Florida Administrative Code, and section 500.04(2), Florida Statutes. A copy of the Department’s inspection report and lab report detailing the specific findings are attached as Exhibit 1 and Exhibit 2, respectively, and are incorporated herein by reference. Wherefore, Petitioner intends to take action pursuant to its authority in section 500.121, Florida Statutes, and Rule Chapter 5K-4, Florida Administrative Code, including, but not limited to the Page 1 of 6 imposition of an administrative fine not to exceed $5,000.00. Failure to respond to this administrative complaint will result in the Department imposing the maximum fine allowed by law. All correspondences regarding this matter shall be directed to the Division of Food Safety, Enforcement section, by telephone at (850) 245-5520 or by e-mail at FSAdministration@FDACS. gov. Send all facsimiles to Compliance at (850) 488-7946. Dated on March 2, 2020 MIS Melissa Sam Division of Food Safety Enforcement Section Page 2 of 6 NOTICE OF RIGHTS In accordance with sections 120.569 and 120.57, Florida Statutes, you have the right to request a formal or informal hearing and to be represented by counsel or other qualified representative. To request a hearing, you must complete the enclosed Election of Rights form and file it with the Division of Food Safety within twenty-one (21) days of receipt of this complaint. For an informal hearing, you have the option of having the hearing conducted by appearing in person, via a telephone conference call, or via review of a written statement. NOTE: If you request a formal hearing, you must also provide a statement of the material facts alleged in this complaint that you dispute. Alternatively, you may waive your right to a hearing and settle this matter by signing and returning the attached Stipulation and Settlement Agreement along with the required payment. Failure to timely file the Election of Rights form with the Division of Food Safety within twenty-one (21) days of receipt of this complaint shall be considered a waiver of your right to a hearing and may result in the issuance of a Final Order without any further notice that may impose up to the maximum penalties as authorized by law. CERTIFICATE OF SERVICE I hereby certify that a copy of this Administrative Complaint with Stipulation and Settlement Agreement and Notice of Rights has been furnished by United Parcel Service on May 8, 2020, to Respondent. MIS Melissa Sam Division of Food Safety Enforcement Section Department of Agriculture and Consumer Services 3125 Conner Boulevard, C-18 Tallahassee, Florida 32399-1650 (850)245-5520 Page 3 of 6 DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES, Petitioner, v. JC INSPIRES INTERNATIONAL INC Agency Clerk No.:B22960 D/B/A JC INSPIRES INTERNATIONAL INC Food Entity No.: 391531 27455 S. DIXIE HWY UNIT 119 Settlement Agreement: $5,000.00 HOMESTEAD, FL 33032 Respondent. / STIPULATION AND SETTLEMENT AGREEMENT The Department of Agriculture and Consumer Services, Division of Food Safety, and Respondent, do hereby stipulate and agree to settle this proceeding as follows: Dawe The Department has regulatory authority over the parties and this proceeding. The Department and Respondent agree to settle the matter payment of an administrative penalty of $5,000.00 on or before twenty-one (21) days after receipt of this Administrative Complaint. Respondent agrees to comply with all laws governing the sale of food products containing hemp extract in the State of Florida. (See Chapter 500, Florida Statutes, section 581.217, Florida Statutes, and Rule Chapter 5K-4, Florida Administrative Code) Each party shall be responsible for its own costs and attorneys’ fees. Respondent will abide by the conditions imposed by this stipulation and settlement. The parties hereby waive all rights to appeal and further review of this Stipulation and Settlement and these proceedings. Upon the filing with the Agency Clerk, this Stipulation and Settlement shall become the final agency action in this proceeding. To conclude this matter, all conditions of this Agreement shall be met as outlined herein. Page 4 of 6 Signature of Respondent Printed Name Executed on this day of , 2020. FOR FINANCE AND ACCOUNTING USE ONLY FIRM NUMBER: 391531 Org. Code: 42140302002 EO: A2 Object Code: 012052 Receivable B22960 $5,000.00 TOTAL: $5,000.00 Page 5 of 6 Florida Department of Agriculture and Consumer Services ELECTION OF RIGHTS NICOLE “NIKKI” FRIED ADMINISTRATIVE COMPLAINT COMMISSIONER Food Entity No.391531 / Case No. B22960 This form must be received by the Division of Food Safety’s office in Tallahassee, Florida, within 21 days of receipt of the Administrative Complaint. Failure to do so shall be deemed a waiver of your right to an administrative hearing. Select one of the following options and sign below: Stipulation | have read and understand the enclosed Stipulation and Settlement. By signing the agreement, | choose not to litigate the issues or facts alleged, hereby waive my right to a hearing under Sections 120.569 and 120.57, Florida Statutes, and will abide by the conditions imposed. Informal Hearing | do not dispute the facts upon which the agency action is based. | wish to make an explanation of those facts by speaking on my behalf at an informal hearing. The informal hearing will be conducted before a hearing officer of the Department of Agriculture and Consumer Services in accordance with Sections 120.569 and 120.57(2), Florida Statutes, and applicable portions of Chapter 28-106, Florida Administrative Code. Informal Hearing by Written Statement | do not dispute the facts upon which the agency action is based. | wish to make an explanation of those facts by submitting a written statement to a hearing officer and | waive my right to appear in person at an informal hearing. The informal hearing will be conducted before a hearing officer of the Department of Agriculture and Consumer Services in accordance with Sections 120.569 and 120.57(2), Florida Statutes, and applicable portions of Chapter 28-106, Florida Administrative Code. Formal Hearing | dispute the facts upon which the agency action is based. | have attached to this form a petition or written statement of the disputed issues of material fact and hereby request a formal hearing to be conducted pursuant to Sections 120.569 and 120.57(1), Florida Statutes, and applicable portions of Chapter 28-106, Florida Administrative Code. | realize that failure to state the disputed issues of material fact may result in the denial of my request for a formal hearing. The formal hearing will be held before an Administrative Law Judge of the Division of Administrative Hearings where | may present evidence and argument on the issues. | have read and understand the Election of Rights form and understand that | have the right to be represented by counsel or qualified representative at either an informal or formal hearing. Mediation, pursuant to section 120.573, Florida Statutes, is not available as an alternative remedy. Respondent's Signature Attorney's Signature if represented Type or print your name Type or print attorney’s name Respondent’s mailing address Attorney's mailing address Respondent's city, state and zip Attorney's city, state and zip Respondent’s telephone number and email address Attorney's telephone number and email address Upon completion of this form, return by fax to (850) 488-7946 or mail to: Florida Department of Agriculture and Consumer Services Division of Food Safety, Enforcement Section 3125 Conner Blvd., C18 Tallahassee, Florida 32399-1650 Forms may also be emailed to: FSAdministration@FDACS.gov Note: In accordance with the Americans with Disabilities Act, persons needing a special accommodation to participate in a hearing should contact the Division no later than seven (7) days prior to the hearing at which such special accommodation is required. Hearing and voice impaired persons may call the Florida Relay Service at (800) 955-8771 (TDD) to reach (850) 245-5491. 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Docket for Case No: 20-002153