Findings Of Fact Petitioner, Rachel H. Wooten, a long-standing legal resident of Florida, submitted an application for licensure by exception as a Marriage and Family Therapist, along with the required fee, to Respondent on September 3, 1982. The form and fee were received by Respondent on September 10, 1982. Attached to the application was supporting documentation to establish that Petitioner received her master's degree in teaching from Rollins College in 1966. Subsequent to the award of her master's degree, as stated, she also earned additional graduate level courses in subjects related to marriage and family counseling. Including both the graduate course work leading up to and subsequent to the award of her master's degree, she had a total of 60 credit hours, of which 43 credit hours were all in specialized courses directed to marriage and family counseling. These courses were taken at accredited educational institutions which are accepted by Respondent. They include Rollins College, University of Central Florida, Florida State University, and the University of North Carolina. Petitioner is currently employed by the State of Florida, Department of Health and Rehabilitative Services, in its Orlando Vocational Rehabilitation Program as a program analyst. As such, she directs and consults with 39 counselors who possess at least a master's degree. Prior to assuming this position in 1970, she was a counselor and supervisor for Vocational Rehabilitation in a position with a counselor case load of 170-175 cases, and a supervisor case load of between 600 and 700 cases. She held that position from 1966 to 1970. She also maintains an active marriage and family counseling private practice which she carries in this area in the evenings. Her patients are primarily professional people. She sees only individuals who are referred to her by other practitioners in one of the professional disciplines such as medicine psychology, the law, or the like. In addition, up through 1980, she was also engaged in a group counseling practice under the supervision of and in conjunction with other counselors and has been engaged in co-practice with another counselor as a part of her continuing practicum. Petitioner is a clinical member of the American Association of Marriage and Family Therapists (AAMFT). A clinical membership is the highest and most professional category of membership is the highest and most professional category of membership available. She has possessed this qualification since June, 1981. In order to be eligible for this type of membership, a candidate must meet the association's academic requirements and undergo 200 hours of supervision by an AAMFT-approved therapist. This supervision is rigid and demanding and includes such elements as continuing education, taped sessions, clinical work, and the like. Respondent does not consider AAMFT's educational requirements as stringent as its own, nor are they comparable. After evaluation by representatives of Respondent, Petitioner's educational background was found not to meet the requirements of the law in effect at the time of Petitioner's application. Respondent's rationale for denying Petitioner's licensure by exception 1/ is based on its contention that pertinent educational requirements include, as an indispensable element, the award of a master's degree in Marriage and Family Counseling or a clearly comparable field of study, and since Petitioner's degree was in teaching, it does not qualify. 2/ Respondent further concludes that since it was not shown Petitioner's relevant undergraduate courses were considered by Rollins College as a part of the course work for the master's degree, these cannot be considered as counting toward the required credits. It was also held by Respondent that since Petitioner's master's degree was not in a specialty recognized by Respondent for licensure by exception, the relevant course work subsequent to the award of the master's degree cannot be counted either. Respondent states as its reason for not considering the course work outside the Master's Degree is that these courses were chosen solely by Petitioner at her discretion and were not required as a part of a formally designed course of study by an educational institution, leading toward a degree in this area of expertise. In that regard, Rule 21U-500.17(1)(c), Florida Administrative Code, requires that the course work leading up to the master's degree in Marriage and Family Counseling or a clearly comparable field of study include 18 semester hours in the specialty area. Here, Respondent gave Petitioner credit only for three courses, totaling nine semester hours, which were ED 544 (Tests and Measurements: Group Testing I), ED 600 (Readings: Adolescent Development), and PSY 549 (Counseling Procedures I). The courses Petitioner took subsequent to the award of her master's degree would meet the requirement for licensure by exception if it has been included in the work leading up to the master's degree. The Respondent concedes that Petitioner is, by training and experience, qualified to be a licensed Marriage and Family Therapist and, were it not for the technical requirements stated above, which Petitioner does not meet, would license her as such.
Recommendation Based on the above, it is RECOMMENDED: That Petitioner's application for licensure by exception as a Marriage and Family Therapist be denied. RECOMMENDED in Tallahassee, Leon County, Florida, this 1st day of February, 1984. ARNOLD H. POLLOCK Hearing Officer Division of Administrative Hearings Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 1st day of February.
Findings Of Fact Based on my observation of the witnesses, their demeanor while testifying and the entire record complied herein, the following relevant facts are found. Respondents, Robert and Melody Chinnici, completed their foster care parent training program during September 16, 1991 (MAPP), and were thereafter licensed as foster care parents in October 1991. The MAPP training included Petitioner's discipline policy which is in the form of a written statement that was given to and acknowledged by Respondents. During times material, Respondents were entrusted to care for foster children Tonya Wilson, a 13-year-old, who resided with Respondents from approximately October 1991 through May 1992, and Jonathan, who was approximately 10 years of age. During this time frame, Respondents' natural son, Christopher Chinnici, also resided with them. During times material, Respondents used a form of "time out" to discipline the foster children when they were disruptive in church. The time out procedure utilized was one whereby the disruptive child would stand and face the wall for periods of five to fifteen minutes. When "time out" was imposed, the church services were over and most of the parishoners had left the parish. On at least one occasion, Respondent, Melody Chinnici, discussed with a foster parent a means of circumventing Petitioner's disciplinary policy respecting the pulling of foster children's hair. There was no evidence that Respondents in fact circumvented HRS' policy. Respondents attempted to serve meals to their foster children in an orderly fashion. During the course of serving meals, there was no evidence that Respondents withheld or otherwise utilized food as a means to discipline foster children in their care. Likewise, Respondent Melody Chinnici did not administer corporal punishment to foster children in her bedroom out of the view of other children.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that: Petitioner enter a final order rescinding its proposed revocation of Respondents' foster care license and issue said licence forthwith assuming Respondents comply with other relevant criteria for the reissuance of their foster care license. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 26th day of July 1993. JAMES E. BRADWELL 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 26th day of July, 1993. APPENDIX TO THE RECOMMENDED ORDER IN CASE NO. 92-6751 Ruling on Petitioner's proposed recommended order. Paragraph 3, adopted as modified, paragraph 4, recommended order. Paragraph 4, rejected, contrary to the greater weight of evidence, paragraph 5, recommended order. Paragraph 5, adopted as modified, paragraph 4, recommended order. Paragraphs 6 and 7 rejected, contrary to the greater weight of evidence, paragraphs 6 & 7, recommended order. COPIES FURNISHED: Raymond R. Deckert, Esquire Department of Health and Rehabilitative Services District Six Legal Office W. T. Edwards Facility 4000 West Dr. Martin Luther King Jr., Blvd. Tampa, Florida 33614 Robert and Melody Chinnici, pro se 5244 De Milley Road Polk City, Florida 33868 Robert Powell, Clerk Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700 John Slye, Esquire General Counsel Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32399-0700
The Issue The issue in this case is whether the Petitioner, the Department of Health and Rehabilitative Services (HRS), should revoke or suspend the foster care license of Larry and Kathleen Abbott.
Findings Of Fact Larry and Kathleen Abbott have been licensed foster parents for a number of years. They were licensed in 1983 in HRS District 6 (Hillsborough County and Manatee County) and in 1986 in HRS District 5 (Pinellas County). Despite some criticism by HRS staff, their license was renewed annually since 1986. Their last license expired and was required to be renewed on October 25, 1991, after the commencement of this proceeding. By their Agreement to Provide Foster Care for Dependent Children, the Abbotts agreed to "hold confidential all information about the child and his family" and to "discuss such information only with representatives of the Department or with appropriate specialists at the request of the Department." On or about January 28, 1990, HRS initiated proceedings to place a female baby named Andrea, who was born on June 28, 1989, in shelter care due to her failure to thrive and her mother's lack of parenting skills. On or about February 23, 1990, the child was placed in foster care in accordance with a Performance Agreement. The goal under the Performance Agreement was to return the child to the care of her mother by August 31, 1990. (This goal was later extended to February 23, 1991.) However, meanwhile, due to the mother's lack of parenting skills and multiple allegations of abuse, the foster parents agreed not only to provide the child with adequate food, clothing, shelter, supervision and affection, but also to report to HRS any concerns regarding visitation with the mother. Since the Abbotts were not Andrea's initial foster parents, they did not sign the Performance Agreement. However, although they never signed the agreement, when they became Andrea's foster parents on or about April 30, 1990, they also agreed to the terms of the Performance Agreement. When the Abbotts got Andrea, she had a medical problem called "G.U. Reflux." HRS wanted the Abbotts to have this condition appropriately followed by a physician and wanted it documented by a physician that the problem had cleared. An appointment scheduled for this purpose had to be cancelled for some reason and, while discussing rescheduling the appointment with the physician's medical staff, Mrs. Abbott reported her observation that the problem already had cleared. Based on the report from Mrs. Abbott, the appointment was not rescheduled, and the physician closed the case based on Mrs. Abbott's report. HRS apparently feels that the Abbotts were less than impartial in their evaluation of Andrea's medical condition. HRS witnesses asserted that the Abbotts decided early on that the child's symptoms that resulted in the G.U. Reflux diagnosis actually were caused by the natural mother's physical abuse and neglect of the child. The HRS witnesses contended that the Abbotts' beliefs warped their judgment and impelled them, inappropriately, to cancel the doctor appointment based on their beliefs, and in order to prove their beliefs to be correct. But the evidence in this case did not prove HRS' contentions. From the outset of the Abbotts' foster care for Andrea, the Abbotts were very interested in knowing all of the background about Andrea, including the allegations against her natural mother. The natural mother was allowed to keep her two other children. The Abbotts were interested to know how the mother was caring for the other two children, in part as it might be relevant to the ultimate disposition of Andrea's case but also in part for the sake of the other children as well. Mrs. Abbott seemed to question whether the HRS investigations on the other children, which were closed as "unfounded," were properly conducted. But there is no evidence that the Abbotts did or said anything in these earlier time periods in their foster care for Andrea that HRS viewed to be improper. At some point relatively early in the Abbotts' foster care of Andrea, Mrs. Abbott pointed out to her HRS foster care counselor that Andrea's name was similar to that of another child living in the home, and Mrs. Abbott wanted to know if it would be permissible to call Andrea by a nickname. The HRS counselor said that would be fine. Later, near the holidays in late 1990, Andrea's natural mother expressed concern to the HRS counselor that the Abbotts had been calling Andrea by the name Nicole and that she was not responding to Andrea any more. The HRS counselor spoke to the Abbotts and asked them to stop calling the child Nicole. She explained that, when she authorized the Abbotts to call Andrea by a nickname, she did not mean they could call her by a different proper name. The Abbotts, who now see the error of judgment that they made, immediately stopped calling the child Nicole. As the goal of reunification by February 23, 1991, approached, Mrs. Abbott began to question the propriety of going ahead according to schedule. HRS protective services had raised questions regarding the natural mother's readiness to take care of Andrea. The HRS counselor also had made statements to Mrs. Abbott which made her suspicious that the counselor's supervisor would not make the decision to reunify the family on the basis of the best interests of the child. (It was intimated that the supervisor might be more concerned with her unit's statistics.) At bottom, the Abbotts thought reunification should be postponed; HRS, especially through the counselor's supervisor, took the position that reunification should go forward as scheduled. The Abbotts also disapproved of the natural mother's male friend, who was cohabiting with her in her apartment. The HRS counselor told Mrs. Abbott that it was not permitted for the natural mother to have a male friend living with her in her apartment while she was receiving certain welfare benefits. She told Mrs. Abbott that the natural mother would be in trouble if the landlord knew. HRS asserted that Mrs. Abbott took it upon herself to tell the landlord, but there was no evidence upon which such a finding could be made.2/ One day, on or about January 11, 1991, the natural mother did not make a scheduled appointment for purposes of visitation with Andrea. Mrs. Abbott understood that the natural mother sometimes worked at the day care facility located at the apartment complex where the natural mother lived. This was the day care facility utilized by the natural mother for her other children. It was also proposed for Andrea after reunification. Mrs. Abbott identified herself to the day care director in terms of Andrea, the natural mother and the children at the day care. The natural mother was not there. No finding can be made as to the subject matter of the remainder of the conversation.3/ The day care director reported some of the conversation with Mrs. Abbott to the HRS protective services staff responsible for the children, who brought the matter of Mrs. Abbott's alleged "meddling" and "breach of confidentiality" to the attention of the HRS counselor and her supervisor. They reprimanded Mrs. Abbott, who became even more suspicious of HRS and its protective services staff. On or about April 5, 1991, Andrea was returned to the Abbotts after a scheduled weekend visitation with the natural mother.4/ Mrs. Abbott observed marked and unusual redness and swelling in the child's genital area and became concerned that the natural mother's male friend might be sexually abusing the child. Although she thought it was diaper rash, the HRS foster care counselor authorized Mrs. Abbott to have the child examined by a physician at the Bayfront Medical Center. The doctor's nurse agreed with Mrs. Abbott that the redness was too concentrated to be diaper rash, reinforcing Mrs. Abbott's beliefs. The doctor prescribed Desitin and sitzbaths, and had Mrs. Abbott call back for test results. The eventual diagnosis was that the child had a bacterial staph infection.5/ Despite the diagnosis, Mrs. Abbott continued to maintain strong feelings that the child was being physically abused. These suspicions were instigated in part by comments from the doctor that the symptoms could come from being touched by dirty hands, from Mrs. Abbott's understanding that the natural mother's male friend worked as manager of an auto service station, and from her having seen him with dirty hands as a result of his work.6/ Mrs. Abbott had several discussions with the HRS foster care counselor about her suspicions. The HRS counselor was unable to convince Mrs. Abbott to drop her suspicions in light of the absence of solid evidence of sexual abuse. Mrs. Abbott felt there were indications that Andrea was "severely traumatized" by visits with her natural mother. But HRS personnel perceived no evidence of this. At this point, HRS and the Abbotts essentially disagreed as to how Andrea's case should proceed. HRS thought that there was no basis on which to change the goal of reunification. Mrs. Abbott felt that reunification should be postponed and also suggested that it was HRS' responsibility to secure a guardian ad litem. HRS decided that a meeting should be held among all concerned to resolve the disagreement. The meeting was held on or about April 9, 1991.7/ From opening remarks made by the counselor's supervisor, Mrs. Abbott felt that the purpose of the meeting was not to discuss the issues to reach a solution but to present a united HRS front to press forward for reunification. Mrs. Abbott felt that, in that atmosphere, there was no point in her speaking against reunification, but she continued to maintain her negative feelings about it and resolved in her mind to continue to oppose reunification on other fronts. She asked the HRS counselor if it was permissible to contact the chairperson of the reunification committee directly and was told that there was nothing to prevent her from doing so. On or about April 11, 1991, the HRS counselor authorized Mrs. Abbott to have the child seen by a child protective team (CPT) physician. The CPT physician affirmed the previous diagnosis and prescribed an antibiotic. The Abbotts did not immediately fill the prescription. They told the HRS counselor that they did not have Medicaid authorization to have the prescription filled through Medicaid. The counselor thought the authorizations had been sent to the Abbots but promised to send or deliver to them another one. On one occasion, when the counselor was at the Abbott house, the counselor went to her car to get the necessary form, but discovered she did not have any with her. On another occasion, the counselor was to give Mrs. Abbott the authorization form at a meeting they were at, but they both forgot to take care of that item of business. Meanwhile, the Abbotts continued to use Desitin.8/ On or about April 19, 1991, after the redness and swelling seemed to the Abbotts to be going away, the natural mother had Andrea for another overnight visit. Still suspicious, Mrs. Abbott had asked the HRS counselor to check the child's genital area as soon as possible after the visit. When the Abbotts got the child back from the HRS counselor, Mrs. Abbott checked the child herself and was surprised and upset to see more redness and swelling. She immediately telephoned HRS and spoke with the counselor's supervisor. She was instructed to bring the child to the child protection center immediately. When the CPT physician learned that the Abbotts had not yet started the prescription from over a week earlier, she became upset and threatened to telephone the Florida abuse registry to report the Abbotts for medical neglect for failure to obtain and administer the prescription. The HRS supervisor intervened and dissuaded the physician from making the call by assuring her that the prescription would be obtained and administered immediately. The CPT physician's diagnosis was that, although sexual abuse could not be ruled out, the problem was more likely secondary to less than adequate diaper changing and persistence of the previous staph vaginitis. Mrs. Abbott did not accept the diagnosis but continued to suspect sexual abuse. She opposed further visitation with the natural mother so long as the male friend resided in the same apartment. Eventually, a reunification meeting was held. The Abbotts did not attend. It was decided to reunify the family. The Abbotts cooperated in making all necessary final arrangements to get Andrea ready. Reunification went forward on or about May 20, 1991. After reunification, Mrs. Abbott continued to show interest in Andrea. After taking a two-week vacation, Mrs. Abbott got permission from the HRS counselor to telephone once a week to see how Andrea was doing. Mrs. Abbott also asked to know the name and address of Andrea's private day care, but the counselor said she could not have that information. After five weeks, the counselor's supervisor had the counselor cut off any further contact with the Abbotts concerning Andrea. Mrs. Abbott said to let her know if HRS had to take Andrea back. She said that she and her husband had much invested in caring for Andrea and that they felt as if she were their own child. If HRS had to take Andrea back, the Abbotts wanted her back and would be interested in adoption. Later, the Abbotts asked for another assignment essentially to help take their minds off of Andrea. On two occasions, Mrs. Abbott criticized the care being provided by other foster parents and suggested that the foster children be transferred to the Abbotts. HRS viewed this as evidence that the Abbotts had become so attached to Andrea that they had lost their good judgment.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Petitioner, the Department of Health and Rehabilitative Services (HRS), enter a final order suspending the foster care license of Larry and Kathleen Abbott for 90 days. 9/ RECOMMENDED this 5th day of March, 1992, in Tallahassee, Florida. J. LAWRENCE JOHNSTON 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 5th day of March, 1992.
The Issue Whether the Department of Children and Family Services (the "Department") had just cause to revoke the license of Petitioner to operate a family day care home.
Findings Of Fact Based upon the testimony and evidence received at the hearing, the following findings are made: From April 15, 1987, through March 31, 2001, Marcia Edwards operated a registered family day care home at 15475 Chloe Circle, Fort Myers, Florida 33908. The Department regulates three types of day care facilities. In descending order of regulatory oversight, they are a licensed child care facility, a licensed family child care home, and a registered family child care home. Sections 402.305 and 402.313, Florida Statutes. While the first two categories of facilities require annual on-site Department inspections, background screening for all personnel, training, and more extensive paperwork, a registered family day care home involves no Department inspections and only requires that the operator complete a training course and provide to the Department certain paperwork and that the operator and other household members undergo background screening. The operator of a registered family day care home must comply with the limits on the number of children under care, as set forth in Subsection 402.302(7), Florida Statutes. Ms. Edwards had been reminded of the requirement for background screening of household members at least once, via letter dated February 12, 1993. Nonetheless, the Department received two complaints in December 1994, regarding the presence of an unidentified person in the home. One complaint noted that an "unidentified male houseguest was eating and drinking the children's food." The second complaint noted that Ms. Edwards was out of town and left the children in the care of her mother and "a guy named Wayne." On January 4, 1995, the Department sent Ms. Edwards a letter informing her of the complaints and reminding her that she could not leave children with persons who had not undergone background screening. The letter noted that neither Ms. Edwards' mother nor "Wayne" had undergone background screening. The adult male referenced in the complaints was Wayne Brueckman, who was residing in the Edwards home. On February 6, 1995, in compliance with the Department's letter, Ms. Edwards submitted the necessary information to initiate background screening on Mr. Brueckman, listed as a "Household Member" and "Sitter/Relief." Mr. Brueckman's background screening revealed no disqualifying information. Ms. Edwards was reminded of the statutory capacity limitations in person and in writing at least 11 times between September 1987 and June 1999. On at least five occasions, Ms. Edwards responded that she understood the capacity limitations. Nonetheless, Department employees personally observed violations of the capacity limitations on at least five separate occasions. By letter dated July 7, 1999, the Department gave Ms. Edwards an administrative warning that she would be subject to imposition of a fine if she continued to operate in violation of the statutory capacity limitations. On August 13, 1996, an abuse report was received by the Department that Wayne Brueckman sexually abused D.S., a three- year-old boy, in the Edwards home. The child had told his mother that Mr. Brueckman kissed his penis, put a "white thing" in his anus, and spanked him when he defecated in his pants. However, the child would not repeat his allegations to protective investigator Mae Cook, and an examining physician could find no physical evidence of sexual abuse. Mr. Brueckman denied the allegations. Ms. Edwards was interviewed by Ms. Cook concerning the August 13, 1996, complaint. Ms. Edwards denied any inappropriate activity and vouched for Mr. Brueckman as her friend of 20 years. Though she closed the file because she did not have sufficient evidence to confirm the allegations, Ms. Cook strongly suggested that children staying overnight not be allowed to sleep in Mr. Brueckman's room and that he not be left alone at any time with children, to avoid any repetition of such allegations. A repeated citation in the violation notices from this point forward was that Ms. Edwards would leave Mr. Brueckman alone with the children in her care for extended periods of time. Concerns regarding Mr. Brueckman were also raised during an investigation of another sexual abuse report received by the Department on November 18, 1996. This complaint involved Z.A., a three-year-old boy in care at the family day care home. The child told a story of some adult in the Edwards home rubbing his genitals, but his limited verbal skills made it unclear whether a man or woman did the touching. Wayne Brueckman and Marcia Edwards were both interviewed by the protective investigator and both denied any inappropriate activity. Again, there was no physical evidence to confirm the allegations. On February 5, 2001, the Department received an abuse report that W.W., a 19-month-old boy in care at the Edwards home, had bruises along his spine and arms, two large bumps on his head, and a patch of hair loss on the top of his head. Medical examinations by the Child Protection Team and the child's pediatrician determined the injuries were significant, inflicted and the result of physical abuse. The abuse report was called in by J.W., the divorced father of the child. W.W. lived with his father and his older sister in the home of J.W.'s mother. J.W.'s teenaged nephew also lived in the house. W.W. did not see his biological mother. J.W. worked as a chef, and left W.W. and his older sister at the Edwards home on evenings that he worked. The medical determination of the approximate time of injury indicated the injuries occurred either at the child's residence or the Edwards family day care home. When at his residence, W.W. was in his father's care. J.W. denied inflicting the injuries on his son, and discounted the possibility that anyone else living in his household might have done so. J.W. was certain that his son's injuries were inflicted at the Edwards home. W.W.'s older sister told investigators that "bad boys" at the Edwards home had inflicted the injuries on the boy. J.W. readily consented to the CAT Scan, eye examination, and clotting factor test recommended by the pediatrician. The father expressed concern about the supervision provided by the family day care home. He recalled several times in the past that when he came to pick up his children at night, he could look in the window of the Edwards home and see Mr. Brueckman sleeping. It required lengthy knocking and ringing of the doorbell to finally rouse Mr. Brueckman or anyone else in the home. Wayne Brueckman and Marcia Edwards were interviewed by the Protective Investigator. Both denied any inappropriate activity or failure to supervise. However, based upon the medical evidence, and multiple interviews including questioning of the children in attendance at the family day care home, the report was closed as verified. The Protective Investigator concluded that the child was injured by other children at the family day care home. The case determination found that Marcia Edwards and Wayne Brueckman inadequately supervised and neglected W.W. On February 22, 2001, while the W.W. case was being investigated, Ms. Edwards applied to renew her family day care home registration. Based upon the W.W. investigation, the Department issued a denial of registration on May 29, 2002. Ms. Edwards requested a formal administrative hearing to contest the denial of registration. The Department forwarded the matter to the Division of Administrative Hearings, where it was assigned DOAH Case No. 01-2840. A hearing was scheduled for September 19, 2001, in Fort Myers, Florida, before Judge Daniel S. Manry. Counsel for Ms. Edwards requested a continuance due to a scheduling conflict. Judge Manry granted the continuance and rescheduled the hearing for October 19, 2001. On October 12, 2001, the Department filed a motion to relinquish jurisdiction, accompanied by a settlement agreement between the parties. On October 15, 2001, Judge Manry entered an order closing the file in DOAH Case No. 01-2840. The settlement agreement required licensure of the family day care home, which would obligate the family day care home to comply with increased regulatory standards. One such standard prohibits the owner from working out of the home during the hours the family day care is operating. Rule 65C- 20.009(1)(a), Florida Administrative Code. In the settlement agreement, Ms. Edwards affirmatively recognized her on-going obligation to comply with all requirements of the Florida Statutes and Administrative Code applicable to family day care homes. The settlement agreement also provided that the Edwards home would receive a consultation by Child Care of Southwest Florida ("CCSWF"), a private, non-profit regional organization that, among many other services, provides training and technical assistance to home-based child care providers. This consultation would be at the Department's expense. CCSWF's consultant would assess the home's compliance with licensing standards and make suggestions as to implementation of best practices. The Department's experience has been that CCSWF's consultation, technical assistance, and training have proven successful in improving marginal child care providers. On December 17, 2001, Lisa Bledsoe, the infant/toddler coordinator for CCSWF, visited the Edwards home for the required consultation. Ms. Bledsoe rated the home based on the Family Day Care Rating Scale ("FDCRS"), an objective tool developed by the National Network for Child Care for the assessment of infant/toddler group care. The FDCRS consists of 32 items which assess the quality of center-based child care for children up to 30 months of age. This 32-item scale covers six categories: Space and Furnishings for Care and Learning, Basic Care, Language and Reasoning, Learning Activities, Social Development, and Adult Needs. Each item can be ranked from 1 to 7. A ranking of 1 describes care that does not even meet custodial care needs while a ranking of 7 describes excellent, high- quality personalized care. The Edwards family day care home received a cumulative score of 2.375 on the FDCRS. Deficits included a sterile and child-unfriendly interior, lack of interesting and colorful pictures and no pictures at child's eye level, insufficient opportunity for outdoor play, minimum hand washing requirements not met, diapers not checked regularly, failure to conduct regular fire drills, dim lighting, and insufficient activities to encourage language development. Ms. Bledsoe contacted Ms. Edwards to notify her the completed rating would be mailed to her. Ms. Bledsoe offered follow-up visits, technical assistance, and training classes for caregivers. Ms. Edwards rejected the offer of further assistance. While acknowledging that her recommendations were not mandatory, Ms. Bledsoe could recall no other day care provider rejecting additional help from CCSWF, which is provided free of charge. The need for Ms. Edwards to provide supervision at the family day care home and to be present was an important issue in the settlement of DOAH Case No. 01-2840. On October 10, 2001, prior to the signing of the settlement agreement, Ellen Blake, a licensing counselor for the Department, conducted a pre- licensing orientation and review at the Edwards home. Ms. Blake and Ms. Edwards had a lengthy discussion about supervision requirements. Ms. Edwards told Ms. Blake that she would be absent only when taking and picking her children up from school. She and Mr. Brueckman were sharing the care of the children. After obtaining licensure, Ms. Edwards appeared to be providing closer supervision of Mr. Brueckman. Ms. Edwards was present for six of the seven licensing inspections the Department performed between October 10, 2001, through June 18, 2002. However, testimony from Ms. Edwards' own witnesses established Ms. Edwards was readily available in the evenings to do extensive hours of volunteer work. Additionally, she transported her own minor children to after-school and weekend activities and was always available to transport other people's children to and from school and outside activities. Further, Ms. Edwards operated a photography business that often involved out-of-home shoots, including a large annual undertaking at St. Xavier School. Mr. Brueckman was left alone with children when Ms. Edwards was out of the home. Ms. Edwards' witnesses also established that she provides child care 24 hours a day, 7 days per week, which is a service not readily available in the community. The home is consistently well utilized, especially during the expanded hours. Mr. Brueckman was providing evening and night supervision, and slept in the same room as the children under his care. The Edwards have three minor children who often have multiple friends spend the night for sleep-overs. Neither the Edwards children nor their friends were restricted from access to the designated child care room. On June 13, 2002, the Department received an abuse report stating that Wayne Brueckman sexually abused D.S., a two- and a half-year-old boy in care at the Edwards family day care home. On June 20, 2002, during an interview with the Lee County Sheriff's Office, Mr. Brueckman admitted to inappropriately touching the child's penis and having the child touch his penis during diaper changes. Mr. Brueckman has been charged with two counts of felony lewd and lascivious molestation and is awaiting trial. Commission of sexual battery on a two-and-a-half-year- old child is a serious violation of the obligation of a child care provider to supervise a child entrusted to their care and for which they are receiving payment. Molestation of a child creates a great likelihood of actual or potential harm. Mr. Brueckman lived at the Edwards home and received only room and board for the continuous care he provided for the children of paying clients, as well as Ms. Edwards' three minor children and their numerous friends. Mr. Brueckman admitted to having had no dating or sexual relationships with an adult for over ten years. He had no private time and felt overwhelmed by his work situation. On June 20, 2002, the Department cited Ms. Edwards for a deficiency in supervision as she failed to meet the needs of children in her care due to Wayne Brueckman's molestation of D.S. The operator of a family day care home is ultimately responsible for the supervision of the children in care. Rule 65C-20.009(3)(a), Florida Administrative Code. Upon learning of Mr. Brueckman's actions, Ms. Edwards immediately evicted him from her house. To meet the requirement that she have a trained substitute caregiver in the home, Ms. Edwards designated her husband as her substitute in July 2002. As of the date of hearing, Mr. Edwards had not completed the required training. During the nine licensing inspections the Department performed between October 10, 2001 through July 1, 2002, various violations of minimum licensing standards were found, including: inadequate lighting in the playroom; failure to keep up-to-date immunization records; failure to keep on file the required enrollment information; ants on the kitchen table; home, furnishings, toys and equipment not kept clean and in good repair; incomplete first aid supplies; and hazardous materials (alcoholic beverages and protein shake mix) within a child's reach. Ms. Edwards corrected all these violations. The Department never sought to fine Ms. Edwards for any of the cited violations. By notice, dated August 14, 2002, the Department revoked Ms. Edwards' license based on the reasons delineated in the letter including past history, licensing inspections, the arrest of Mr. Brueckman for lewd and lascivious molestation of a child at the family day care home, and the ongoing failure to have a qualified substitute.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entered revoking the license of Marcia Edwards to operate a family day care home. DONE AND ENTERED this 5th day of February, 2003, in Tallahassee, Leon County, Florida. LAWRENCE P. STEVENSON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 5th day of February, 2003.
The Issue Whether Respondent failed to meet the minimum standards of performance required by Section 491.009(2)(s), Florida Statutes, on two occasions.
Findings Of Fact The Department is the state agency charged with regulating the profession of marriage and family therapy pursuant to Section 20.43(3)(g) 29, and Chapters 456 and 491, Florida Statutes. Respondent is, and has been at all times material, a marriage and family therapist holding Florida license number MT1416. The last address of record of Respondent was 1416C, West 16th Street, Panama City, Florida 32405. Events relating to Ms. P.D. Ms. P.D. is a registered X-ray technologist, a registered ultrasound technologist, and a registered specialist in mammography. Ms. P.D. and her husband sought Respondent's professional help because they were experiencing marital difficulties. Ms. P.D. did not know Respondent until her husband chose Respondent as counselor. This occurred in June or July of 1997. They continued in counseling until March of 1999 or 2000. The dates provided herein are nonspecific because Ms. P.D. could not recall the exact years. At the beginning of the counseling, Ms. P.D. and her husband received counseling at Respondent's office. Later they went to dinner together and received these services in a less formal setting. At least two of Ms. P.D.'s daughters received counseling also. Ms. P.D. and her husband owned property in Panama City, Florida, located at 703 Kristana, a house in St. Croix, a farm in Nova Scotia, and waterfront property in Nova Scotia. Mr. and Ms. P.D. also owned a building at 810 Grace Avenue in Panama City, Florida. This property was purchased probably in 1994, and was sold in May or June of 2001. Ms. P.D. and her spouse operated an ultrasound school on the premises from about 1994 until late 1997. The ultrasound school was eventually closed due to lack of business. Ms. P.D. was a client of Respondent during the latter part of the time in which the ultrasound school was in operation. In the latter part of 1997, or in the early part of 1998, Respondent found that she could no longer occupy the office in which she had been practicing. During a counseling session, Respondent mentioned that she needed an office for her practice and Ms. P.D. informed her that she could lease the premises at 810 Grace Avenue. Respondent paid rent to Ms. P.D. by check. Ms. P.D. deposited the checks to one of at least two accounts she maintains. At some point subsequently, Ms. P.D. volunteered to work with Respondent in her practice. This was motivated in part because Ms. P.D. was an adoptive mother of two children who were acquired through an international adoption process. Respondent has experience in adoptions including working with the Florida Department of Children and Family Services. Eventually, an organization was formed with the corporate name of Future Choices, Inc. (FCI). Initial participants in the organization included Mr. and Ms. P.D. and Respondent, among others. This organization involved the adoption process. It also involved "supervised visitations." The record does not fully explain what a "supervised visitation" actually is, but it is apparent from the record that someone or some entity is willing to pay for "supervised visitations" and therefore, "supervised visitations" provided income for FCI. The business plan called for the organization to become profitable before any participants received a salary. Ms. P.D. was a member of the board of directors and was vice- president. She assumed these positions in 1998. She worked as a volunteer. She was not a subordinate of Respondent. They were business associates. Ms. P.D. served on the board until around 2000 or 2001. Events relating to Ms. P.M. Ms. P.M. works for the Salvation Army Domestic Violence Program. She sought family counseling from Respondent in 1997. She thereafter received individual counseling from Respondent until 1998. Ms. P.M. became friends with Respondent almost immediately upon the initiation of counseling. Respondent visited her in Ms. P.M.'s home, and Ms. P.M. visited Respondent in her home while the counseling relationship was ongoing. They had lunch together and went shopping. Her friendship with Respondent ended in 1999 when Ms. P.M. was informed that Respondent had revealed matters Ms. P.M. had provided to her in confidence. Events relating to both Ms. P.D. and Ms. P.M. Ms. P.D. traveled with Respondent to Tallahassee, Florida, for supervised visitation training, and to Hollywood, Florida, for a batterers intervention program, and to Orlando, Florida, for a program dealing with sex offenders. Ms. P.M. also went on the Hollywood and Orlando, Florida trips. These trips required an overnight stay or stays. Ms. P.D. also traveled with Respondent to near-by cities such as Marianna, Florida. During these trips Ms. P.D. remained a counseling client of Respondent, and Ms. P.D. voluntarily paid the cost of these trips. Ms. P.D. was excited about the business prospects of FCI. As a member of the board of FCI, Ms. P.D. signed checks drawn on the corporation. Ms. P.D. also paid the utility bills, and paid for much of the office equipment, for the benefit of FCI out of her personal funds. Sandy Gorman was a business associate of Ms. P.D. Ms. Gorman was introduced to Respondent by Ms. P.D. Ms. Gorman eventually bought the building at 810 Grace Avenue for $57,000. Mr. and Mrs. P.D. had purchased it for about $30,000. The sale to Ms. Gorman was for less than market value because Mrs. P.D. wanted to help her. During the time that Mr. and Mrs. P.D. owned the building, improvements were made on it, including the completion of an extant second floor. Respondent contributed to these improvements by causing Ms. P.M.'s husband to contribute toward making the top floor of the building habitable. Sandy Gorman is now a direct competitor of Respondent in the visitations and adoptions business in Panama City, Florida. Ms. Gorman continues to be close friends with Ms. P.D. Eventually the relationship between Ms. P.D. and Respondent soured. Around March, 2000, Ms. P.D. ejected Respondent and her belongings from the premises at 810 Grace Avenue. However, the business was beginning to turn a profit about the time Respondent was ejected. Expert testimony Debra Frank is a licensed marriage and family therapist, a licensed psychiatric mental health nurse practitioner, and a professor at Florida State University. She received her Ph.D. from Florida State University in the Interdivisional Program in Marriage and Family. She is an expert on the practice of marriage and family therapy in the State of Florida. Dr. Frank related that a marriage and family therapist provides counseling with regard to marital concerns or relationship concerns. She noted that the relationship between counselor and patient is based on trust. She opined that the counselor, because of her position, would often be able to exert influence on the client. She noted that clients come to the counseling relationship with emotional vulnerability and that it is the counselor's responsibility to act in the client's best interest. Dr. Frank explained that a dual relationship is one where there are relationships other than the counselor-client relationship. These relationships would include relationships based on business interests as well as those based on friendship. Dual relationships are not per se prohibited by either the law or by ethical standards. However, they are prohibited where they may have the potential to harm a client. In order to obtain a permissible dual relationship the therapy must terminate and there should be a gap in time prior to moving to another relationship. Moreover, the client should be referred to another counselor so that the client can discuss with another counselor the dual relationship prior to entering into it. Respondent accomplished neither of these actions.
Recommendation Based upon the Findings of Fact and Conclusions of Law, it is RECOMMENDED: That a final order be entered which finds that Respondent violated Section 491.009(2)(s), Florida Statutes, on two occasions, and which places Respondent on probation for a period of three months with remedial action as the Board may find appropriate, so long as such action is not inconsistent with the provisions of Section 491.009(1)(g), Florida Statutes. DONE AND ENTERED this 8th day of May, 2002, in Tallahassee, Leon County, Florida. HARRY L. HOOPER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 8th day of May, 2002. COPIES FURNISHED: Deborah B. Loucks, Esquire Agency for Health Care Administration 2727 Mahan Drive Post Office Box 14229 Tallahassee, Florida 32317-4229 Russell K. Ramey, Esquire 1042 Jenks Avenue Panama City, Florida 32401 Susan Foster, Executive Director Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Department of Health 4052 Bald Cypress Way, Bin C08 Tallahassee, Florida 32399-1701 R.S. Power, Agency Clerk Department of Health 4052 Bald Cypress Way, Bin A02 Tallahassee, Florida 32399-1701
The Issue The issue in this case is whether Respondents' child- placing agency license should be revoked.
Findings Of Fact The Department is the state agency responsible for licensing and monitoring child-placing agencies. The Center, whose address is 1602 East Third Avenue, Tampa, Florida, received its initial child-placing agency license from DCF in 2004. The license was renewed October 12, 2006. Susan Morgan has been the director of the Center since its inception. DCF contracts with HKI to provide community-based child welfare services in Hillsborough County. HKI contracts with Camelot Community Care for the performance of adoption related services. DCF received complaints about Respondent and issued an Administrative Complaint with the following categories of violations: A foster parent home study was finalized after only one home visit lasting half an hour. The home study document indicates four home consultations for that client. Files relating to clients were left in an unsecured environment at the Center with unauthorized persons having access to them. An adoptive home study was completed without a visit being made to the prospective adoptive parents' home. Respondent lost or misplaced paperwork from clients which contained confidential information. Respondent failed to timely provide foster parents with a copy of their foster parent licenses once the licenses were issued. Regarding the first violation, two home studies are required to finalize a foster parent home study. The subject family was provided a template for filling in information about their home. This is a reasonable means of gathering information about a family. The family was directed to fill in the template using the third person format (so that anyone reading the document might infer that someone other than the family had written the information). Morgan did not visit the home at issue, but did send her associate (Wendy Martinez) who conducted a brief 30 to 40-minute visit. The home study was signed by Morgan and dated March 13, 2007, some four or five weeks prior to Martinez's visit. The home study included the following table concerning visits and consultations: Contact Information Inquiry Date 01/05/06 Inquiry Home Visit 02/10/06 Initial Home Consultation 03/15/06 MAPP Graduation 02/26/06 2nd Home Consultation 04/02/06 Final Home Consultation 03/08/07 Date Application Signed 03/08/07 The table seems to indicate a single home visit on February 10, 2006, and three home "consultations" on later dates. Morgan says the date of the home visit is a typographical error; it should say April 18, 2006, i.e., the date of Martinez's visit. Morgan admits only one home visit was made, but says the home study was not final. Her testimony on that topic is not credible. The home study appears complete, has references to several home visits and/or consultations, and is signed by Morgan subsequent to the dates appearing in the aforementioned table. DCF considers the references to home consultations to be tantamount to home visits. Inasmuch as at least two home visits are required for a foster parent home study, this interpretation makes sense.1 A discussion of the differences, if any, between home visits and home studies follows. There was much testimony at the final hearing as to whether a home visit and a home study are the same thing. Each of the experienced social workers and managers who testified (other than Morgan) seemed to believe the two were synonymous. Even the two witnesses called by Respondent to address the issue opined that home visit and home consultation mean essentially the same thing. Respondent introduced definitions from The Social Worker's Dictionary, but there is nothing in those definitions to suggest they apply to foster care or adoption situations. None of the social workers who testified indicated they would rely on that source to define home visits versus consultations. The home study at issue appears to suggest that four home visits/consultations were conducted, when in fact only one (of the required two) was done. The second category of rule violation concerns unsecured client records. Files belonging to clients of child- placing agencies are extremely confidential in nature. Respondent moved into a new office in the Ybor City section of Tampa during September 2006. The office was shared with a company that specializes in estimating construction project costs. The estimating company had two employees, a receptionist and the owner of the company. The office was set up so that the receptionist was in the same room as Respondent's employee, Martinez. Morgan had a separate office for herself, and the owner of the estimating company had an office upstairs. The Ybor City office had been inspected by DCF in October 2006 and was found to be sufficient for its intended purposes. A client, Angela Ferguson, visited the Center in early April 2007. Morgan was not present when Ferguson arrived, but Martinez was there, as were employees from the other business. Martinez called Morgan on the client's behalf so that Morgan could come to the office. While waiting for Morgan, the client noticed 50 to 60 file folders lying around the office. Some of the files belonged to other clients whose names were visible to Ferguson. Some of the files were probably forms and other non- confidential documents. The client files were not locked in a cabinet or otherwise protected from persons using Respondent's office. On or about May 2, 2007, another client, Jennifer Moody, also visited the Center to get her file (so that she could transfer to another adoption agency). She walked into the office and found the estimating company's receptionist, but no one from the Center was there. The receptionist called Morgan because Moody wanted to wait for her to arrive. While waiting, Moody observed files lying around the office in plain view. When Ferguson expressed her concerns to DCF about the way files were being handled, a licensing specialist was sent out to investigate. DCF employee Melissa Leggett made an unannounced visit to the Center on May 16, 2007, at 10:00 in the morning. Martinez was in the office when Leggett arrived; Martinez called Morgan for Leggett, and Morgan arrived shortly thereafter. Leggett noticed confidential files lying around the office, including files for some clients who she personally knew. Leggett advised Morgan that the files would have to be protected by placing them in a locked file cabinet or locked room. Morgan agreed to remedy the situation and seems to have done so by the date of the final hearing. Files are now being protected from public scrutiny. Each employee of the estimating company has signed a Confidentiality Office Policy agreeing to keep all records of the Center confidential. The third category of violation concerned an adoptive home study for Moody (the same client who had visited the Center). The home study for this family was also sent in blank template form with instructions to fill it out using the third person. Moody filled out the form and sent it back to Morgan. In April 2006, Moody and her husband were scheduled to attend a meeting with prospective adoptee children at Splitsville, a Tampa bowling alley. In order to attend such meetings, prospective adoptive parents must have a home study completed in advance. This serves the purpose of making sure that such parents actually qualify as adoptive parents before they are exposed to the children. The home study for Moody and her husband was finished by Morgan in time for the Moodys to attend the Splitsville function. Although several home visits were scheduled, each of them was cancelled due to various circumstances. No home visit was ever made. However, the home study was completed and signed by Morgan with a recommendation that the family be approved to adopt. The recommendation section of the home study included as its basis: "Based on MAPP training, personal interviews, home consultations . . .". The home study contains a thorough description of the home, including the pool and yard, presumably based on details provided by the Moodys. Moody decided to terminate her relationship with Morgan and the Center after not hearing from Morgan during the period of July through November. As stated earlier herein, Moody picked up her file, which included the signed home study, from the Center. Morgan maintains the home study was still a "work in progress" at that time. However, it had already been signed and was dated April 18, 2006. (Moody was scheduled to attend the Splitsville event on April 22, 2007, and would have needed a completed home study in order to attend.) By Morgan's own admission, she was never in the home of Moody and did not "effectively or efficiently manage" that client's case. It was, as Morgan admitted, wrong to sign the home study without having visited the home. It appears the home study was finished so that the family could attend the MAPP event. The next category of violation had to do with lost or misplaced paperwork. A child placing agency must protect all information provided to it by clients so that confidentiality is maintained. LaClair and her husband submitted a large packet of information to Morgan as part of their attempt to adopt a child through the Center. The information was lost or misplaced by the Center on at least two (but possibly three) occasions. The submitted information contained extremely confidential information, including: marriage licenses, divorce decrees, birth certificates, social security numbers, military identification numbers, and insurance information. The last category of violation concerned failure by Respondent to timely provide licenses to approved foster parents. One of Respondent's clients, Barry Plesch, indicated a long interval between verbal approval and receipt of his paper license. However, he could not quantify the number of times nor specifically remember what dates he may have called Respondent to ask about the license. Another client, Brad Farber, made numerous requests for his license. When he expressed an urgent need for it, the license was produced forthwith. On May 17, 2007, Morgan met with representatives of HKI to discuss the Moody home study and the situation relating to confidential records. At that time, Morgan admitted to falsifying the Moody home study. Morgan acknowledged the gravity and severity of that mistake. She did explain that her office was undergoing reorganization at the time of Leggett's visit, which was the reason so many files were lying around the office.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entered by the Department of Children and Family Services upholding the revocation of Respondent's child-placing agency license. DONE AND ENTERED this 29th day of November, 2007, in Tallahassee, Leon County, Florida. S R. BRUCE MCKIBBEN Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 29th day of November, 2007.
The Issue The issue for consideration in this hearing is whether Respondent's License as a Marriage and Family Therapist in Florida should be disciplined because of the matters alleged in the Administrative Complaint filed herein.
Findings Of Fact At all times pertinent to the issues herein, the Petitioner, Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling (Board), was the state agency responsible for the licensing of Marriage and Family Therapists and the regulation of that profession in Florida. Respondent was licensed by the Board as a Marriage and Family Therapist in Florida holding license number MT0001128. P. S., a 56-year-old married, material control associate for Verizon, was introduced to the Respondent at the 34th Street Church of God, her church, by the Pastor, Reverend Scott, in the early 1990's. She began to see the Respondent professionally in individual sessions at least once a week at that time because her psychiatrist had recommended she see a marriage and family therapist after she had been hospitalized for mental health problems approximately five times. Before she began her sessions with the Respondent, P. S. had never been in individual counseling except with her psychiatrist for testing and medications. Her psychiatrist had diagnosed her with depression, as did the Respondent, and she is currently in therapy seeing a therapist every two months or so. This therapist has also diagnosed her as suffering from depression. He has also diagnosed sexual dysfunction. While she was in counseling with the Respondent, P. S. would also periodically see her psychiatrist who had prescribed Prosac, Tofonel, Zanax, and other medications for her. She remained in counseling with the Respondent for at least four years, and during that period, her medications were mixed. Old ones were discontinued and restarted, and new ones were started and discontinued. She remembers that she was on Prosac, Tofonel, and Elavil prior to commencing sessions with the Respondent. She is not currently on any medications. The issues P. S. discussed with Respondent primarily dealt with her depression and with family problems. She told Respondent of her prior hospitalizations and believes she gave him her medical records, but cannot be sure whether she told him of the diagnoses. She told him of her abuse as a child and he told her that was a part of her problem. Respondent suggested cognitive therapy to her, which he described as changing how she saw things. He incorporated relaxation therapy into her plan of treatment, showing her techniques to achieve this. When she was in Respondent's office she would sit either on the sofa or a bed lounger, and he would sit at his desk, rolling over to the bed lounger on which she was reclined on his wheeled chair from time to time. At no time would she ever lie down on the sofa. As P. S. recalls, all counseling sessions, except for a few which took place when she was hospitalized, were held in his office in Temple Terrace. P. S. contends Respondent's relaxation techniques included her relaxing her lips and massage during which he touched her face, her breasts, her feet, her legs, and her vaginal area. Sometimes she was clothed, she relates, and sometime she was not fully clothed. When she was not fully clothed, she says, it was mostly her top that was removed, but sometimes it was her bottom. She claims, as well, that on several occasions, no more than two or three, she was fully unclothed. P. S. also contends Respondent had told her she was ashamed of her body and encouraged her to take off her clothes to "integrate" -- get in touch with her feelings and her body. P. S. also admits that at times she hugged Respondent and touched his penis. She is unable to remember how this came about, but she thinks he asked her to do this. As she recalls, he said she should not be ashamed of her body. During the sessions she had with Respondent, P. S. discussed her relationship with her husband and with a friend she had had prior to marriage. She told him of comments men had made to her -- compliments which she did not know how to accept. She also spoke with him about being abused when she was a child and her relationships with siblings -- one sister in particular. Most of the sessions P. S. had with Respondent were one-on-one. At some however, she was accompanied by her sister, and on two occasions, her husband came to discuss with Respondent his therapy methods. On those occasions, Respondent denied any wrong doing. When Respondent would touch her, P. S. was usually lying on the bed lounger, though he also did so, she claims, at times when she was standing. If she was not comfortable with his touching of her breasts or other body parts, he would merely hug her. She claims, as well, that he would have her touch herself on her lips, her breast, and her vaginal area. She would do this both in his office and when at home alone. She contends this made her uncomfortable, but he explained to her it was a part of her therapy -- to help her get in touch with her body. P. S. admits, however, that she engaged in sessions of mutual masturbation with Respondent's sister-in- law at home on occasions. P. S. also went to support groups, one of which was an incest support group. In this regard, she would discuss her feelings about her husband with Respondent and brought up comments people would make about her. She discussed her counseling with Respondent with the support group and with other patients and therapists, asking about the method of therapy he was using and whether it was correct or not. When Respondent found out about this he dismissed her as a patient twice, taking her back each time. Though she did not go into gross detail with the others with whom she discussed Respondent's therapy, she concluded most felt his actions were inappropriate, and one therapist threatened to report Respondent if his name were disclosed. According to P. S., Respondent's touching of her began shortly after she started her sessions with him, and she was uncomfortable with them. Though his hugs initially were around the shoulder, she claims they became more intense with full body contact. The massages started about six months after she began the sessions after she called him to tell him she was uncomfortable. When she did this, he would stop for a while, but she asserts, the touching would start up again. P. S. indicates she had mixed feelings about Respondent. She liked him at times and spoke freely with him. Those positive feelings had a romantic tone to them, and when she told him about it, he told her it was "transference of feelings." Though, she claims, the touching made her uncomfortable and she would, at times, see other therapists, she felt guilty about leaving Respondent's care. She contends that when she discussed leaving he would express feelings of rejection and said he felt he had helped her. His sister-in- law also made her feel guilty when she discussed leaving Respondent's care. In addition to office visits, P. S. also saw Respondent at church, at his home, and at the homes of his family members with whom she was friendly, and whenever he would introduce her to other people, he did not refer to her as a patient. At one point in the relationship, she gave him photographs of herself, though she claims these were to show "before" and "after" depictions and not for romantic keepsakes. P. S. was active in her church activities all through this period and so was the Respondent. She was mostly involved in youth activities and in the women's ministry. Respondent was a minister at the church but not the main pastor. Though he preached periodically, he mostly counseled. During the period she was in counseling with Respondent, P. S. was hospitalized several times. One occasion was based on her taking an overdose of a drug; one was because of her strained relationship with her sister; and others when she could see she needed more intense help than Respondent could provide. The last time she was hospitalized the facility was out of state, and when she discussed this with the Respondent, he was supportive of her efforts. Because she believed that Respondent had been instrumental in her being relieved as head of her church organization in favor of his sister-in-law, P. S. stopped counseling with him in early 1995. At that time she sent him several letters, some of which were unsigned. One letter dealt with her belief Respondent had shared the details of his counseling of her with Pastor Scott; one dealt with her relationship with his sister-in-law; one accused him of recommending her dismissal from the women's ministry position she held; and at least one letter dealt with his therapy, though not in detail. In February 1995, P. S. wrote another letter to Respondent, claiming she was capable of doing her church-work tasks; discussing what another patient had told her of that individual's therapy; and relating her feelings regarding his therapy and what she considered his sexual abuse of her while in therapy. P. S. also discussed her counseling sessions with Respondent in detail with Pastor Scott. She also wrote him a letter explaining the therapy, and upon receipt of that letter, Pastor Scott called her and told her to do what she had to do about it. P. S. has not been hospitalized since 1994, and she is not currently on any medications. She is currently, and since 1995, has been under treatment with Dr. Logan, who is seeing her for monthly sessions. She started with Dr. Logan while still seeing Respondent and initially asked her about Respondent's therapy. Notwithstanding, she continued to see Respondent. At the time she was also seeing another therapist named Phillips with whom she discussed Respondent's therapy. Phillips indicated she had other patients with the same complaint, but no additional evidence on that matter was forthcoming. P. S. admits to having strong feelings, both good and bad, about her relationships with men. Sometimes she found them despicable, and as a result of these relationships she developed a strong distrust of men. In July 1993, while still under Respondent's care, P. S. wrote down thoughts indicating she often developed a strong dislike for most men which bordered on hate. During these periods she would try to convince others how horrible men are. She also developed a problem with her sister and distrusted her as well. The problem with her sister stemmed from childhood when she was abused by the sister's father who was not P. S.'s father. Her feelings about Respondent were ambivalent; sometimes she liked him and other times she did not. She visited his home several times for church functions during her treatment at which times his wife and daughter, as well as other family members, were there. Respondent's sister-in-law, Ardell, defended Respondent when P. S. told her of his actions, telling her he was just trying to help her. They were close at one time, even progressing to a physical relationship, but their relationship deteriorated when Ardell replaced her as head of the women's ministry at church. P. S. blamed Respondent for much of this and it played a part in her termination of treatment with him. During her hospitalization at University Hospital, P. S. did not report Respondent's actions even though she was visited there by Dr. Ruiz, her psychiatrist, Dr. Logan, her therapist, and a staff psychiatrist. She claims to have told the incest abuse group at Charter Hospital about it but can't recall when this was. She also discussed his misconduct with her support group at Ridgeview Hospital in Georgia toward the end of their relationship. Nevertheless, when asked upon release who she wanted to see for continuing therapy, she included Respondent. P. S. claims that at one point during their professional relationship she told Respondent she was developing amorous feelings for him. He did not, however, suggest the relationship be terminated nor did he suggest she see another therapist. On another occasion, at a point where she was having misgivings about his methods, she asked him for a list of potential other therapists, but did not do anything about it. In fact, she has referred other patients to Respondent while she was in therapy with him; probably, she believes, even after his alleged misconduct with her started. In the letter she subsequently wrote to the Board regarding Respondent's actions with her, she alleged his misconduct started within six months or less of her initial visit to his office. In April, 1993, P. S. started seeing Dr. Sandra Logan, a psychologist, initially for job stress. She told the doctor she had been seeing another therapist but she cannot be sure if she mentioned Respondent by name. At that time, P. S. wanted to transfer into another job with the company and discussed her job- related problems, but she also discussed other problems with her as well. Dr. Logan first met with P. S. on April 13, 1993, at the GTE family health clinic where she worked. P. S. reported she had been in treatment for depression since 1988 and was under the care of a psychiatrist, Dr. Ruiz. Dr. Logan put P. S. in a group for therapy. The group sessions were over after six weeks, and Dr. Logan did not see P. S. again until February 1994. At that time, P. S. said she had been seeing Respondent and wanted to change, but because Logan was white, P. S. could not be sure she could trust her. As a result, Dr. Logan recommended an African-American therapist. P. S. again came to Dr. Logan for work-related stress on January 24, 1995. At that time, Dr. Logan put her on medical leave, and she was then hospitalized at Ridgeview. Dr. Logan again saw P. S. in February and April 1995. On the former visit, P. S. started talking about her relationship with Respondent, but nothing significant was reported. P. S. came into the clinic sporadically until 1998 when she started to come in again on a regular basis with issues regarding her family. When P. S. finally reported her allegations regarding Respondent to Dr. Logan, the latter recommended she send in a complaint. At that point, Dr. Logan felt the allegations were credible and not the result of delusions. P. S. had had only one incident of a delusion, and that was work related. P. S.'s husband, also hospitalized several times for depression, relates that P. S. entered her first period of hospitalization after their marriage. He contends, however, that even when suffering from bouts of depression, her memory was not affected. She often spoke with him of her therapy with Respondent, indicating she was not comfortable with some of the things Respondent was doing, such as inappropriate touching of her sexual parts which, she contended, happened several times. However, since she indicated it was a part of the therapy and since he wanted her to improve, he accepted that. Finally, after several years of this therapy, Mr. S. and P. S. met with Respondent about what was allegedly happening in the therapy sessions. When the meeting was set up, Mr. S. thought only the three of them would be involved, but when they got to Respondent's office, a fourth party was present. During this meeting, they discussed Respondent's method of therapy. Respondent did not go into details of what he did during the sessions, but he categorically denied P. S.'s allegations and would not discuss the issue. P. S. stayed in treatment with the Respondent for a short while after this meeting but remained uncomfortable with the process. She continued, however, when Respondent assured her he was providing therapy. Dr. Deborah Frank, a certified sex therapist possessing a doctorate in marriage and family therapy, is familiar with the state rules and regulations governing the practice of family therapy and with the effects of the various medications used therein. She reviewed the investigative file in this matter and was present during the testimony of P. S. According to Dr. Frank, cognitive therapy is used frequently in the treatment of depression. It helps the patient see that not all is bad -- that there are ways for the patient to see themselves so as to find good within himself, herself, or the situation. This is done through verbal discussion and through the patient's keeping a journal of negative versus positive thoughts. There are also other counseling technologies such as task setting and exercises which suggest ways for patients to take charge of their life. The degree of depression impacts on which methodology is chosen. Extreme depression may leave the patients so tired they can do no more than follow advice. Cognitive therapy is sometimes used in the treatment of depression resulting from abuse of the victim. Sex therapy allows the patient to feel comfortable with his or her own sexuality. This can be done by talking with the patient and their partner and is used to treat issues arising out of childhood sexual abuse. A woman who was abused as a child tends to sexualize later relationships as indicating acceptance and affection. There is also hate and anger as a result of the abuse which can be carried over to adulthood and relationships with men. In Dr. Frank's opinion, P. S.'s attitude is typical of that. Outcomes of sexual abuse as a child include depression and a lack of self worth; a feeling in the abused that she is dirty and sex is dirty; and a lack of trust manifesting itself in sexual dysfunction. Relaxation techniques can help a patient suffering from sexual dysfunction. Different techniques include imaging, deep breathing exercises, confrontation, and massage, but the latter is inappropriate for a victim of sexual abuse. If massage is used with someone other than a depressed individual or a victim of abuse, it may set up a relationship that the patient misinterprets and result in development of feelings for the therapist (transference). In such a case, the therapist must set boundaries and convince the patient that he is not a valid love object. If and when it becomes apparent that transference has taken place, it is wrong to continue to have physical contact with the patient. Some physical contact, such as a hug, is acceptable if it is a therapeutic hug. Even this, however, can be dangerous in some cases, and it is up to the therapist to know this and when any physical contact is contraindicated. According to Dr. Frank, all of the areas that Respondent touched on P. S. were wrong in this case -- even the face -- because of her proclivity to misinterpret. This is even more so when the client is not comfortable with it. Individuals with experiences like P. S. have trouble setting boundaries, but it is up to the therapist to do this, not the client. In this case, in Dr. Frank's opinion, if the allegations by P. S. are true, Respondent did not meet standards. His education and training should have made him careful to set boundaries with the patient. He should have recognized and protected her vulnerability. It was inappropriate for Respondent to suggest guilt to P. S. when she said she was uncomfortable with his approach, and it was also inappropriate for him to suggest he would feel rejected by her attitude. Under the circumstances, however, Dr. Frank does not find it surprising that P. S. stayed in therapy with Respondent even though uncomfortable with his approach. She did not have a sophisticated understanding of the therapeutic process and was obviously too trusting. Dr. Frank recognizes that individuals with psychosexual dysfunction may have a tendency to fantasize more than others and misinterpret the actions of the therapist. According to Dr. Frank, it doesn't matter in the evaluation of these allegations that P. S. does not recall whether Respondent asked her to touch his penis or not. Quite often parties to a sexual relationship do not remember who made the initial overture; what is significant in the relationship is that it happened at all. By the same token, Dr. Frank believes it is not at all inconsistent for P. S. not to mention Respondent's actions to other professionals because she did not feel empowered to do so. She might consider it a betrayal of Respondent to do so and suffer feelings of guilt thereafter. Under the circumstances, having reviewed P. S.'s records and being aware of her background, Respondent had the responsibility not to do anything which could be misinterpreted by her. To be fair to Respondent, Dr. Frank admits that from her review of P. S.'s record of treatment by Respondent, not all of her issues were sexual in nature, and in these other issues the Respondent provided help. He addressed family issues, general relationships, rejection, conflict, and trust. He used reality testing and cognitive behavior techniques, allowing her to express her feelings. Dr. Frank believes, however, that it would have been helpful to bring in her husband more often and Respondent could have delved more into the homosexual issues presented. P. S. took several medications during the period of her treatment by Respondent, as indicated here. Zoloft is a very safe antidepressant whose side effects are minimal. Elavil may cause an exaggeration of symptoms of paranoia. Wellbutrin has the side effect of causing confusion in some patients. Desyrel, used to treat P. S., may cause hallucinations and delusions when given in high doses and though low doses are unlikely to produce such side effects, it is possible. Ambien's possible side effects include a variety of abnormal thinking and behavior patterns, including agitation, hallucinations and depersonalization. While medications may affect a patient's memory of dates, they will ordinarily not remove the patient's memory of the incident or occurrence, nor will they likely, in the doses prescribed here, cause hallucinations. The medical literature offered in evidence by Respondent show doses considered by the mainstream practice to be reasonable for treating depressed patients. P. S.'s records do not show any psychological reaction to her medications. The doses she was receiving were small. P. S. was also subjected to psychological tests, including the Millon Clinical Multiaxial Inventory-II (MCMI), the results of which must be interpreted by a clinician to have validity. Here, in Dr. Frank's opinion, P. S.'s responses and the information developed regarding P. S. is not so far out of the medical mainstream as to merit being disregarded. This test was administered in 1989, at which time P. S. was an inpatient in a mental hospital, and the results reflect her feelings at the time the test was administered. If she was hospitalized for depression, the test would reflect her depressed state. In this case, the interpretation given to the test administered to P. S. reflects the severe psychotic episode which resulted in her admission. The results suggest the use of cognitive techniques and building trust in the patient, and this is important. Respondent's practice deals primarily with sex therapy and depressive states. He first saw P. S. as a referral from Pastor Scott in 1989. Before he could hold his first session with her, she was hospitalized. In the intake evaluation, P. S. referred to depression, the ease with which she could be hurt, spiritual issues, her relationship with her husband, and sexual issues brought on by touching. The visits with P.S. were not easy. She would switch issues. Sometimes one problem would surface and on another occasion, other issues would surface, including grief, insomnia, and hypo- vigilance involving her spouse and daughter due to her own abuse when she was a child. Respondent's approaches then to the patient's depression were cognitive and supportive. Sometimes he would bring the family into the session. In dealing with her anxiety, he would use cognitive therapy, deep breathing, relaxation therapy, and restructuring (getting her to convince herself of the reality of things); P. S. and Respondent also dealt with her anger, which was destroying the family. A major area of discussion was P. S.'s sexual abuse as a child. When she first came to Respondent, he was very careful not to touch her or close himself off with her, leaving the office door open. He used a method of therapy through which the client first talked about her experience. They then moved to her reaction to it, and then on to her mastery of the problem. One of the main concepts to develop was her inability to trust anyone. They also worked on her relationship with her family, the church, and her stress as a result of these relationships. He found her to be hyper- sensitive and reactive to the most innocuous of comments. Respondent used the LoPicolo method to work on P. S.'s sexual anxiety. He had found she had a low sexual desire, in fact, an aversion to sex, and she had some orgasmic difficulties. To treat this he attempted to use awareness therapy and cognitive therapy. To make this work, however, the patient must accept her own body. To bring this about, he would have her touch her face and other body parts and tell him what she felt. Concerning the area of her marital issues, they spoke of mental causes and dysfunction. P. S. and her husband had not had sex for a number of years. Her husband had two children by a previous marriage, and P. S. had a difficult time relating to the children. There was a lack of communication, and the couple separated several times. There was also an issue with P. S.'s sister. P. S. gave her sister money for college and felt betrayed when the sister took the money but did not use it for school. This required therapy on forgiveness. P. S. also experienced occupational stress, and he brought her to the point where P. S. would decide when she was well enough to go back to work, but the overall need for stress management was continuous. P. S. also suffered from panic attacks and had an issue with Ardell James, Respondent's sister-in-law. Ardell and P. S. were close friends, but P. S.'s emotional problems put so great a stress on the relationship that Ardell, over the objections of Respondent, began to back away from P. S. P. S. could not handle this and became even more depressed, resulting in the hospitalization at Ridgeview. According to Respondent, when P. S. came back from Ridgeview, she hoped to reestablish the relationship with Ardell, but Ardell refused. This further depressed P. S. When she had first come back from Ridgeview, P. S. indicated she wanted to start therapy again with Respondent. Thereafter, Respondent saw her eight times in the short month after her return until on one occasion he received a hysterical call from her saying she had been replaced with Ardell in the women's ministry. P. S. alleged that Respondent had told Pastor Scott to replace her, and as a result, she would never forgive him and would see that he paid. Notwithstanding this accusation and threat, she asked him to set up another meeting with Ardell, and at that meeting, she told him she could not continue therapy with him. Dr. James then began to hear that P. S. was spreading rumors about his inappropriate therapy. He tried to set up a meeting with P. S. and Ms. Williams, another patient also alleged to be spreading rumors about him. Mr. S. also came to the meeting. At the meeting, P. S. made her allegations. When he asked Mr. S. if he had ever heard these allegations before that time, he allegedly said no. With that, Respondent claims, P. S. stormed out of the meeting and continued her attack on him with the Department and with the church. P. S. alleged that the Respondent instructed her to touch all her body area, but Respondent denies this. He admits to telling her to touch her face and her breasts, but not her vaginal area in his presence, and he also contends she never disrobed in his presence. Self-touching is discussed in several authoritative publications entered into evidence which suggest desensitization as a valid therapy. "Sensate forces" is described as self-touching, and Respondent admits to letting P. S. do this. However, the therapist must monitor the client's level of discomfort, and he unequivocally states he let her touch her face and breasts only and at no time suggested she engage in masturbation. Respondent also categorically denies ever having touched P. S.'s breast or her vaginal area, or let her touch his penis during a session, and he denies ever making any sexual comments which involved him. In fact, he claims, he rarely touched her at all. On one occasion when she was very tense and could not talk, he gently massaged her neck and shoulders and thereafter gave her a prescription for massage therapy. The Respondent claims he will not touch portions of clients which are off limits. He contends that at no point did P. S. ever share with him, verbally or otherwise, any discomfort she felt when he massaged her neck. Respondent admits that P. S. brought him pictures of herself at one point in their relationship, but contends there were only two through which she wanted to show him the "before" and "after" stages of his therapy. When Respondent realized that transference was taking place, he tried to explain what it was to P. S. and that it was all right to talk openly with him. However, he asserts, he told her that because of the transference, he felt she should take therapy with another therapist and recommended Dr. Sanderson. Respondent administered the MCMI-II to P. S. as an outpatient in his office. The responses she gave in answer to the questions asked are about what might be expected from a paranoid, delusional, and hallucinatory individual. This is how Respondent described P. S. at the time the test was administered. This description is not consistent with that used by Dr. Frank, who also opined he should not have interpreted the results himself. Dr. James also claims that P. S. spoke with him of sexual improprieties by a prior therapist. When he asked for the therapist's name, she refused to provide it, nor would she give him any other information about the alleged incident. He did not enter this allegation into P. S.'s records, nor did he place on the record all the late night phone calls she made to him. Pastor Scott cannot recall any instance over the years he was P. S.'s minister when she said anything negative to him about Respondent's treatment of her, even though Pastor Scott was the person who brought them together. She always seemed happy and was displeased only when Pastor Scott removed her from her position of responsibility at the church. Notwithstanding her belief that the Respondent was behind that removal, he was not, and Pastor Scott tried to make that perfectly clear to her. Dr. Marian Sue Street, an expert in the field of marriage and family therapy and mental health counseling, has known Respondent for approximately ten years as a co-member of the faculty at the University of South Florida where he teaches a course in legal and ethical considerations and human sexuality for counselors. In her professional opinion, his teaching is well within accepted boundaries, and the school is particularly pleased with the quality of his teaching. He has high standards and demands high performance from his students. Dr. Street has not had the opportunity to observe him with clients, but she believes his treatment of them is also good. He maintains high moral standards among students and faculty members, and his reputation is good. His standards and work ethic have him rated highly in the community. According to Dr. Street, "transference" in counseling implies that the client will transfer feelings they have for another person of whom the therapist reminds them onto the therapist. This would make it possible for the client, having transferred erroneous feelings to the therapist, to fantasize the therapist has the traits of the other person. The client then believes that fantasy to be the truth. In that regard, Dr. Street contends there is a great deal of evidence that memories can be constructed. Dr. Jon E. Mundorff, a certified sex therapist and an expert in marital counseling, sex therapy, and mental health, talked at length with Respondent about his background and philosophy before agreeing to testify in his behalf. He is aware of the allegations made, has reviewed Respondent's records, and heard the testimony of all witnesses. Based on his review of the records, his conversations with Respondent, and his own experience and training, he does not believe the allegations against Dr. James are true. Based on his understanding of P. S.'s background and testimony, he can see no rational basis for her allegations. She alleges inappropriate behavior by Respondent over a period of time, sexual in nature, in which Respondent allegedly acted out sexually and requested she do the same. Yet Dr. Mundorff saw nothing in the evidence to support the allegations. He found her to be profoundly disturbed and capable of making up the allegations. Dr. Mundorff considers Respondent's evaluation of P. S. to be within a reasonable standard of care. Recognizing the potential that Respondent's actions in the sessions could have been misinterpreted, he believes P. S. is capable of considerable misinterpretation. In his opinion, Respondent was aware of P. S.'s distress and compensated for it in his treatment, and Respondent's interest in and care of P. S., as manifested by his late-night time and demonstrated concern, indicate she received far more care than she paid for. Dr. Mundorff sees as a major issue for P. S. her replacement as head of the woman's forum by Pastor Scott, and he believes she blames Respondent for it though she probably would not know that herself. He is impressed by her threat to never forgive Respondent and her determination to make him pay for her removal. Dr. Mundorff also does not believe P. S. understood the concept of transference. Transference is not always a conscious thing, and the recipient may have nothing to do with it. Nonetheless, the transference becomes a reality to the client who has mental health problems, and the matters affixed to the therapist become reality to the client. According to Dr. Mundorff, "manufactured memory" is a real scenario. He considers P. S.'s repeated hospitalizations to be indicative of her lack of reliability as a witness because, "they don't put people in a hospital for no reason." He also opined that P. S.'s almost inaudible soft-spoken testimony is indicative of a desire not to be heard or to hide. Neither of these arguments is considered persuasive, however. In Dr. Mundorff's opinion, the state of P. S.'s mental health was such that, under the stress she was facing, it was likely that a fair amount of her recollections are delusional. That being the case, he further opines that the medications she was on, even at a low dose, could have increased her delusions. Significant as a factor in his evaluation is his opinion that most clients would not go back to a therapist who did what Respondent is accused of. P. S. repeatedly returned and consistently failed to report Respondent's alleged misconduct even though she had several opportunities to do so. He places little credibility in her testimony.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling enter a Final Order finding Respondent, Melvin William James, not guilty of the misconduct alleged and dismissing the Administrative complaint filed herein. DONE AND ENTERED this 19th day of April, 2001, in Tallahassee, Leon County, Florida. ___________________________________ ARNOLD H. POLLOCK Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6947 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 19th day of April, 2001. COPIES FURNISHED: Deborah B. Loucks, Esquire Agency for Health Care Administration Post Office Box 14229 Mail Stop 39 Tallahassee, Florida 32317-4299 A. S. Weekly, Jr., M.D., Esquire Holland and Knight, LLP 400 North Ashley Drive Suite 2300 Post Office Box 1288 Tampa, Florida 33601-1288 William W. Large, General Counsel Department of Health 4052 Bald Cypress Way Bin C07 Tallahassee, Florida 32399-3257 Susan Foster, Executive Director Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling 4052 Bald Cypress Way Tallahassee, Florida 32399-1701 Theodore M. Henderson, Agency Clerk Department of Health 4052 Bald Cypress Way Bin C07 Tallahassee, Florida 32399-3257
The Issue The issue in this proceeding is whether the Department of Children and Family Services should revoke the foster care license of Thomas and Shana Stone.
Findings Of Fact At all times material to this proceeding, the home of Thomas and Shana Stone was licensed by the Department as a foster home. Jeffrey G. was placed in the Stones' home on or about November 9, 2001, when he was approximately 10 months old. Two other children, who were eleven and four-year-old siblings, were also placed in the Stones' home around the same date that Jeffrey was placed in their home. The three children slept in the same bedroom which contained a bunk bed and a crib. According to Mrs. Stone, the siblings were unruly and she requested that the Department remove them from their home. The other children were removed from the home on November 12, 2001. On November 16, 2001, the Department received a report alleging that Jeffrey had a bruise three inches in length on his thigh. Jeffrey was brought to the Department's office by a foster care worker on November 16, 2001, for a scheduled visit with his mother. There is nothing in the record to indicate that Jeffrey was brought to the Department on November 16, 2001, as a result of the abuse allegation. Joann Lycett is a licensed protective investigator supervisor for the Department. Prior to becoming a supervisor, she was a protective investigator. During the time she has been an investigator and a supervisor, she took part in between 400 to 500 reports of child abuse or neglect. In addition to her experience as an investigator and a supervisor, Ms. Lycett received specialized training in child abuse investigations and earned certification in the child protection field. Her training includes determining the nature and cause of injuries to children. Ms. Lycett was present at the Department when Jeffrey was brought in for the visit. She observed an oval shaped bruise approximately three inches by two inches extending out from under the child's diaper onto his upper thigh. When the diaper was removed, Ms. Lycett could see bruising on the child's buttock as well. Ms. Lycett observed the bruise to be dark which was an indication to her that the bruise was recent as opposed to a bruise yellow or green in color. From her experience and training, the bruise did not appear to be accidental. Jeffrey was examined on November 16, 2001, by Richard C. Trump, a Child Protection Team medical doctor of the University of Florida.1 Dr. Trump's report reads in part: . . . on the buttocks there are some fairly fresh vertical and linear 1mm wide bruises which are external to the buttock crease. There is a 7x3cm bruise on the left buttock below the aforementioned linear bruises, which ends in a circular bruise at the lower left buttock. The thin linear bruises come together perfectly when the buttocks are compressed flat. All of the bruises are fairly superficial and are red and blue in color; no yellow or green is present. There are no bruises medial to the linear bruises in the crease of the buttocks. Mrs. Stone first observed the bruise the morning of November 16, 2001. Mrs. Stone did not report the bruise to the Department. Jeffrey generally attended daycare from seven or eight o'clock in the morning until 5:30 or 6:00 in the evening. Jeffrey attended day care on November 16, 2001. Mrs. Stone conceded that the bruise could not have happened at the daycare center because she observed the bruise the morning of November 16, 2001, before Jeffrey attended the center. According to Mrs. Stone, Jeffrey wore a brace on his leg which caught on the crib a couple of days before the incident. This, however, would not explain a fresh bruise as described by Ms. Lycett and supported by Dr. Trump's report. Likewise, the other foster children could not have caused the bruise as they were removed from the home four days prior to the incident in question. While the evidence did not prove that Mrs. Stone directly caused the injury, the evidence did prove that the child suffered harm while in the custody and control of Respondents.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law set forth herein, it is RECOMMENDED: That the Department of Children and Family Services enter a final order revoking the foster care license of the Stones. DONE AND ENTERED this 16th day of August, 2002, in Tallahassee, Leon County, Florida. BARBARA J. STAROS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 16th day of August, 2002.
The Issue The issue in the case is whether the application for registration of the Tonya Rodreguez Registered Family Day Care Home (Respondent) should be denied.
Findings Of Fact Since 1994, and at all times material to this case, Mrs. Rodreguez has operated the Respondent, which is located at 2736 Lemon Street, Fort Myers, Florida. On October 25, 2010, Mrs. Rodreguez filed an application with the Petitioner for registration of the Respondent. The previous registration had lapsed. Since 1992, and at all times material to this case, Mrs. Rodreguez has been married to her husband, Terry Rodreguez (Mr. Rodreguez). In 1990, Mr. Rodreguez was convicted of possession of a controlled substance and a concealed firearm. Mrs. Rodreguez was aware of her husband's criminal conviction. The registration application included a section where an applicant was directed to list "OTHER FAMILY/HOUSEHOLD MEMBERS." The application filed on October 25, 2010, by Mrs. Rodreguez disclosed only herself and her three children. Mrs. Rodreguez did not list her husband on the application. On June 23, 2010, a child protective investigator (CPI) commenced an unrelated investigation of the Respondent and went to the Lemon Street address. Mr. Rodreguez was present in the home when the CPI arrived. The CPI testified without contradiction that Mr. Rodreguez was uncooperative. She returned to the Respondent later that day accompanied by a law enforcement officer, but, when they arrived, Mr. Rodreguez was no longer present at the Respondent. On June 24, 2010, the CPI returned to the Lemon Street address, and Mr. Rodreguez was again present. During questioning by the CPI on that date, Mr. Rodreguez stated that he resided in the home. Additionally, Mrs. Rodreguez advised the CPI that she and her husband had separated, but acknowledged that she and her husband both resided at the home. At the hearing, Mrs. Rodreguez asserted that she has been separated from her husband for many years; however, she acknowledged that they remain legally married, that he uses her address as his legal address, and that her address is listed on his driver's license. She testified that he is homeless and that he returns to the house to see her children. Mr. Rodreguez was issued several traffic citations between January and July of 2010, and all of the citations identified his address as 2736 Lemon Street, Fort Myers, Florida.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Children and Family Services enter a final order denying the application for registration of the Tonya Rodreguez Registered Family Day Care Home. DONE AND ENTERED this 13th day of April, 2011, in Tallahassee, Leon County, Florida. S WILLIAM F. QUATTLEBAUM Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 13th day of April, 2011.
