The Issue The issue presented is whether the Respondent committed the offenses set forth in the Administrative Complaint filed in this case and, if so, what disciplinary action should be taken.
Findings Of Fact At all times material hereto, Respondent, Kathy Bergerson, held a family foster home license for her residence issued by the Children, Youth and Family Program Office of Petitioner, Department of Health and Rehabilitative Services. As it relates to the license at issue, Respondent was first licensed by Petitioner in April 1987. In her home, Respondent was responsible for several developmentally disabled children and a developmentally disabled adult. Respondent's mother lives in an apartment adjoining the home and has access to the residence. Respondent's mother is a registered nurse. During the period since the licensure, the several incidents described in the following paragraphs occurred. Because the incidents involved Respondent or her home and the incidents were unexplained, Petitioner became concerned for the safety of the children in Respondent's care. The incidents at issue are as follows: Sometime during 1987 while one of the children was hospitalized, the child was discovered in what appeared to be a drug-induced sleep during a visit by Respondent. No harm to the child was demonstrated from the incident, and Respondent relayed the incident to Petitioner during her relicensure interview in 1988. Also, sometime in 1987, a housekeeper, provided by Metro-Dade County, allegedly assaulted Respondent's mother while attempting to steal toys and bed sheets from the home. No harm to the children was shown from the incident, and Respondent reported the incident to Petitioner during her relicensure interview in 1988. Then, early in 1988, Respondent received a delivery of medication which did not contain full amounts of the prescribed contents. The medication was delivered by a representative sent by Petitioner. No harm to the children was proven from the incident, and Respondent reported the incident to Petitioner. In July 1988, a report of the sexual abuse of the developmentally disabled adult living with Respondent was filed with Petitioner. The final disposition of the incident was not shown; however, neither Respondent nor Respondent's mother were classified as perpetrators of the alleged abuse. In September 1988, a child under Respondent's care, and custody was hospitalized after she became, untypically, lethargic and unresponsive when Respondent gave the child a dose of Panadol for her fever. Fearing that the child was allergic to the medicine, Respondent brought the bottle from which she had administered the medicine with them to the hospital, and reported her fear to the medical personnel at the hospital and to Petitioner. Although Petitioner asserted that the bottle of medicine was tested for its contents, the proof failed to demonstrate that a test was performed or the results of any such test. Respondent kept the medication for the children in a locked cabinet in her kitchen. Included in the drugs in the cabinet were Panadol, Valium and Benedryl. In addition to Respondent, Respondent's mother and nurses provided by Petitioner, on occasion, had access to the cabinet. While Petitioner contended that the Panadol given to the child was adulterated with Valium and Benedryl, the proof failed to indicate that the Panadol was altered, or that the child suffered from the ingestion of the medication. Petitioner asserted that it was unusual for a foster parent, such as Respondent, to have as many unexplained events reported within an almost two- year period. Therefore, based on the above incidents and what Petitioner perceived to be a pattern of unexplained incidents involving Respondent and her home, and after ordering a psychological evaluation of Respondent and her mother, Petitioner issued its notice of intent to revoke Respondent's family foster home license on February 14, 1989. Petitioner alleged that Respondent was not capable of handling the stresses associated with maintaining a family foster home. At the hearing Respondent demonstrated a tendency to become overly excited; however, the proof failed to demonstrate that she is unable to handle the stresses of her life. Respondent is a caring person who has an obvious interest and concern for the children in her charge. She expressed deep concern over each of the incidents recited above and, in fact, reported the majority of the incidents to Petitioner. Although the incidents described above generate concern, was not shown that the safety of the clients was endangered by the incidents.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is: Recommended that the Department of Health and Rehabilitative Services issue a Final Order withdrawing its intent to revoke Respondent's family foster home license. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 15th day of December 1989. JANE C. HAYMAN Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Park way Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 15th day of December 1989.
The Issue The issue is whether Petitioners should be licensed to operate a foster home in Marianna, Jackson County, Florida.
Findings Of Fact Respondent licensed Petitioners to operate a foster home in Respondent's District No. 9, West Palm Beach, Florida, beginning in 1995 through April 1, 2000. The Department of Health, under its Children's Medical Services Program, licensed Petitioners as medical foster parents for almost two years of that time. At all times material to this proceeding, Petitioners had five children living with them in West Palm Beach, Florida. Two boys, aged six and three, were Petitioners' adopted sons. A two-year-old boy, A.B., and his one-year-old sister, T.B. were medical foster children. C.S. was a two-year-old female foster child. In August 1999, Petitioners bought a home in Respondent's District No. 2, which includes Marianna, Jackson County, Florida. Mr. Mayes is a carpenter and intended to make repairs to the home before moving his family to North Florida. Petitioners knew their foster home license in District No. 9 was not transferable to District No. 2. Therefore, they applied for a foster home license in District No. 2. Petitioners wanted their three foster children to move with them to Mariana, Florida. Petitioners hoped to adopt C.S. and to keep A.B. and T.B. in the same placement until another family adopted them. All of the foster children had been in Petitioners' home since they were a few days old. A.B. was a very active two-year-old child. He regularly climbed out of his crib. On one occasion he climbed up on the stove and turned on the burners. He seemed to "have no fear." In the fall of 1999, Mrs. Mayes requested Respondent to provide her with behavior management assistance for A.B. Because Petitioners were planning to move out of District No. 9, Respondent decided to wait until A.B. was settled after Petitioners' move to perform the behavior management evaluation. In the meantime, Petitioners could not keep A.B. in his highchair during mealtime. They had difficulty keeping him in his crib. They bought a safety harness and attempted to use it to keep A.B. in his crib on one occasion and in his highchair on another occasion. A.B. was able to wiggle out of the harness on both occasions. Petitioners subsequently discarded the harness. They resorted to tightening the highchair's feeding tray in order to keep A.B. still long enough to feed him. Petitioners never used and never intended to use the harness to punish A.B. Petitioners usually disciplined the children by placing them in timeout for one minute per year of age. Timeout for Petitioners' foster children usually meant being held in Mrs. Mayes' lap. Mrs. Mayes admitted using the safety harness on A.B. during a telephone conversation with Respondent's medical foster care counselor in January 2000. The counselor informed Ms. Mayes that foster parents are not allowed to use a harness to restrain foster children. Prospective foster parents must participate in and complete training classes designed by Respondent. Persuasive evidence indicates that Respondent teaches prospective foster parents during this training that children should never be restrained by a harness. Petitioners have taken these training classes. If A.B. and the other children were free to go into a bedroom, they would pull everything out of the chest of drawers. They would flush objects down the toilet in the bathroom. Mr. Mayes put a hook-type latch on the door to the Petitioners' bedroom, A.B.'s bedroom, and the bathroom in the hall. The primary purpose of the door latches was to keep the children out of unsupervised areas of the home. Petitioners never used the door latches as a means of discipline. On two occasions Mrs. Mayes latched the door to A.B.'s room while he was in the room asleep. The first time she latched the door while she went to the mail box in front of her home. The other time, she latched the door while she bathed another child who had a doctor's appointment later that afternoon. On both occasions, A.B. was locked in his room for only a few minutes. Petitioners knew that they needed permission from Respondent in order to take A.B., T.B., and C.S. out of the state on vacations. On several occasions, Respondent's staff gave Petitioners permission to take the foster children to North Florida for short visits during the time that Mr. Mayes was remodeling the home. Respondent's staff approved these short visits as if they were vacations. Petitioners knew that they needed to be licensed in Respondent's District No. 2 before Respondent's staff in District No. 9 could approve the permanent transfer of the foster children. At the same time, the Respondent's staff in District No. 2 could not license Petitioners until they actually made the move with all of their furniture. Petitioners discussed their dilemma with several members of Respondent's staff in District No. 9. During these conversations, Petitioners asked Respondent if they could take the children with them and treat the time that they would be temporarily unlicensed as if it were a vacation. At least one member of Respondent's staff responded that treating the move initially as if it were a vacation was "an option that could be explored." Respondent's staff subsequently advised Petitioners that under no circumstances could the foster children move to Jackson County, temporarily or permanently, until Petitioners were properly licensed. Petitioner's never attempted to deceive Respondent; to the contrary, they were openly looking for an acceptable way to take the foster children with then when they moved. They never intended to circumvent the proper licensing process. Based on Petitioners' former experience with Respondent, they believed that treating the move as a vacation would be an appropriate way to solve what was otherwise a "catch twenty-two" situation. By letter dated March 14, 2000, Respondent's staff in District No. 2 advised Petitioners that they would receive a provisional foster home license as soon as information furnished by Petitioners and copies of Petitioners' file from the licensing unit in District No. 9 could be sent to Respondent's office in Panama City, Florida. Respondent removed the three foster children from Petitioners' home just before Petitioners moved to Jackson County on April 1, 2000. In a memorandum dated April 19, 2000, Respondent listed Petitioners' home as one of two medical foster homes in Jackson County, Florida. Despite the representation in this memorandum, Respondent issued the letter of denial on June 5, 2000.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED: That Respondent enter a final order denying Petitioners a foster home license. DONE AND ENTERED this 20th day of October, 2000, in Tallahassee, Leon County, Florida. SUZANNE F. HOOD 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 20th day of October, 2000. COPIES FURNISHED: James Mayes Gail Mayes 4561 Magnolia Road Marianna, Florida 32448 John R. Perry, Esquire Department of Children and Family Services 2639 North Monroe, Suite 252-A Tallahassee, Florida 32399-2949 Virginia A. Daire, Agency Clerk Department of Children and Family Services Building 2, Room 204B 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Josie Tomayo, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
The Issue The issue to be resolved in this proceeding concerns whether Petitioners committed violations of Florida Statutes and Florida Administrative Code sufficient to justify revocation of Petitioners’ license to operate a foster care facility.
Findings Of Fact Petitioners’ foster home is a private agency foster home licensed by Respondent to provide substitute care for children in foster care. On or about August 24, 2000, a report was made to the Florida Abuse Registry indicating that a child, A.C., who suffers from Downs Syndrome and who resided in Petitioners’ care at the time, had suffered a burn mark that was three to four inches long. The burn reportedly appeared to be from an iron. Pursuant to this report, Respondent’s Child Protective Investigator commenced an investigation of the matter on August 24, 2000. During the course of the August 24, 2000, investigation, Respondent’s investigator observed the burn on A.C.’s arm. Testimony of the investigator establishes the presence of such a burn on A.C.’s arm at the time. That testimony is corroborated by photographs in Respondent’s Composite Exhibit No. 3 and fairly and accurately depicts A.C.’s burned arm as it appeared on August 24, 2001. Petitioner Carol Golden, when asked about the situation, stated that she was unaware of the burn on A.C.’s right arm until the matter was brought to her attention by the investigation which commenced on August 24, 2000, following the discovery of the child's injury by school personnel. Interviews with other children in the home revealed that another child was ironing clothes on the evening of August 23, 2000, and left the iron unattended momentarily, during which time A.C. burned his arm on the iron. Respondent’s investigator referred A.C. to the Child Protection Team for an examination of his injury. Subsequently, A.C. was removed from Petitioners’ foster home after the findings of the Child Protection Team revealed that the child’s injury was indicative of inadequate supervision. Respondent’s investigator concluded her investigation and closed the case, Abuse Report 2000-133049, with verified findings for lack of supervision and failure to seek medical attention for A.C. Subsequently, Petitioners’ foster care license was revoked because of the verified findings of neglect and inadequate supervision found in Abuse Report 2000-133049. Medical examination of A.C.’s injury, as it appeared on August 24, 2000, reveals that the injury was on the child’s right arm; was five by eight centimeters in size; and was a charred burn in the shape of an iron with the circles for the steam holes clearly visible. The burn was in such a place, and of such a size, that any caretaker responsible for the bathing and clothing of A.C. should have seen the injury. Attempts by Respondent’s employees to conduct an assessment of A.C. were not successful. He was friendly and interacted well; however, he only pointed to his injury and could not communicate how it happened.
Recommendation Having considered the foregoing findings of fact, conclusions of law, the evidence of record, and the testimony of the witnesses, it is, therefore, RECOMMENDED: That a Final Order be entered confirming the revocation of Petitioner’s foster license. DONE AND ENTERED this 9th day of January, 2002, in Tallahassee, Leon County, Florida. DON W. DAVIS 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 9th day of January, 2002. COPIES FURNISHED: Charles Golden Carol Golden 7939 Denham Road Jacksonville, Florida 32208 Robin Whipple-Hunter, Esquire Department of Children and Family Services Post Office Box 2417 Jacksonville, Florida 32211 Peggy Sanford, Agency Clerk Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204B Tallahassee, Florida 32399-0700 Josie Tomayo, General Counsel Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204 Tallahassee, Florida 32399-0700
The Issue The issue in this case is whether Respondents' foster home license should be revoked for violating Florida Administrative Code Rule 65C-13.030(3).
Findings Of Fact The Department is the state agency responsible for foster care licensing, pursuant to section 409.175, Florida Statutes, and Florida Administrative Code Chapter 65C-13. Respondents are a mother, Mary Highsmith, and daughter, Dawndrell Martin, who reside together and obtained a joint license to provide foster care to children on November 16, 2017. On July 16, 2018, the Department’s Florida Abuse Hotline received an abuse report regarding B.H., a five-year-old female, who had been previously removed from her parents due to abuse, abandonment, or neglect and placed in the foster home of Respondents in November of 2017. The abuse report stated that B.H. had bruising on her back, face, and on top of her head. B.H. told the abuse reporter that “TT” had hit her with a brush or comb. “TT” was B.H.’s nickname for Ms. Martin. Daniel Henry, a child protective investigator with the Department, was assigned to investigate the abuse report. He interviewed B.H., who told him that Ms. Martin had punished her by hitting her with a comb, a switch, and a flip-flop and that Ms. Highsmith had repeatedly “thumped” her forehead with a flick of her finger. Mr. Henry interviewed the reporter of the abuse. He contacted local law enforcement to facilitate a joint investigation, contacted the Department’s licensing staff, and interviewed Respondents. Based on B.H.’s statements, Mr. Henry immediately referred the case to the CPT. The CPT is an independent entity created by statute and overseen by an interagency agreement between the Department of Children and Families and the Department of Health. Among other services, the CPT performs assessments that include medical evaluations, specialized clinical interviews, and forensic interviews. See § 39.303, Fla. Stat. In this case, B.H.’s physical injuries led the CPT to arrange a forensic interview and a medical evaluation of the child. Kimberly Dykes is an ARNP working for the CPT. She has undergone specialized training in child maltreatment, including the nature, origin, manifestations, and symptoms of abuse and injuries inflicted upon minor children. Her training included recognizing the difference between accidental and intentional injuries. Ms. Dykes performed a medical examination and interviewed B.H. about the cause of her injuries. Ms. Dykes concluded that B.H.’s wounds were consistent with inflicted injury, and were consistent with the causation described by the child as “having been repeatedly struck with a comb and a switch and having been repeatedly thumped in the forehead.” Ms. Dykes testified that she spoke with the investigator for the Jackson County Sheriff’s Office, Sergeant Cheree Edwards. Ms. Dykes stated that Sgt. Edwards provided her with the explanations that Respondents had offered for B.H.’s injuries. Ms. Dykes testified that she was able to medically rule out each of these explanations as lacking appropriate medical and testimonial support for their causation. Ms. Dykes further recommended that B.H. be removed from Respondents’ home and placed in alternate custody. Angela Griffin is a specialist with the CPT, who is certified to provide specialized clinical interviews and forensic interviews of minor children. Ms. Griffin conducted a forensic interview of B.H. Ms. Griffin testified as to the safeguards necessary to protect the integrity of the interview process with a child, such as building rapport, discussing the difference between telling the truth and telling a lie, and explaining the “rules of the room” to the child, including the fact that the interview will be recorded and that the child should make it known if she does not understand a question. Ms. Griffin stated that she employed all these safeguards during her interview with B.H. During her interview with Ms. Griffin, B.H. described how her injuries were inflicted. This description was consistent with the story B.H. told to the abuse reporter, to Mr. Henry, and to Ms. Dykes.1/ B.H. told Ms. Griffin that Ms. Martin had hit her on the head, in the face, and on the back with a comb, a switch, and a flip-flop, and that Ms. Highsmith had thumped her forehead. Upon concluding the forensic interview and medical evaluation, Ms. Griffin and Ms. Dykes provided recommendations for the care of B.H. They recommended that B.H. be removed immediately from the home of Respondents. They further recommended that any and all other children placed with Respondents be removed, and that no further children be placed with them. They recommended counseling for B.H. After concluding his investigation and consulting with the CPT, Mr. Henry verified the allegations of physical abuse by Ms. Martin. He recommended that Respondents’ foster home license be revoked and that no other children be allowed to reside with them. At the hearing, Sgt. Edwards testified as to the investigation she conducted for the Jackson County Sheriff’s Office. She stated that in cases of joint investigation by the Department and law enforcement, the CPT is critical in allowing a single point of contact with the minor victim. It is in the best interest of the child to avoid multiple and redundant interviews that could cause repeated trauma. Following the joint investigation protocol, Sgt. Edwards did not conduct her own interview of B.H., but observed the recording of Ms. Griffin’s interview with B.H. Sgt. Edwards also reviewed the notes made by Mr. Henry, the Department’s investigator. Sgt. Edwards interviewed Respondents and took repeated statements from them regarding possible origins of the injuries to B.H. She allowed Respondents to provide any and all evidence relevant to this matter. Sgt. Edwards testified that she contacted, or attempted to contact, every witness named by Respondents, including the day care teachers, and reviewed every piece of evidence presented by Respondents. During her investigation, Sgt. Edwards discovered a hair comb at Respondents’ residence. A photograph of the comb taken by law enforcement was presented as an exhibit in this proceeding. The photo shows a long-handled “rattail” comb. Sgt. Edwards determined this comb to match the item described by B.H. as the implement used by Ms. Martin to hit her on the head. Ms. Dykes testified that the comb showed in the photograph could easily have been the cause of the injuries to the top of B.H.’s head. Based on her independent investigation, Sgt. Edwards found probable cause to file criminal charges against Ms. Martin for inflicting injury on B.H. At the time of the hearing, the criminal case was still pending. At the hearing, the Department presented 13 photographs, taken by Ms. Griffin, of B.H.’s injuries. The photos detail multiple sources of trauma and bruising to B.H.’s face, head, back, eyes, neck, and scalp. None of the wounds appeared deep or serious, but did appear to be more severe than the usual bumps and bruises a parent expects from an active child. Ms. Dykes testified that the injuries in the photos were entirely consistent with B.H.’s statements that Ms. Martin caused them by hitting her with a comb, a switch, and a flip- flop. Respondents did not testify. Through cross- examination and argument, Respondents were able to put forward some of their explanations for the injuries to B.H. They contended both that B.H. is inclined to self-harm and that the injuries must have been inflicted at Caverns Learning Center, the day care facility that reported the injuries to the Florida Abuse Hotline. They contended that the child may have hit her head on a dresser while bouncing on her bed. They stated that B.H.’s skin had been rubbed raw by a seat belt. Her scalp injuries may have been caused by a harsh shampoo used to treat for lice, or by self-pulling of her hair, or by undiagnosed folliculitis. Ms. Highsmith theorized that the entire case was fabricated by authorities who did not like the fact that black foster parents were caring for white children. Respondents argued that Mr. Henry did not pursue other theories as to the cause of the injuries. For example, he took employees of Caverns Learning Center at their word when they told him B.H. was injured when she arrived at the day care on the morning of July 16, 2018. They also questioned why approximately two hours passed between B.H.’s arrival at the day care and the call to the Florida Abuse Hotline. Mr. Henry plausibly addressed both issues raised by Respondents. He testified that the Department bases its investigations on the identity of the alleged perpetrator. Because B.H. repeatedly and consistently identified Ms. Martin as the person who inflicted the injuries, Mr. Henry saw no reason to cast about for other suspects. Mr. Henry stated that he did not find it unusual for a busy day care to take a couple of hours to report to the abuse hotline. Respondents did not themselves testify on the advice of their criminal defense attorney. Respondents did present the testimony of their licensing specialist, Kristy Hancock, and a “courtesy” dependency case manager, Precious Ingram.2/ Ms. Hancock testified that she was the instructor for Respondents’ foster home licensing class. Respondents were “very engaged” during the seven weeks of coursework and seemed to understand the implications of being foster parents. Ms. Hancock stated that she had visited Respondents’ home and all seemed well.3/ Ms. Hancock also testified that she was aware of “issues” with Caverns Learning Center, but did not elaborate. Ms. Ingram testified that Respondents were cooperative with her when she made her monthly home visits. She observed nothing that would indicate abuse or neglect. She never saw marks on B.H. resembling those in the photographs introduced by the Department. Ms. Ingram stated that she saw nothing out of the ordinary in Respondents’ foster home and never had cause to raise concerns about the care of the children there. Jeanne Durden is employed by Big Bend Community Based Care (“BBCBC”) and is in charge of BBCBC’s licensing responsibilities. BBCBC is a contractor retained by the Department to provide foster care services in Circuits 2 and 14. BBCBC manages foster care licensing for the cited jurisdictions. Ms. Durden testified that it was her responsibility to provide quality assurance for all foster care licensing operations. BBCBC contracts with other entities to provide front line case management, and Ms. Durden provides oversight for those subcontractors. Ms. Durden testified that she removed all of the minor children from Respondents’ home immediately after reviewing the findings of the child protective investigator and the CPT. Ms. Durden also recommended immediate termination and revocation of Respondents’ foster home license. Ms. Durden explained that her recommendation was due to the nature and findings of the Department’s verified child protection abuse report as well as the criminal charges filed against Ms. Martin. She noted that Department rules do not permit corporal punishment of any kind for foster children, because of the traumas these children have already experienced. Ms. Durden did not believe that anything short of revocation was legally appropriate. She opined that mitigation was not possible based on the nature and cause of B.H.’s injuries. Regina Pleas is safety program manager for the Department’s Northwest Region. Among her duties is management of the Department’s licensing operations. BBCBC has the contractual responsibility to recruit, retain, and manage foster homes, but the Department is ultimately responsible for all decisions and maintains final approval for BBCBC’s licensing actions. Ms. Pleas reviewed Ms. Durden’s recommendation of revocation of Respondent’s foster home license. After considering the nature and cause of the injuries inflicted, the consistency of B.H.’s statements, and the analysis of the CPT, Ms. Pleas concurred that revocation was necessary. In considering the appropriateness of revocation, Ms. Pleas also took into account that Respondents were now subject to a verified abuse report, meaning that the Department could no longer place minor children in their care. Ms. Pleas drafted the letter notifying Respondents of the Department’s decision to revoke their foster home license. The letter, dated September 28, 2018, appropriately notified Respondents of the Department’s intended action and of their due process rights in challenging the Department’s preliminary decision.
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 Families revoking the foster home license of Respondents Dawndrell Martin and Mary Highsmith. DONE AND ENTERED this 22nd day of March, 2019, in Tallahassee, Leon County, Florida. S LAWRENCE P. STEVENSON 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 22nd day of March, 2019.
The Issue Whether the Petitioner should be granted a foster home license.
Findings Of Fact Petitioner, Kate Shaw, applied for a license to operate a family foster home. By letter dated November 18, 1998, the Department notified Petitioner that based on findings in FPSS Abuse Report No. 92-069954, the Department was denying her application for a license to provide foster care. Furthermore, the letter advised Petitioner that she had the "right to request an [a]dministrative [h]earing to review the Department's decision and to request an exemption." FPSS Abuse Report No. 92-069954 named Petitioner as the perpetrator of abuse upon her 13-year-old daughter, Crystal Fishburne (Crysal)/Ms. Fishburne). That report was classified as confirmed in July or August 1992. The incident which was the subject of the abuse report occurred on the evening of July 3, 1992, and was reported to the abuse hotline on that same evening. The Department of Health and Rehabilitative Services, the agency previously responsible for investigating reports of child abuse, assigned a child protection investigator to investigate the subject report. On July 4, 1992, the investigator assigned to the case went to Petitioner's home and interviewed Petitioner and her daughter, Crystal. During the interviews, both Petitioner and her daughter told the investigator that Petitioner had hit Crystal with an extension cord the prior evening. Welts or marks were left on Crystal's legs, arms, and back as a result of Petitioner's hitting her. As a part of the investigation, these marks were photographed. However, no medical examination was ever conducted. On July 4, 1992, after the investigator interviewed Petitioner and Crystal, she tried to take Crystal to the Family Services Program for a cooling-off period, but Crystal refused to go. After the investigation, an abuse report was prepared finding that Petitioner had hit Crystal several times with an extension cord leaving linear and looped marks on the daughter's legs, arms, and back. Petitioner has never denied that she hit Crystal with an extension cord on the evening of July 3, 1992. However, during the investigation and at the hearing, Petitioner disputed two statements that Crystal made to the investigator on July 4, 1992. First, Crystal reported that Petitioner had hit her with an extension cord on one other occasion. Second, with regard to the July 3, 1992, incident, Crystal stated that her step-father had held her down while her mother hit her. At hearing, Ms. Fisburne (Crystal) provided credible testimony that the aforementioned statements were not true, but were made only because she was angry and wanted to get away from her mother. At the time of the July 1992 incident and during the two years prior thereto, Crystal was a difficult child who refused to follow Petitioner's directions, did whatever she wanted to do, and threatened to call the police if Petitioner "did anything" to her. Crystal exhibited numerous behavior problems. Crystal became violent with Petitioner; routinely skipped school; left home for days at a time; and stole Petitioner's car twice within a one-month period. The first time Crystal stole Petitioner's car, she kept it for one day; the second time Crystal stole the car, she kept it three days. When Crystal ran away from home, she would often return to Petitioner's house during the day when no one was at home and break in and steal food and money. Also, in one instance, Crystal broke into someone else's house. On the day of the incident, Petitioner was "pushed to the limit" and resorted to the use of corporal punishment as a means of redirecting her daughter's behavior. Petitioner expressed regret about hitting her daughter with an extension cord. However, she believed that corporal punishment was appropriate given the seriousness of Crystal's behavior, the length of time Crystal had been exhibiting this behavior, and the ineffectiveness of other disciplinary methods, such as placing Crystal on restrictions and giving her extra chores to perform. Prior to the July 3, 1992, incident, Petitioner had sought help in dealing with Crystal's behavioral problems from various community resources. At the suggestion of a school counselor, Petitioner arranged for counseling for Crystal. However, after several sessions, the counseling was discontinued because Crystal was uncooperative. In Crystal's words, referring to the counselor, "I didn't want to talk to the man." When Crystal ran away from home, Petitioner contacted the Sheriff's Office but was told that it could provide no assistance because there was no law against a child running away from home. However, Petitioner was told by the Sheriff's Office that since Crystal was a minor, whenever she came home, Petitioner would have to allow her to return. Finally, during one or more of Crystal's episodes, Petitioner attempted to take her to the detention center for a 72-hour cooling-off period. These efforts were likewise unsuccessful because the detention center refused to accept Crystal. Other than the incident referred to in the FPSS Abuse Report No. 92-069954, Petitioner has not been the subject of an abuse report. Since the July 1992, Petitioner has been employed in several jobs that involve working with children. She was employed as a house parent in a home for teenage mothers and their babies; a back-up parent for the Department of Juvenile Justice to children who were removed from their home; and a substitute teacher. Despite the discrepancies in statements made by Petitioner and her daughter and in FPSS Abuse Report No. 92-069954, there is no evidence that Petitioner requested a hearing to have the abuse report expunged or amended as required in Section 415.504(4)(d)1.b., Florida Statutes (1991). Because the report was never challenged, FPSS Abuse Report No. 92-069954 remains and is properly deemed a confirmed report of abuse. Furthermore, there is no indication that Petitioner ever applied for or was granted an exemption from disqualification as provided in the Florida Statutes. In light of the confirmed report of abuse naming Petitioner as the perpetrator of abuse against a child and in absence of the Department's granting an exemption from disqualification, the Department properly found that Petitioner failed the required screening and thus, properly denied her application for a foster home license.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Department enter a final order denying Petitioner's application for licensure as a family foster home. DONE AND ENTERED this 29th day of July, 1999, in Tallahassee, Leon County, Florida. CAROLYN S. HOLIFIELD 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 July, 1999. COPIES FURNISHED: Gregory D. Venz, Agency Clerk Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204 Tallahassee, Florida 32399-0700 John S. Slye, General Counsel Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204 Tallahassee, Florida 32399-0700 Kate Shaw 619 38th Street South St. Petersburg, Florida 33711 Amy V. Archibald, Esquire Department of Children and Family Services 11351 Ulmerton Road, Suite 100 Largo, Florida 33778-1630
The Issue The issue is whether Respondent is guilty of acts and omissions to justify the revocation of his license to operate a family foster home, pursuant to Section 409.175(8), Florida Statutes.
Findings Of Fact Petitioner licensed Respondent to operate a family foster home from June 22, 2000, until May 15, 2001, at which time Petitioner revoked Respondent's license. The only foster children placed with Petitioner were Ju. K. (Ju.) and J. K. (J.), who are brothers. During the majority of the period in question, Ju. was 16 years old and J. was 17 years old. The boys were adopted at infancy. However, their adoptive mother died when they were young. The adoptive father remarried, but died a few years later, in January 1999. The stepmother never adopted the children, and, shortly after the death of their adoptive father, she turned over the two children to foster care. Respondent had been a friend of the stepmother since the mid-1980s and, through her, had met the adoptive father. Respondent became close with the couple and their children, whom he often visited on holidays. Learning that at least one of the boys had had problems in foster care, Respondent decided to qualify to become their foster father. At the time, Respondent was 40 years old and single and had not raised any other children. However, Respondent took the training courses required for licensing as a foster parent. After Respondent obtained his foster parent license, Project Teamwork for Kids, which is the private entity in Brevard County that recruits, trains, and licenses foster parents and places foster children with these parents, placed Ju. and J. with Respondent. J. began to live with Respondent in January 2000, and Ju. joined him in June 2000. During the summer of 2000, relations among Respondent, J., and Ju. were good. They took vacations and settled into their new lives during a period relatively free of stressful demands. Respondent asked Project Teamwork 4 Kids representatives not to start any family therapy during the summer and, once school started, asked that they again defer the initiation of such services. Respondent was aware that Ju. had been diagnosed with dissociative personality disorder, but believed that a normal home life would ameliorate this condition. During the summer, Respondent was concerned with the high school to which Ju. had been assigned for ninth grade. Respondent convinced school officials to reassign Ju. to a different high school, but school officials warned Respondent that, due to the reassignment, they would not tolerate disruptive behavior from Ju. Respondent was satisfied with J.'s assignment for tenth grade because it was the same school from which he had earlier dropped out. At the start of the school year, Respondent required weekly progress reports from J.'s teachers. However, as J.'s grades improved, Respondent dropped this requirement. During the period covered by this case, Respondent's relationship with J. was better than Respondent's relationship with Ju. Respondent and J. had a major disagreement arise at the end of October when J. returned home drunk from a homecoming celebration. A day or two later, after giving the matter considerable thought, Respondent discussed the matter with J. and imposed the punishment that Respondent would not provide his written consent for J. to obtain his driving learner's permit for six months, although Respondent would reconsider at three months. When J. learned of his punishment, he became irate and telephoned his case manager with Project Teamwork 4 Kids, Karen McCalla. He demanded that she remove him from Respondent's home. Ms. McCalla visited the home and spoke with J. alone for several hours, then Respondent, and then J. again alone. This home visit provides an early, but typical, example of the difference in perspectives of Respondent and Petitioner's witnesses. According to Respondent, Ms. McCalla arrived at the home, spoke with J. alone for several hours, spoke with Respondent, and then spoke with J. alone again. She then announced that Respondent should sign for J.'s learner's permit, but not allow him to drive for three months. Although he disagreed with the recommendation and felt that Ms. McCalla's recommendation had undercut his authority, Respondent complied with the request. Ms. McCalla's version is considerably different. Agreeing that J. was demanding that she remove him from Respondent's home, Ms. McCalla noted that J. complained generally that Respondent was "overbearing, overpowering and does not give [J.] any privacy." Focusing on the larger issues than merely the proper punishment for J.'s recent misbehavior, Ms. McCalla recommended that the family undergo family therapy. Ms. McCalla's version is credited. By Respondent's own account, Ms. McCalla spent "several hours" speaking with J. initially. Although underage drinking is a serious matter that may necessitate serious discussions, it is unlikely that Ms. McCalla and J. could have spent "several hours" on this single transgression. It is more likely that J. broadened his complaints in the manner described by Ms. McCalla. Respondent's contrary version either undermines his credibility as a witness or, if sincere, his competence as a foster parent. During the fall, Respondent's relationship with Ju. deteriorated. In general, Respondent's nascent parental skills were insufficient to meet the needs of Ju. When a conventional menu of incentives and disincentives failed to produce the desired results, Respondent grew increasingly frustrated, but declined to take advantage of the support resources available to him through Project Teamwork 4 Kids and its contractors. Instead, Respondent, alone, proceeded with his own disciplinary scheme, intensifying his disciplinary measures each time that less intense measures failed. Eventually, conflict between Respondent and Ju. escalated, and the domestic situation became unbearable for both of them. For instance, at school, Respondent was legitimately concerned that Ju. not jeopardize his placement at the high school to which he had been assigned due to Respondent's efforts. Worried about Ju.'s associations at school, especially due to Ju.'s poor school associations in the past, Respondent required Ju. to sign into the library immediately after eating lunch, so he would not have the chance to socialize with his peers. If Ju. failed to sign in, a teacher was to telephone Respondent, who would go to school to find Ju. By Respondent's admission, he enforced this arrangement for four to six weeks. Respondent was adamant that Ju. not date until he was 16 years old. This was a legitimate concern due to sexual behaviors that Ju. had displayed prior to his arrival in Respondent's home. Early in the school year, while Ju. was still 15 years old, Respondent overheard him speaking on the telephone with a girl from school. Respondent interrupted the conversation and asked Ju. to ask the girl if her mother were home. Finding that she was, Respondent asked to speak to the mother. Explaining to the mother that Ju. was not allowed to go on one-on-one dates until he reached 16 years of age, Respondent, by his own testimony, managed to agitate and offend the mother. Respondent admitted that Ju. became upset because he had considered the girl his girlfriend. On another occasion, Respondent required that Ju. end a relationship with a girl at school. Without detailing any concerns about sexual activity, Respondent explained his intervention by noting that Ju. had taken another boy's girlfriend, who seems to have not been suitable for Ju.--in Respondent's opinion. At home, numerous times Respondent employed more intense strategies when conventional disciplinary interventions failed to produce the desired results. For instance, when Ju. persisted in viewing sexually unsuitable material on the television in his room, Respondent removed the bedroom door, thus depriving Ju. of all privacy. Also, when Ju. persisted in abusing and overusing the telephone, even after being placed on telephone restriction, Respondent removed the handsets when he left the home, leaving the boy without telephone service in the home, although he could walk outside the apartment to a neighbor or a pay phone. Gradually, frustration erupted into physical confrontations. Twice, Respondent ripped T-shirts off the back of the boy during angry exchanges. Once, Respondent lightly slapped the boy on the mouth when he swore at Respondent. Twice, Respondent intentionally damaged audio equipment used by Ju. For each of these actions, Respondent devised transparent stories to cover up his failure to handle Ju.'s transgressions in a positive, effective manner. As the above incidents suggest, Respondent sought to impose a level of control over Ju. that was unsuitable for Ju.'s age and the circumstances of the relationship that existed between Respondent and Ju. Lacking both experience and maturity, Respondent obstinately dug in deeper each time his discipline failed to produce the desired result. Never lacking in good motives, Respondent lacked the resources needed for the difficult parenting task that Ju. presented, and Respondent exacerbated the situation by refusing to accept the assistance of professionals who might have been able to help him with Ju. Over time, even Respondent's innocuous behavior- modification techniques became counterproductive. For instance, Respondent routinely insisted that he and a child not go to sleep without first resolving any conflicts that may have arisen. Although a salutary policy, if applied with discretion, Respondent's overbearing implementation of this policy intensified hostilities, rather than defused them. An example of the injudicious use of this policy took place in early February 2001 when Respondent and Ju. got into an argument over an uncompleted homework assignment. Respondent warned Ju. that Petitioner lacked sufficient beds to accommodate Ju. at the time and that, if Ju. did not compose himself, Respondent would call the police to have Ju. removed from Respondent's home. This was especially hurtful to a child who had already known the pain of abandonment and abuse. Trying to defuse the confrontation, Ju. demanded time to step outside and cool off, but Respondent, insistent on a resolution on his terms, ordered Ju. to remain inside until Respondent had finished talking to him. By March 2001, Project Teamwork 4 Kids representatives had tried to intervene on at least two occasions in recent weeks, but Respondent had become increasingly resistant to what he viewed as interference from caseworkers with Ju. and J. By this time, Ju. wanted out of the home, and Respondent wanted him out of the home. On March 28, 2001, Project Teamwork 4 Kids removed Ju. from Respondent's home. About six weeks later, Project Teamwork 4 Kids also removed J. from Respondent's home. Petitioner proved some of its specific allegations and failed to prove others, but, as the Administrative Law Judge noted at the final hearing, the basic issue in this case is whether Petitioner can prove that Respondent has committed an intentional or negligent act materially affected the health or safety of children in his home. Petitioner has met its burden with respect to Ju. Ju. would have been a considerable challenge to a person with considerable parenting experience and skills. Respondent lacked both, but, knowing Ju.'s special needs, nonetheless sought the responsibility of serving as Ju.'s foster father. As the situation worsened, Respondent lacked the insight to avail himself of the resources offered to him and Ju. Instead, Respondent resorted to ineffective disciplinary strategies that eventually deteriorated into angry outbursts, culminating in Respondent's angry and desperate threat to end the placement itself--a most injurious act, given Ju.'s circumstances and dissociative personality disorder. Although it is clear that Respondent assumed a very difficult undertaking, his incompetent discharge of these responsibilities, coupled with his obstinate refusal to accept readily available help from others with greater training and experience, justifies the revocation of his family foster home license.
Recommendation It is RECOMMENDED that the Department of Children and Family Services enter a final order revoking Respondent's family foster home license. DONE AND ENTERED this 22nd day of January, 2002, in Tallahassee, Leon County, Florida. ROBERT E. MEALE 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 22nd day of January, 2002. COPIES FURNISHED: Kathleen A. Kearney, Secretary Department of Children and Family Services 1317 Winewood Boulevard Building 1, Room 202 Tallahassee, Florida 32399-0700 Josie Tomayo, General Counsel Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204 Tallahassee, Florida 32399-0700 Peggy Sanford, Agency Clerk Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204B Tallahassee, Florida 32399-0700 Deborah Guller Department of Children and Family Services 201 West Broward Boulevard, Suite 502 Fort Lauderdale, Florida 33301 Samuel D. Lopez Samuel D. Lopez, P.A. 629 Southeast Fifth Avenue Fort Lauderdale, Florida 33301 Alan Siegel 500 Northwest 34th Street, Apartment #105 Pompano Beach, Florida 33064
The Issue Whether Respondents should be granted a family foster home license.
Findings Of Fact Petitioners, Alfonso and Lynda Zapata, applied to be licensed as a family foster home care with the Department through the Devereux Foundation. The Devereux Foundation maintains a network of foster homes to serve parents who need to temporarily place their children in foster care (private placements) and dependent children in the custody of the Department (public placements). Previously, Petitioners had been licensed as a family foster care home with the Department through Florida Baptist Children's Home (Florida Baptist). Like the Devereux Foundation, Florida Baptist maintains a network of foster homes to serve parents who need to temporarily place their children in foster care and dependent children in the custody of the Department. Petitioners had withdrawn form the relationship with Florida Baptist after a disagreement with Florida Baptist personnel over the removal of a child from their home and reunification of that child with her mother. In 2001, about half of the children placed in Florida Baptist's homes were placed by the Department in connection with cases of child abuse, or abandonment, while the other half were private placements by families whose circumstances necessitated that their children temporarily reside elsewhere. In July 2001, Petitioners had two foster children living in their home. One of these children, T.D., also known as J., had been placed in the Petitioner's home by the Department. The other, C.R., a three-month-old boy, had been privately placed in the home by Florida Baptist at the request of the child's mother, E.R., who was single. E.R. had placed her child in Florida Baptist care because she had enlisted in the United States Army and was undergoing basic training out of state. E.R. had enlisted in order to provide her family a better life. It was initially anticipated that E.R. would be gone six months, but due to injuries sustained during basic training, she was actually gone for eight or nine months. There was no evidence of abuse, neglect or abandonment on E.R.'s part. During C.R.'s stay, Petitioners developed a negative impression of E.R. They did not think that E.R. called or wrote frequently enough. Petitioners had commented to Florida Baptist staff that E.R. was an unfit mother, that Petitioners provided C.R. with a better home than E.R. could, that E.R. did not love C.R., and that Petitioners could love C.R. more than E.R. could. Petitioners' opinion was based on their belief that no really good mother would take a job which required her to be away from her child for extended periods and a belief that C.R.'s grandmother was physically abusive towards C.R. Unfortunately, Petitioners let their beliefs about appropriate parenting interfere in their duties as foster parents to aid in reunification of a child with that child's legal parents. Florida Baptist staff also believed that Petitioners had become too attached to C.R., which caused them to attempt to undermine the Department's later attempts to reunify mother and child at the planned time E.R. would return from basic training and be able to provide a home to C.R. In late July 2001, Florida Baptist staff also became concerned about other behavior exhibited by Petitioners involving confidentiality issues and concerned that the Department had removed T.D. (aka "J.") from Petitioners' home. The behavior concerning confidentiality arose because Mrs. Zapata had discussed the fitness of E.R. to be C.R.'s custodial parent with a Department employee. C.R. was not a Department placement. However, it should be noted that the discussion was with a Department employee involved in the fostering program. Such an employee could reasonably be viewed as a person to report any suspected abuse or neglect to. In this instance, the conversation did not involve a report of abuse or neglect, but concerned Petitioners' belief that E.R. was not a good mother. On the other hand, the evidence was unclear whether the same confidentiality requirements regarding public placements by the Department appertain to private placements by the parents. The incident does cast doubt on Petitioners' awareness and desire to comply with privacy considerations should they be licensed by the Department. During the month of July 2001, T.D., also known as "J.", lived in Petitioner's home. T.D. was a little less than a year old at the time and had been placed in Petitioner's home by the Department because of ongoing juvenile dependency proceedings. On July 31 or August 1, 2001, the Department counselor, Wendy Cheney, picked T.D. up at Petitioner's home to take him to a doctor's appointment. Ms. Cheney noticed that there were crumbs and dirt in the car seat in which Petitioners had placed T.D. Ms. Cheney also noticed that T.D.'s clothes and diaper bag had a strong odor of spoiled milk. A crust also appeared on the nipple of the baby bottle and the eye medicine bottle Mrs. Zapata gave her to take with T.D. to the physician's appointment. During the preceding month, Ms. Cheney had visited Petitioners' home on at least a weekly basis to monitor T.D.'s situation. On many of these occasions, Ms. Cheney also observed that T.D.'s clothes had the same sour milk smell she experienced during the doctor's appointment. She also noticed during these visits that the nipples of T.D.'s baby bottles were not properly covered. On one occasion, Ms. Cheney saw T.D. drop his pacifier and then observed Mrs. Zapata pick it up and replace it in T.D.'s mouth without washing it off. This is of particular concern, as Petitioners had a long-haired dog whose hair was apparent on the floor of Petitioners' home. The Department removed T.D. from Petitioners' home because of these observations. Again, these observations cast serious doubt on the quality of hygienic care provided by Petitioners to foster children. There was no evidence offered to contradict the apparent lack of good hygienic care provided to T.D. However, there was also no evidence that Petitioners' care of T.D. constituted neglect or abuse of T.D., since a finding of neglect or abuse requires demonstration of harm or significantly dangerous conditions. Because of these concerns, Florida Baptist staff agreed that C.R. should be removed from Petitioners' home at least until these issues sorted themselves out. On August 1, 2001, Florida Baptist social worker Sue Kiser telephoned Mr. Zapata and scheduled an appointment for 4:30 p.m., on August 2, 2001, to discuss the reunification of C.R. with E.R. Later that day, Florida Baptist staff decided that since E.R. had recently returned from basic training, the optimum way of accomplishing reunification was to have E.R. meet Ms. Kiser and C.R. at a previously scheduled medical appointment on August 2, 2001, following which C.R. and E.R. would stay together at another foster home. Florida Baptist social worker, Jackie Barksdale, communicated this plan by telephone to Mr. Zapata on August 1, 2001. Mr. Zapata became angry and stated that he refused to allow C.R. to leave his home and go to visit with E.R. He accused Ms. Barksdale of "screwing with" C.R.'s life and committing "child abuse." He promised that "heads would roll" and disparaged E.R.'s family. Ms. Zapata then got on the telephone. She also accused Ms. Barksdale of child abuse and threatened to call the abuse hotline on Florida Baptist. Since no abuse reports were made by Petitioners, these threats were made as a bluff in an attempt to coerce Florida Baptist to leave C.R. with Petitioners. Given this conduct, the staff of Florida Baptist felt they had little choice but to remove C.R. from Petitioner's home. C.R. was removed from Petitioners' home on August 2, 2001. C.R. stayed in the other foster home without incident for about five weeks. C.R. and E.R. were then reunited, and continue to live together as a family. No reports of any problems between C.R. and E.R. have been received since that time. These facts clearly demonstrate Petitioners' unwillingness to cooperate in reunification plans for a child and mother. Petitioners permitted their low opinion regarding C.R.'s mother to interfere with their duty as foster parents. There was no evidence that Petitioners' attitude regarding the parents of foster children would not cause future interference in reunification efforts should their application for licensure be granted. An abused child, V.V., was placed in shelter care with Petitioners. V.V. had sustained a broken arm from abuse she had suffered. She stayed less than three days with Petitioners because her crying kept them up at night and interfered with Mrs. Zapata's home schooling of her biological children. Petitioners acted appropriately in requesting the removal of the child when it became apparent that the placement could not work out and does not demonstrate a lack of qualification for licensure. Finally, a pregnant teenage girl who wished to place her child with Florida Baptist wanted to see the home her child was to live in. Florida Baptist arranged for the girl to look at Petitioners' home. After the visit, Petitioners asked Florida Baptist never to ask them to submit to such an inspection, as they felt they were under some heightened level of scrutiny. Florida Baptist staff explained that parents frequently made this request, and Petitioners repeated that they did not wish to undergo it again. Petitioners request is troubling since one of the duties of the foster parent is to work with the biological parent of a foster child. Again, Petitioners' negative attitudes toward the parents of foster children demonstrate that Petitioners' application for licensure should be denied.
Recommendation Based on the foregoing Findings of Facts and Conclusions of Law, it is RECOMMENDED that the Department of Children and Family Services enter a final order denying the application for a foster care license submitted by Petitioners Alfonso and Lynda Zapata. DONE AND ENTERED this 15th day of April, 2003, in Tallahassee, Leon County, Florida. DIANE CLEAVINGER 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 15th day of March, 2003. COPIES FURNISHED: John R. Perry, Esquire Department of Children and Family Services 2639 North Monroe Street, Room 252-A Tallahassee, Florida 32399-2949 Alfonso Zapata Lynda Zapata 1947 Treeline Drive Tallahassee, Florida 32303 Paul F. Flounlacker, Agency Clerk Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204B Tallahassee, Florida 32399-0700 Josie Tomayo, General Counsel Department of Children and Family Services 1317 Winewood Boulevard Building 2, Room 204 Tallahassee, Florida 32399-0700
The Issue The issue to be resolved in this proceeding concerns whether the Respondent Marie Smith has committed an intentional or negligent act materially affecting the health or safety of children for whom she operated as a "medical foster care" parent or provider.
Findings Of Fact The Respondent, Marie Smith, was first licensed in 1992, as a foster care parent by the Department of Health and Rehabilitative Services, since re-named the Department of Children and Family Services. In 1996 she became a qualified medical foster parent, authorized to keep children with special medical problems. The Respondent received special training to become a medical foster parent from Children's Medical Services, a unit of the Department of Health, which oversees the progress of children placed in medical foster care. Some of the training the Respondent received concerned a child, T.B. It involved the use of the medication Flovent, which is used to treat asthma and other bronchial conditions. Flovent is dispensed in a small aerosol container and is administered by use of an inhaler. The training which the Respondent received includes the manner in which the person administering Flovent can ascertain when the container is empty and no longer usable. In connection with the Respondent's training as a medical foster parent, Ms. Smith was also instructed in the importance of giving all medications as prescribed and in how to document administration of medications. Through training and practice she learned to execute forms provided by Children's Medical Services (CMS) called treatment records and medication records, in which were logged each dose of medication given. Although not connected with her training as a foster parent, she also received ninety hours in classroom instruction which resulted in her being certified as a pharmacy technician by the State of Florida. On July 29, 1996, the child D.P. was born. D.P. and his twin brother were placed in Ms. Smith's foster home in October 1996. D.P. lived with Ms. Smith continuously until he was removed from the home in March 1999. In July 1998, D.P. was diagnosed as having bronchiolitis, a chronic inflammation of the bronchial passages of the lungs, later identified as asthma. In order to treat this condition he was prescribed Flovent. The purpose of the medication was to reduce the frequency of exacerbations or "asthma attacks." The medication was not designed to alleviate attacks already in progress, but to prevent future attacks. The medication is only effective if given as prescribed over an extended period of time. If Flovent is not administered as prescribed over a period of time the patient may suffer an increased incidence of asthma. The failure to take preventive steps can result in long-term damage to the lungs according to Dr. Bailey. Ms. Smith filled the first prescription for Flovent at Smith's Pharmacy on July 9, 1998. Only one container of Flovent was dispensed on that occasion. A container of Flovent contains an advertised one hundred and twenty (120) metered actuations or "puffs." The literature inserted into every package contains a warning to the user to use the number of actuations, one hundred and twenty, indicated on the box because the correct amount of medicine in each puff cannot be guaranteed after that point. D.P.'s prescription required him to receive two puffs per day, once in the morning and once in the evening. Since the label on the container itself stated that there were only one hundred and twenty puffs per canister, the first container was due to be replaced after sixty days of use at two puffs per day. Notwithstanding this fact, the prescription was not refilled until October 16, 1998, or ninety-eight days after the first container was obtained. Thus, for a period of thirty- eight days, D.P. either received no dose at all, or potentially received an inadequate dose of medicine. An actual test of a full canister of Flovent was conducted at the hearing. That revealed that one could get approximately one hundred and fifty- seven puffs from a canister before it is empty. However, the literature which comes with the medication makes it clear that a user cannot depend on the adequacy of the dosage after one hundred and twenty puffs. Thus, even if Ms. Smith could have dispensed one hundred and sixty puffs from a canister, and if she maintained that she was administering two puffs per day, she would have run out of the medication after no more than eighty days. Ninety-eight days elapsed however, between the filling of the prescription and the first refill which was obtained in October 1998. Even under Ms. Smith's description of the dosing and administering of the medication, D.P. either had to have gone without his medication for some days or was receiving a less-than-standard amount in order for the medication to last as long as she maintained it did (i.e., possibly one puff per day). Ms. Smith maintained that she actually obtained two packages of Flovent from the pharmacy rather than one on October 16, 1998. The pharmacy records, however, show only one container being dispensed both in July and in October. Those records were made contemporaneously with the receipt and filling of the prescription. The pharmacist and pharmacy technician each double-check the work of the other. Thus if Ms. Smith had obtained double the amount of medication, both the pharmacist and the pharmacy technician would have had to make the same error at the same time, which is improbable. Moreover, there is no label on the extra box taped to the box dispensed on October 16, 1998. It is not the practice of the Smith Pharmacy to tape such boxes together or to label only one box. In any event, on October 16, 1998, Ms. Smith got the prescription refilled. On that day she picked up one container of Flovent. The prescription had not changed at that point so D.P. was still supposed to receive two puffs per day, so the container should have been replaced after sixty days. In view of the fact that Ms. Smith was keeping T.B., another child at the same time she provided foster care for D.P., and since T.B. also had a prescription for Flovent, it has not been established that Ms. Smith could have only gotten an extra Flovent box from the pharmacy, with the boxes containing the two canisters taped together and dispensed together on October 16, 1998. She could have simply used T.B.'s prescription box. The prescription obtained on October 16, 1998, was not re-filled again until March 10, 1999. A period of one hundred and forty-five days had thus passed before a new container was obtained. The test performed at hearing showed that as much as one hundred and fifty-six to one hundred and sixty puffs are contained in such a canister and therefore the medication might have lasted the one hundred and forty-five days. However, if the manufacturer's warning or instruction on the literature supplied with the canister is to be believed, after one hundred and twenty puffs had been dispensed (a sixty-day supply) then less medication might be dispensed with each puff thereafter. Since one hundred and forty-five days elapsed before a new prescription and container of medicine was obtained, D.P. may have failed to received one hundred and seventy doses of medicine over a period of five months. This could clearly have resulted in a worsening of D.P.'s condition. Moreover, Ms. Smith incorrectly documented the administration of the Flovent as though she were in fact giving the medication twice per day as prescribed. See Petitioner's Exhibit No. 2 in evidence. The testimony of the witnesses employed with the CMS who oversee the care for children in medical foster care uniformly found that the Respondent provided good care and they never saw any evidence that medical care for the child D.P. was neglected. In fact, Dr. Samir Ebbeid, a pediatric cardiologist who treated the child from October 1996 through April of 1999, found that the Respondent uniformly complied with his instructions about care for the child and thought that the care of the child by the Respondent between the visits to his office was appropriate. In fact he found that the child improved while under the Respondent's care and that there was no reason to believe that the child's medical care under the care of Ms. Smith, the Respondent, was ever neglected. The child's asthmatic condition actually improved during the time he was under the Respondent's medical foster care.
Recommendation Having considered the foregoing Findings of Fact, Conclusions of Law, the evidence of record, the candor and demeanor of the witnesses, and the pleadings and arguments of the parties, it is, therefore, RECOMMENDED: That a final order be entered by the Department of Children and Family Services suspending the foster care license of Marie Smith for a period of ninety days, during which time she should undertake an approved course of instruction concerning the proper administration and record-keeping of administration of prescription drugs for children in her care. DONE AND ENTERED this 15th day of March, 2000, in Tallahassee, Leon County, Florida. P. MICHAEL RUFF 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 15th day of March, 2000. COPIES FURNISHED: John R. Perry, Esquire Department of Children and Family Services Room 252-A 2639 North Monroe Street Tallahassee, Florida 32399-2949 Richard D. Ogburn, Esquire Post Office Box 923 Panama City, Florida 32402 Samuel C. Chavers, Acting Agency Clerk Department of Children and Family Services Building 2, Room 204B 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 John S. Slye, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
The Issue Did Respondent violate Section 409.175(8)(b)1, Florida Statutes, or Rule 65C-13.011(d) and (f)1, Florida Administrative Code, and, if so, should Respondent's license as a foster home be revoked?
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant findings of fact are made: At times pertinent to this proceeding, Respondent was licensed as a foster home, having been issued such license on October 23, 1997. The Department is the agency of the state charged with the responsibility and duty to carry out and enforce the provisions of Chapter 409, Florida Statutes. Respondent received the Department's Model Approach to Partnership Parenting (MAPP) training to become a foster parent between September 1995 and December 1995. The Department provides MAPP training to teach persons how to become foster parents. The MAPP training that Respondent received included instructions concerning appropriate sleeping arrangements, namely that an adult should not sleep in the same bed with a foster child. Respondent agreed that the MAPP training was very useful and that he gained insight from that training on how to be a foster parent. Respondent received his foster care license on October 23, 1997, and the Department placed its first foster child with Respondent in January 1998. Foster child D.D., born October 23, 1985, was placed with Respondent by the Department January 20, 1998, and stayed with Respondent until March 12, 1998, when he was removed by the Department. Foster child E.T., born December 12, 1984, was placed with Respondent on January 12, 1998, and stayed with Respondent until January 21, 1998, when he was removed by the Department. E.T. was again placed by the Department with Respondent on January 23, 1998, and stayed with Respondent until March 12, 1998, when he was removed by the Department. Foster child R.M., born October 10, 1984, was placed with Respondent by the Department on March 2, 1998, and stayed with Respondent until March 9, 1998, when he was removed by the Department due to an alleged incident between R.M. and E.T. which occurred on March 9, 1998. The incident resulted in the Department's conducting an investigation concerning an alleged abuse on the foster child, E.T. by the foster child, R.M.. It appears from the record that the allegations were unfounded. In any event, R.M. was removed from Respondent's foster home on March 9, 1998, because his record indicated that in an earlier incident R.M. had sexually victimized another child (not E.T.). Also, because E.T. had been sexually victimized by another child (not R.M.) previous to being placed in Respondent's care the Department decided to remove E.T. from Respondent's home. It should be noted that the Department was aware of these prior incidents concerning R.M. and E.T. and the sleeping arrangements at Respondent's foster home at the time these foster children were placed with Respondent by the Department. Foster children, B.B. and C.L., dates of birth not in evidence, were placed with the Respondent by the Department on February 24, 1998, and stayed with Respondent until February 25, 1998, when they were removed by the Department. During the investigation concerning the alleged abuse incident involving R.M. and E.T. and at the hearing, Respondent admitted to sleeping in the same bed as E.T. and D.D. Respondent testified that on at least five occasions E.T. had slept in the same bed as Respondent. The facts surrounding this sleeping arrangement was that E.T. was suffering from an upper respiratory problem and would go to sleep on Respondent's bed before Respondent, who stayed up late reading, was ready for bed. As a result Respondent would sleep with E.T. to keep from waking him. There was no allegation, and certainly no evidence, that Respondent sexually or otherwise molested E.T. at any time. Respondent also admitted to sleeping in the same bed as D.D. on one occasion. Again, there was no allegation, and certainly no evidence, that Respondent sexually or otherwise molested D.D. At the time the Respondent applied for and was granted a foster home license and during the intervening time, the Department's personnel who worked with Respondent were well aware of the lack of sleeping spaces in Respondent's home. In fact, one of the Department's employees upon being advised of Respondent's sleeping arrangements commented that "it was better than sleeping on the floor at HRS." Upon being advised of the restriction on adults sleeping with foster children, the Respondent did not at first fully understand the risk of harm to the children. However, after being reminded of his MAPP training and the risk of harm to children in such a sleeping arrangement, Respondent realized his mistake in allowing such sleeping arrangements. Under Respondent's tutelage, E.T. and D.D. thrived academically and have continued to thrive since they left Respondent's home. The Department had some concern that Respondent's son was living in the home and that it had not been made aware of that circumstance. However, the Department knew, when Respondent's license was issued, that his son was living in the home.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law and the mitigating circumstances, it is recommended that the Department enter a final order suspending Respondent's foster home license for a period of one year, staying the suspension and imposing such reasonable conditions as the Department deems necessary to further educate Respondent as to his responsibilities as a foster parent. DONE AND ENTERED this 26th of July, 1999, in Tallahassee, Leon County, Florida. WILLIAM R. CAVE 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 26th day of July, 1999. COPIES FURNISHED: Jack E. Farley, Esquire Department of Children and Family Services 4720 Old Highway 37 Lakeland, Florida 33813-2030 Thomas D. Wilson, Esquire Law Office of Gregory Ruster 1525 South Florida Avenue Suite 3 Lakeland, Florida 33803 Gregory D. Venz. Agency Clerk Department of Children and Family Services 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 John S. Slye, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
The Issue Should Petitioners' application for family foster home license be granted?
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant findings are made: The Department is the agency in the State of Florida responsible for the licensure of family foster homes. Linda Patterson and Robert Patterson (Pattersons), a married couple, applied for licensure as a family foster home. The Pattersons completed the initial training for prospective foster parents in March of 1995. The Department completed a home study on the Pattersons. The results of the home study and background information on the Pattersons, including the Pattersons tenure as foster parents in Connecticut, were considered by the Department before denying the Pattersons' application for licensure as a family foster home for children. On August 24, 1994, the Department issued Notice Of Denial to the Patterson which in pertinent part provides: This letter provides notice to you that your application for a family foster home license is denied, based on Section 409.175(8)(a), Florida Statutes, and Rule 10M-6.023, Florida Administrative Code (FAC). The reasons for this denial are: Mr. Patterson has been charged with numerous law violations in the past. Although none of the law violations auto- matically disqualifies him from fostering, they do reflect a lack of judgment needed to provide adequate care for foster children, indicating an inability to comply with Rule 10-6.023(e). Your home was investigated in August of 1992 because of allegations of sexual abuse on your 18 year old adopted daughter. You admitted inappropriate contact with this child. As a result of this investigation your license was limited, and your home was approved only for males, ages 5 to 11. In April of 1993, your marital coun- selor stated that you have difficulty setting limits with sexuality, and recommended against the placement of any child with a known history of sexual acting out, or approaching puberty. This recommendation was made shortly after an incident of child on child sexual abuse in your home. In September of 1993, a clinical psychologist evaluated you. He stated that Mr. Patterson's ability to control his impulses is "probably" satisfactory, but should not be tested with sexually active adolescent females. He also opined that your family might have some difficulty dealing with sexually abused and acting out children without professional guidance. All of these incidents indicate an inability to comply with Rule 10M-6.023(1)(e), particularly in view of the fact that approxi- mately 85 percent of our foster children fall into the categories of children that should not be placed with Mr. Patterson. Robert Patterson admitted to several law violation between 1960 and 1980. However, most of these violations were misdemeanors and committed while he was a juvenile. There was one felony violation (car theft) by Robert Patterson while he was a juvenile. Robert Patterson admitted that in 1980 he was charged with larceny concerning an alleged fraudulent claim for unemployment compensation to which he pled nolo contendere. Notwithstanding that he pled nolo contendere to the charge, Robert Patterson contended that the unemployment compensation claim was a legal claim. There was no evidence of any further law violations after the nolo contendere plea in 1980. The Pattersons were licensed in Connecticut as foster parents for approximately 10 years. During the time the Pattersons were licensed as a foster home in Connecticut the Patterson home was investigated because of a complaint alleging sexual abuse of a female foster child in the Pattersons' home. Although there was no finding of sexual abuse of this female, Robert Patterson admitted to having unintentionally touched the female's breast and buttocks while they were wrestling. There was another incident where this same female foster child, while inebriated, rubbed Robert Patterson' penis several times. Robert Patterson testified that he felt sexually attracted to this female child, but that he never acted on those feelings. The female child that was the subject of the abuse complaint was not removed from the Pattersons' home, and subsequently the State of Connecticut allowed the Pattersons to adopt this child. After this investigation, the Pattersons requested that their foster care home license be limited to males, ages 5 years to 11 years. This limitation on placement was requested by the Patterson because they felt inadequate to cope with sexually acting out or sexually abused children. The Paterson's marriage counselor in Connecticut advised the Connecticut DCF (the equivalent of Florida DHRS) that the Pattersons had difficulty setting limits with sexuality, and recommended against placement of any child in the Pattersons' home with a known history of sexual acting out, or approaching puberty. Many foster children are victims of sexual abuse and sexual exploitation which causes these foster children to behavior inappropriately. Often the Department is unaware of prior abuse or the resultant behavior when a child is placed in a foster home. A foster parent's ability to deal appropriately with sexually abused and sexually acting out children is a very important attribute, particularly given the number of children in foster care with these difficulties. The Pattersons requested to be licensed for placement of males only, ages 5 years to 11 years. The Department has licensed foster homes with age and sex restrictions on placements. However, the Department attempts to avoid licensing homes with such restrictions. Such restrictions on placement interfere with the Department's statutory duty to keep siblings together, and with the goal of attempting to avoid moving children from foster home to foster home.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law it is recommended that the Department of Health and Rehabilitative Services enter a final order denying the Petitioners licensure as a family foster home. RECOMMENDED this 23rd day of September, 1996, at Tallahassee, Florida. WILLIAM R. CAVE, 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 23rd day of September, 1996. APPENDIX TO RECOMMENDED ORDER CASE NO. 96-1567 The following constitutes my specific rulings, pursuant to Section 120.59(2), Florida Statutes, on all of the proposed findings of fact submitted by the Department in this case. Petitioners' Proposed Findings of Fact. Petitioners elected not to file any proposed findings of fact and conclusions of law. Department's Proposed Findings of Fact. 1. Proposed findings of fact 1 - 19 are adopted in substance as modified in Findings of Fact 1 through 19. COPIES FURNISHED: Gregory D. Venz, Agency Clerk Department of Health and Rehabilitative Services 1317 Winewood Blvd., Bldg. 2, Room 204X Tallahassee, Florida 32399-0700 Richard Doran, General Counsel Department of Health and Rehabilitative Services 1317 Winewood Blvd., Room 201 Tallahassee, Florida 32399-07001 Robert and Linda Patterson 8653 Indian Ridge Way Lakeland, Florida 33809 M. Elizabeth Wall, Esquire Department of Health and Rehabilitative Services 200 North Kentucky Avenue Lakeland, Florida 33801
