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MICHAEL WALENDZUK vs ST. CLOUD VILLAGE ASSOCIATES, LTD, 13-000030 (2013)
Division of Administrative Hearings, Florida Filed:Kissimmee, Florida Jan. 07, 2013 Number: 13-000030 Latest Update: Oct. 06, 2024
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LEILA BRUTON vs CLAY FINANCE, LLC, 04-004031 (2004)
Division of Administrative Hearings, Florida Filed:Jacksonville, Florida Nov. 05, 2004 Number: 04-004031 Latest Update: Oct. 06, 2024
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AGENCY FOR HEALTH CARE ADMINISTRATION vs MARYDALE, INC., D/B/A MARYLAND MANOR, 08-000621 (2008)
Division of Administrative Hearings, Florida Filed:New Port Richey, Florida Feb. 01, 2008 Number: 08-000621 Latest Update: Oct. 06, 2024
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NINA DIAMOND vs DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, 93-002035 (1993)
Division of Administrative Hearings, Florida Filed:Tallahassee, Florida Apr. 12, 1993 Number: 93-002035 Latest Update: Feb. 08, 1994

Findings Of Fact Respondent Nina Diamond has taken care of other people's children at least since 1961. As long as the law has required such registration, her residences have been registered as home day care centers. In addition, she has taken care of more than 150 foster children. Five or six years ago she obtained an emergency shelter family home license for the first time. After routine annual renewals, the question arose whether one Thomas Floyd Mash was sharing the licensed premises, a house at 2139 Faulk Drive in Tallahassee, with her. Mr. Mash, who was convicted in 1987 of armed robbery and kidnapping, Respondent's Exhibits Nos. 7, 8 and 9, spent time in prison and is now on probation. On March 29, 1991 Mr. Mash and Ms. Diamond purchased the house at 2139 Faulk Drive, taking title and giving a mortgage together in both their names. Respondent's Exhibits Nos. 5 and 6. Ms. Diamond and her family furnished the down payment, but her income was (and remains) too low to borrow the money secured by the mortgage by herself. At least until November of 1991, Mr. Mash helped with mortgage payments. When they bought the house, Mr. Mash, Ms. Diamond and her son, a middle schooler, moved in. In late November of 1991, Mr. Mash rented a room in Beth Edwards' home, and Ms. Diamond told HRS personnel that he had moved out. Until recently, petitioner told probation officers that Mr. Mash, who receives his mail at 2139 Faulk Drive, lived with her, while assuring HRS that he did not. Since November of 1991, Cathy Asbell has seen Mr. Mash at 2139 Faulk Drive with some frequency, including on or about September 4, 1993, in the late afternoon. Martha Salas assumed he lived there, so often did she see him when she dropped off three-year-old Esmerelda between eight and ten o'clock evenings, on her way to work. She last saw him at the house two to three weeks before the hearing. Ms. Diamond herself testified that he was wont to come for one- to three-hour visits afternoons, straight from driving the dump truck he is hired to operate. HRS counsellors Rosina Roberts Butler and Irene Ruth Adams (who has since taken other employment) saw Mr. Mash at 2139 Faulk Drive toward the end of 1991 and the beginning of 1992. He was at the house every Saturday morning Ms. Adams came by. Mid-day January 28, 1993, Ms. Butler saw Mr. Mash enter the house and make sandwiches for five or six children Ms. Diamond was caring for at the time. Among Mr. Mash's obligations as a probationer has been a duty to keep the authorities apprised of a current address. He has consistently given 2139 Faulk Drive as his address, before and after December 9, 1991, the only pertinent date on which he gave any other address. Probation officers found him at the house on several occasions. On July 22, 1993, a probation officer saw him driving away from the house at quarter past six o'clock in the morning.

Recommendation It is, accordingly, RECOMMENDED: That HRS deny petitioner's application for relicensure as an emergency shelter family home. DONE AND ENTERED this 6th day of December, 1993, in Tallahassee, Florida. ROBERT T. BENTON, II Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 6th day of December, 1993. APPENDIX TO RECOMMENDED ORDER, CASE NO. 93-2035 Petitioner's proposed finding of fact No. 1 has been adopted, in substance, insofar as material. With respect to petitioner's proposed findings of fact Nos. 2 and 3, it was not clear how long the room was rented for or that Mr. Mash ceased to reside at 2139 Faulk Drive while the room was rented. Respondent's proposed findings of fact Nos. 1, 2, 3, 4, 6 and 8 have been adopted, in substance, insofar as material. With respect to respondent's proposed finding of fact No. 5, it was not proven that petitioner represented herself as Mr. Mash's wife. Respondent's proposed finding of fact No. 7 pertains to a subordinate matter. With respect to respondent's proposed finding of fact No. 10, it was not clear how long the room was rented for or that Mr. Mash ceased to reside at 2139 Faulk Drive while the room was rented. COPIES FURNISHED: Marc E. Tapps, Esquire Legal Services of North Florida, Inc. 2119 Delta Boulevard Tallahassee, Florida 32303-4220 Charles A. Finkle, Esquire District Legal Counsel 2639 North Monroe Street Tallahassee, Florida 32399-2949 Robert Powell, Agency Clerk Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700 Kim Tucker, General Counsel Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700

Florida Laws (3) 409.175787.01812.13
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MICAH AND STACY ETHRIDGE vs GEORGE AND DONNA DEWRELL, 13-004040 (2013)
Division of Administrative Hearings, Florida Filed:Fort Walton Beach, Florida Oct. 16, 2013 Number: 13-004040 Latest Update: Oct. 06, 2024
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FIVE STAR PREMIER RESIDENCES OF HOLLYWOOD vs AGENCY FOR HEALTH CARE ADMINISTRATION, 13-003273 (2013)
Division of Administrative Hearings, Florida Filed:Lauderdale Lakes, Florida Aug. 27, 2013 Number: 13-003273 Latest Update: May 20, 2014

Conclusions Having reviewed the Statement of Deficiencies, and all other matters of record, the A Health Care Administration finds and concludes as follows: gency for 1. The Agency has jurisdiction over the above-named Petitioner pursuant to Chapter 408, Part II, Florida Statutes, and the applicable authorizing statutes and administrative code provisions. 2. The Agency issued the attached Statement of Deficiencies to the Respondent. (Ex. 1) 3. The Petitioner requested a formal hearing to challenge the Agency’s findings. 4. The parties have since entered into the attached Settlement Agreement. (Ex. 2) Based upon the foregoing, it is ORDERED: 1. The Settlement Agreement is adopted and incorporated by reference into this Final Order. The parties shall comply with the terms of the Settlement Agreement. 2. The Petitioner’s petition for a formal administrative hearing is withdrawn. ORDERED at Tallahassee, Florida, on this LF day of Lhae Filed May 20, 2014 11:29 AM 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 correct Bey ot this Final Order was served on the below-named persons by the method designated on this ay of LD? a , 2014. Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Bldg. #3, Mail Stop #3 Tallahassee, Florida 32308-5403 Telephone: (850) 412-3630 Jan Mills Finance & Accounting Facilities Intake Unit Revenue Management Unit (Electronic Mail) (Electronic Mail) Lourdes A. Naranjo, Senior Attorney Office of the General Counsel Agency for Health Care Administration (Electronic Mail) Thomas W. Caufman, Esq. Quintairos, Prieto, Wood & Boyer, P.A. 4905 West Laurel Street Tampa, Florida 33607 (U.S. Mail) Edward T. Bauer Administrative Law Judge Division of Administrative Hearings (Electronic Mail) PRINTED: 11/21/2013 FORMAPPROVED (3) DATE SURVEY COMPLETED (X2) MULTIPLE CONSTRUCTION A. BUILDING: (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION B. WING AL11953616 05/16/2013 STREET ADDRESS, CITY, STATE, ZIP CODE 2480 NORTH PARK ROAD HOLLYWOOD, FL 33021 NAME OF PROVIDER OR SUPPLIER FIVE STAR PREMIER RESIDENCES OF HOLLY (X4) ID SUMMARY STATEMENT OF DEFICIENCIES 1D PROVIDER'S PLAN OF CORRECTION (x8) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) Initial Comments Surveyor: 28825 An Assisted Living Facility Complaint inspection survey CCR# 2013002354 was conducted on 05/16/2013. The Five Star Premier Residences of Hollywood Assisted Living Facility had no deficiencies found at the time of the visit related to this allegation. Deficient practice was identified at the time of the survey unrelated to the complaint. , 58A-5.023(3) FAC Physical Plant - Safe Living Environ/Other (3) OTHER REQUIREMENTS. (a) All facilities must: 1. Provide a safe living environment pursuant to Section 429.28(1)(a), F.S.; and 2. Must be maintained free of hazards; and 3. Must ensure that all existing architectural, mechanical, electrical and structural systems and appurtenances are maintained in good working order. (b) Pursuant to Section 429.27, F.S., residents shall be given the option of using their own belongings as space permits. When the facility supplies the furnishings, each resident bedroom or sleeping area must have at least the following furnishings: 1. Aclean, comfortable bed with a mattress no less than 36 inches wide and 72 inches long, with the top surface of the mattress a comfortable height to ensure easy access by the resident; 2. Acioset or wardrobe space for hanging clothes; ; 3. Adresser, chest or other furniture designed for storage of personal effects; 4. Atable, bedside lamp or floor lamp, and waste basket; and 5. Acomfortable chair, if requested. AHCA Form 3020-0001 LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE STATE FORM se09 8GJI11 If continuation sheet 1 of 4 EXHIBIT 1 PRINTED: 11/21/2013 FORMAPPROVED Agency for Health Care Administration STATEMENT OF DEFICIENCIES (Xt) PROVIDER/SUPPLIER/CLIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: (Xa) DATE SURVEY (X2) MULTIPLE CONSTRUCTION COMPLETED A. BUILDING: B. WING AL11953616 05/16/2013 STREET ADDRESS, CITY, STATE, ZIP CODE 2480 NORTH PARK ROAD HOLLYWOOD, FL 33021 NAME OF PROVIDER OR SUPPLIER FIVE STAR PREMIER RESIDENCES OF HOLLY (x4) iD SUMMARY STATEMENT OF DEFICIENCIES 1 PROVIDER'S PLAN OF CORRECTION (x5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) Continued From page 1 (c) The facility must maintain master or duplicate keys to resident bedrooms to be used in the event of an emergency. (d) Residents who use portable bedside commodes must be provided with privacy during use. (e) Facilities must make available linens and personal laundry services for residents who require such services. Linens provided by a facility shall be free of tears, stains and not be threadbare. This Statute or Rule is not met as evidenced by: Surveyor: 28825 Based on observation, interview and record review, the facility failed to provide a safe environment, free from hazards. As evidenced by facility failure to prevent resident access to construction areas on the facility grounds. The findings include: During a tour of the facility on 5/16/2013 at approximately 12:00 PM with the Administrator and Corporate Attorney, residents were observed ambulating with rolling walkers throughout the facility and going outside to the front of the building. The complex was undergoing renovation. Multiple buildings were covered with scaffolding engulfing them completely. The demolition construction on the buildings was very loud and construction vehicles were coming and going throughout the facility parking lots and the facility entrance. Construction debris was noted in AHCA Form 3020-0001 STATE FORM 6000 8GJit1 If continuation sheet 2 of 4 PRINTED: 11/21/2013 FORMAPPROVED (X3) DATE SURVEY COMPLETED (X2) MULTIPLE CONSTRUCTION A. BUILDING: {X1) PROVIDER/SUPPLIERICLIA IDENTIFICATION NUMBER: STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION B. WING 05/16/2013 AL11953616 STREET ADDRESS, CITY, STATE, ZIP CODE 2480 NORTH PARK ROAD FIVi E IVE STAR PREMIER RESIDENCES OF HOLLY HOLLYWOOD, FL 33024 NAME OF PROVIDER OR SUPPLIER (X4) 1D SUMMARY STATEMENT OF DEFICIENCIES 1D PROVIDER'S PLAN OF CORRECTION (x5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) Continued From page 2 the parking lots. During the tour inside the facility, the main resident elevators were observed. During an interview with the Administrator at 12:40 PM on 05/16/13, she stated the facility had put up an enclosure fence for safety, which prevents resident access to the lakes edge. She stated that due to the renovation construction, the benches along the sidewalk had been removed. The surveyor observed scaffolding on the entire building next to the lake enclosed area. A white metal fence was observed to enclose the lake walkway and building frontage. Key pad access was noted on the outside entrance gates coming into/out of this gated area. The Administrator stated that the residents would need to know the pass code to enter or leave this enclosed area when outside the building. She stated that due to the renovation, residents should not have access to the construction area due to safety concerns. On 5/16/2013 at approximately 3:30 PM the surveyor observed that a section of the metal fence enclosure around the lake walkway, (next to the front parking lot) was missing. The keypad and gate remained intact but the lake area had open access due to the missing fence section. An interview was conducted with the Administrator and Executive Director on 05/16/13 at 3:40 PM, inquiring about the enclosed lake front area. They stated the fenced enclosure provided safety for the residents. The Administrator, Executive Director, Regional Director of Operations and surveyor observed the section of the fence that had been removed. The Executive Director stated she was not aware that the fencing had been removed and immediately went to speak with the construction foreman. She stated that the area was a construction site and AHCA Form 3020-0001 STATE FORM 6899 8Guit1 If continuation sheet 3 of 4 PRINTED: 11/21/2013 FORMAPPROVED Agency for Health Care Administration STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: (X3) DATE SURVEY COMPLETED AL11953616 B. WING 05/16/2013 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 2480 NORTH PARK ROAD FIVE STAR PREMIER RESIDENCES OF HOLLY HOLLYWOOD, FL 33024 (X4) ID SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (x5) PREFIX {EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE DATE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Continued From page 3 should be closed off to prevent injury. The ground surrounding the open section of fence, was observed to be uneven, rocks and construction debris littered the pathway. Due to the fence removal, the enclosure did not provide protection for the vulnerable elderly residents since access could be achieved to both the lakes edge and construction site. Class Ill AHCA Form 3020-0001 STATE FORM 6808 8GJi11 If continuation sheet 4 of 4

Florida Laws (2) 429.27429.28 Florida Administrative Code (1) 58A-5.023
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