The Issue The issue in this case is whether the Respondents' application for re-licensure of their therapeutic foster home should be approved.
Findings Of Fact The Respondents have operated a licensed foster home since 1994 and have operated a therapeutic foster home since 2011. The Respondents' foster home was originally licensed under the supervision of Lee County Mental Health Center, which was the local agency responsible for placing children in the home. In 2009, responsibility for supervision of the home was transferred to "Florida MENTOR" (MENTOR), which also assumed the responsibility for placement of children in the home. The children placed in the Respondents' foster home have been between eight and 11 years of age. Children placed in therapeutic foster homes have significant special needs and can be emotionally unstable. A safe and supportive therapeutic environment is required for their protection. The Respondents' license was valid through September 30, 2011. On August 3, 2011, the Respondents applied for renewal of the license. Florida Administrative Code Rule 65C-13.027 requires that changes in a licensee's household composition or employment be reported within 48 hours of the event. When the application was filed, the Respondents disclosed that their adult daughter and her three children had been residing with them for approximately three weeks. Prior to the application, the Respondents had not advised MENTOR that there had been any change in household composition. Mr. Williams became unemployed in December 2010, but the Respondents failed to report the change in the employment prior to filing the application. MENTOR was concerned about the financial stability of the household due to additional residents in the home and the reduction in income related to the loss of Mr. Williams' employment. An applicant for re-licensure of a foster home is required to submit financial information sufficient to establish that the applicant has the resources required to provide a stable household and meet basic expenses. The financial information initially submitted by the Respondents with the application for re-licensure was incomplete and did not appear to be an accurate reflection of household expenses. Attempts by MENTOR to obtain additional information were resisted by Ms. Williams. MENTOR eventually determined that, although the household had sufficient income to support their own expenses, placement of a foster child into the Respondents' home would cause a financial hardship for the family. Foster parents are permitted, with approval of the supervising agency, to add payments received to board a foster child to their income calculation, but the Respondents have not obtained such approval. By the time of the hearing, the Williams' adult daughter and her children no longer resided in the home, but Mr. Williams remained unemployed and was selling scrap metal to obtain income. At the hearing, he testified that his scrap metal income had been declining as more unemployed people began to collect and resell scrap. In September 2011, MENTOR completed the re-licensing study, a 24-page document that outlines the history of the foster home, including abuse reports and licensing deficiencies, and the efforts of the licensee to correct such issues. Rule 65C-13.028(3)(i)2. requires that the re-licensing study include documentation related to the level of cooperation by the licensee with the case plans developed for the child placed in the foster home. The re-licensing study documented MENTOR's concerns about the physical safety of children residing in the home and the Respondents' willingness and ability to provide appropriate support to therapeutic foster children placed in the home. During a significant period in 2011, the Respondents maintained a collection of junk metal and other debris in the yard of the foster home. The junk was apparently being collected by Mr. Williams for sale to scrap dealers. Jodi Koch, a MENTOR therapist who was assigned to work with the children in the Respondents' home, testified at the hearing about her observations of conditions in the home and about her interactions with the Respondents. In November 2010, Ms. Koch observed a child begin to play with a rusty machete that the child discovered in the Respondents' yard, and she so advised Ms. Williams, who expressed her displeasure that Ms. Koch had exceeded her authority as a therapist. Ms. Koch reported her observation to MENTOR personnel. MENTOR officials, including the program director and re-licensing coordinator, discussed the unsafe conditions of the property with the Respondents. Suggestions that the Respondents relocate the debris or otherwise prevent access by children to the debris were initially ignored by the Respondents. On May 2, 2011, MENTOR issued a Written Notice of Violation (Notice) to the Respondents, documenting the hazardous conditions of the property. The Notice was hand-delivered on May 5, 2011, at which time the Respondents refused to read or sign the paper. On May 6, 2011, the Lee County Code Enforcement Authority issued a nuisance citation against the Respondents for the accumulation of junk and debris on their property. The violation was cured on May 13, 2011, but, on June 1, 2011, the Lee County Code Enforcement Authority issued a second nuisance citation for the same violation. That violation was not resolved until November 2011, after the Lee County Code Enforcement Authority had prosecuted the violation through a hearing, and more than a year after Ms. Koch observed the child with the machete. At the hearing, Ms. Williams asserted that Ms. Koch was a therapist and that she had exceeded her authority by reporting the observations of the property to the MENTOR officials, essentially the same position Ms. Williams asserted in 2011 when Ms. Koch reported the situation to MENTOR. The MENTOR re-licensing study also documented the failure of the Respondents to cooperate in therapeutic plans developed for the children placed in the home and to supervise the children properly. Ms. Williams often refused to cooperate with the therapeutic plans and goals Ms. Koch developed for the children in the Respondents' foster home. Ms. Williams apparently concluded that she was better able to address the needs of a therapeutic foster child than was Ms. Koch, but the evidence failed to support such a conclusion. Ms. Williams refused to implement standard behavioral therapies suggested by Ms. Koch and opined that they were a "waste of her time." Ms. Williams refused to allow one foster child to have toys purchased for the child by Ms. Koch. Ms. Williams claimed that the child would have destroyed the toys, but Ms. Koch testified they had been purchased to allow the child to have her own possessions for the first time in the child's life and to develop a sense of responsibility. The Respondents routinely put children to bed at an early hour as a means of discipline and refused to comply with Ms. Koch's direction to develop other disciplinary practices. In one discussion with Ms. Koch at the home, Ms. Williams discussed the circumstances of one foster child in the presence of another foster child, violating the confidentiality of the children. The Respondents failed to contact MENTOR staff to address behavioral issues exhibited by children placed in the home and instead called upon law enforcement authorities to respond when a child refused to comply with their directions. The Respondents failed to supervise one child placed in their home sufficiently to prevent the child from accessing pay- per-view pornography on cable television, resulting in a charge in excess of $700 on one bill. It was clear, based on Ms. Williams' testimony and demeanor at the hearing, that Ms. Williams disliked Ms. Koch. Much of Ms. Williams' presentation of evidence during the February 17 portion of the hearing was directed towards discrediting MENTOR and Ms. Koch. After completing the re-licensing study, MENTOR forwarded the application and study to the Department, which received the materials on October 5, 2011. Notwithstanding the continuing problems between MENTOR and the Respondents, MENTOR recommended in the study that the Respondents' home be conditionally re-licensed. The conditions, essentially intended to increase the possibility that the Department would approve the application for re-licensure, were as follows: Reduction in the licensed capacity from two therapeutic individuals to one therapeutic individual. Unannounced visits to monitor the home in terms of food content, refrigerator temperature, client supervision and safety concerns. Continuing monitoring of the foster parents ability to work in conjunction with service providers regarding the best interests of the child. Monitoring to ensure that the living situation of the additional four residents was resolved within six months. Ms. Williams was dissatisfied with the results of the study, disagreed with the proposed conditions, and refused to accept them. While MENTOR (as the supervising agency) was responsible for the evaluation of the application, the Department has the responsibility for the making the final determination regarding licensure or re-licensure of a foster home. The Department considered the MENTOR recommendation when making the licensing decision. The primary focus of the Department's decision was whether the Respondents could provide an appropriate and safe environment for a therapeutic foster placement. The Department has no financial interest in the decision and had no direct contact with the Respondents. As the regional licensing manager for the Department, Kristine Emden was tasked with the responsibility of reviewing the application and materials. Based on her review, Ms. Emden determined that the application should be denied. Ms. Emden based her decision on the Respondents' lack of cooperation with therapeutic programs developed for the children in their care, their failure to supervise children adequately or to maintain confidentiality regarding the children, and their lack of cooperation with the MENTOR personnel who attempted to resolve the identified deficiencies. Additionally, Ms. Emden considered the Respondents' response to issues related to the hazardous conditions of the premises, the lack of financial resources to support a therapeutic foster placement in the home, and the rejection of conditions proposed by MENTOR in the study. Ms. Emden was unable to identify any remedial measures that would alter the denial of the application for re-licensure. The Respondents failed to offer credible evidence to establish that the Department's denial of the application was incorrect or that the application should otherwise be approved.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Children and Families enter a final order denying the license application filed by the Respondents at issue in this proceeding. DONE AND ENTERED this 19th day of July, 2012, 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 19th day of July, 2012.
The Issue Whether the Department of Children and Family Services (DCF) may revoke Respondent's family foster care license due to her continued contact with her husband after he was convicted of sexual molestation of their teen-aged daughter.
Findings Of Fact Lila and Charles Dean were licensed foster parents from 1986 through 1991, when they adopted their daughter who was then six years old. The couple subsequently had two natural daughters. In January 2001, the 16-year-old adopted daughter reported that Charles Dean had been sexually abusing her for approximately two years. Lila Dean immediately had Charles Dean move out of the family home. She has been consistently supportive of their daughter and went with her through the whole abuse and rehabilitation system. Charles Dean was convicted in 2001 of sexually abusing his adopted daughter and is a registered sex offender. Lila Dean has been separated from Charles Dean since January 2001, but she has not filed for divorce. On March 13, 2002, Lila Dean was relicensed by DCF as a family foster parent. George Payne, DCF Family Counselor III, testified that during the family foster home re-licensing process prior to March 13, 2002, Lila Dean admitted to him that she was seeing her husband away from the home once every two or three months to discuss child support, insurance, etc., and that he had no contact with the children. She also admitted that with the permission of his probation officer, Charles Dean had come to the home, while the children were at school, to make needed repairs. At Mr. Payne's urging, she promised to get someone else to make any future repairs. The licensing process took eleven months because of DCF's concerns about Mrs. Dean's contacts with her husband, but DCF licensed her individually on March 13, 2002, because of her previous excellent record as a foster parent in another district supervised by Mr. Payne from 1985 to 1989. On May 13, 2002, upon receiving an abuse report that Mrs. Dean had been having regular contacts with her husband; that Mrs. Dean had made comments in the community that Mr. Dean's sexual abuse was not that serious because the girl was his adopted, not his biological child; and that Mrs. Dean had spoken on Mr. Dean's behalf requesting that he be spared a prison sentence, DCF removed the two non-verbal, toddler, foster children who were then in Mrs. Dean's foster care and instituted a further abuse investigation. After the abuse report had been received regarding Mrs. Dean's 2002 contacts with her husband, she told Mr. Payne that she was not looking for a relationship with any other men because they might want a sexual relationship with her, but that sex was not an issue with her husband, so she felt comfortable with him. The abuse report, which related the couple's more frequent contacts, suggests the family is "working toward reconciliation," something Mrs. Dean has denied to Mr. Payne. The abuse report verifies the old abuse information as to the adopted daughter. It does not verify the tipster's allegation that Mrs. Dean does not view Mr. Dean's molestation of their adopted daughter as less serious than it would have been with a natural daughter. There is no direct testimony or otherwise reliable evidence on this issue, on the issue of whether or not she has spoken publicly on his behalf, or on the issue of whether or not a reconciliation is anticipated. There is no evidence that Charles Dean has been in the home since Lila Dean was relicensed. DCF sent a license revocation letter to Mrs. Dean after becoming aware of the increasing frequency of her contacts with her husband. The basis for revocation was given as: . . . pursuant to Section 409.175(8)(b)3. [now Section 409.175(9)(b)3] Florida Statutes, because your continued and repeated contacts with Charles Dean are inconsistent and incompatible with your role as a foster parent. It is not in the best interests of vulnerable foster children to be placed with a foster parent who considers it appropriate to have a relationship with a registered sex offender. [Clarification of statutory citation agreed-to and supplied]. Mr. Payne was unaware of any DCF rules Mrs. Dean broke by having contact with her husband. Mr. Payne has no indication that any children, natural or foster, were at greater risk post-licensing than pre- licensing due to Mr. And Mrs. Dean's increased contact. DCF cannot constantly monitor a foster parent to ensure that the children in her care are not placed at risk by her personal associations.
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 reinstating the family foster home license of Lila Dean and specifically limiting any appearance on the foster home premises by Charles Dean. DONE AND ENTERED this 17th day of January, 2003, in Tallahassee, Leon County, Florida. ELLA JANE P. 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 17th day of January, 2003. COPIES FURNISHED: Lucy Goddard, Esquire Department of Children and Family Services Post Office Box 390, Mail Stop 3 Gainesville, Florida 32602 Robert Vest, Esquire 613 St. Johns Avenue Suite 212 Post Office Box 2525 Palatka, Florida 32177 Paul F. Flounlacker, Jr., 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 Whether denial of Respondent's re-licensure application as a Foster Care Home for the reasons stated in the Department's denial letter of October 30, 2000, was appropriate.
Findings Of Fact Based upon observation of the witnesses and their demeanor while testifying, the documentary materials received in evidence and the entire record complied herein, the following relevant facts are found: Under Section 409.175, Florida Statutes (2001), the Department of Children and Family Services is the State Agency responsible for evaluating, qualifying, licensing, and regulating family foster care homes. Petitioner, a single male, previously employed with an abused children agency in Broward County, Florida, was granted a foster care parent license by the DCF's Foster Care Licensing unit effective August 10, 1999, through November 10, 1999. A second child specific foster home license for G.K. was issued to Petitioner, effective from March 3, 2000, through August 10, 2000. DCF takes the position that Petitioner is not eligible for re-licensure as a family foster home primarily because he exhibited "poor judgment" relative to a single medical treatment, taking the temperature of an eleven-year-old male foster child through his rectum during the month of August 2000. DCF further alleges that Petitioner has willfully violated specific statutes and rules relating to the conduct and maintenance of the foster home. Those alleged violations are specified in the licensure denial letter dated October 30, 2000, from the DCF to Petitioner. Nicara Daniels is a foster care licensing unit worker with the DCF since November 1999. Ms. Daniels had on-the-job- training and some Professional Development Center Training for new employees. In the licensing unit, Ms. Daniels had training in physical abuse, sexual abuse, drug abuse, and emotional abuse toward children. The DCF used Ms. Daniels to provide testimony regarding each violation as they appeared in the letter of denial. Herein below the allegations are chronologically addressed. Medication and cooking wines in Petitioner's bathroom. On or about July 31, 2000, a period when Petitioner was licensed, Ms. Daniels, Child Protection Investigator assigned Petitioner, made an unannounced visit to Petitioner's home during a period when Petitioner was medicating himself. During her walk through Petitioner's bedroom she entered his bathroom and saw Petitioner's medication for his diabetes on the bathroom shelf along with several bottles of cooking wines. Ms. Daniels acknowledged that she observed the cooking wines in the bathroom. Along with bottles of medication she also observed the lock box in which Petitioner kept his medications and cooking wines when not in use. The door to Petitioner's bedroom and bathroom each had operative locks on them. Ms. Daniels knew that Petitioner took medication for his diabetic condition prior to this inspection and she acknowledged having no experience with the use of cooking wines. Rule 65C-13.011(14)(a) and (b), Florida Administrative Code, requires all medication, poisonous chemicals, and cleaning materials to be in a locked place and inaccessible to children, and that alcoholic beverages should be stored out of the reach of small children; with the recommendation that these beverages be kept in a locked place. Ms. Daniels admitted that for the children, all of whom were 11 years or older, to have access to the medication or cooking wines, they must enter the bedroom, go into the bathroom and open the lock box. There is no evidence presented of any foster care child having access to Petitioner's bedroom, bathroom or the locked medicine box at any time. In making the foregoing finding, I have considered Ms. Daniel's testimony that she knew Petitioner was on medication. Ms. Daniels, however, never questioned the children whether they entered or attempted to enter Petitioner's bedroom at any time when he was not present. I find the mere presence of medications and cooking wines in Petitioner's bathroom, absent other evidence, is not a violation of the cited rule. John Snider in Petitioner's Foster Care home. Ms. Daniels testified that during an early morning visit on an unspecified date in July of 2000, she observed a young man, John Snider, in Petitioner's home. After she advised Mr. Snider had to be screened, Petitioner followed the DCF's process and a screening application for Mr. Snider was submitted to the Department. The Department screened and cleared Mr. Snider and advised Petitioner and Mr. Snider by letter on August 21, 2000. Rule 65C-13.010(4)(g), Florida Administrative Code, requires that the foster care parent notify the department of the presence of such person. Rule 65C-13.007(1), Florida Administrative Code, requires screening for "all persons that provide respite care in the . . . home on an overnight basis must be screened." Rule 65C-13.009(6)(a)5., Florida Administrative Code, requires a criminal records check for "all persons 18 years and older residing in the . . . home." Petitioner, during a telephone conversation with Ms. Daniels on July 31, 2000, informed her that Broward Juvenile Justice placed Mr. Snider in his home on July 27, 2000. It is Ms. Daniels' opinion that a four-day period between entry and notifying DCF is not reasonable notification. This "unreasonable" delay formed the basis for violation of the cited rule, notwithstanding the particular circumstances. Rule 65C-13.007(1), Florida Administrative Code, which requires "all persons that provide respite care . . . must be screened.” I find Ms. Daniels' opinion that four days is not "reasonable" notification not based upon any protocol, policy or rule of the DCF. In making the foregoing finding, I have considered the following. Petitioner informed Ms. Daniels by telephone that there were matters to discuss; however, the discussion took place four days later when Ms. Daniels was available. The Department of Juvenile Justice for Broward County placed Mr. Snider in Petitioner's home. After submitting an application, Mr. Snider was screened and cleared by the DCF. Considering the evidence as a whole, I find Mr. Snider's presence in Petitioner's home, under authority of the Broward County Juvenile Justice unit, and with telephonic notice to the DCF's licensing unit worker four days after entry into the home is not unreasonable, under the circumstances. Home Department's placing of T.J. in Petitioner's Foster Sometime during the first week of August 2000, Robert Mistretta, Department's child protection investigator and T.J.'s initial case worker, removed T.J. from his family and sought overnight foster care for him. Mr. Mistretta, aware of T.J.'s family situation, his medical, physical, emotional, and sexually abusive history sought a foster care home with those factors in mind. The Department's placement unit instructed him to take T.J. to Petitioner's home for an overnight stay. Mr. Mistretta took T.J. to Petitioner's home with the intention of an overnight stay and reassessment of the situation the following morning. After discussion with Petitioner of T.J.'s need for an overnight stay, Petitioner agreed. Mr. Mistretta chose not to provide Petitioner with information regarding T.J.'s medical, social, physical, emotional, or abusive family history. However, Mistretta gave Petitioner the DCF's emergency pager phone number [570-3081] for use during non-working hours and for emergencies should the need arise. Rectal Temperature Taking What had begun as an overnight stay resulted in a permanent placement and on or about August 6 or 7, 2000, T.J. became ill. His illness began during the day and continuing into the night. According to Petitioner, T.J. exhibited symptoms of a cold or flu, including fever, chills and headache. During the night, he was restless, tossing and turning in his sleep. Petitioner, having no medical history on T.J., became concerned about T.J.'s condition. He made several calls to the Department's emergency pager number [570-3081] provided him by Bob Mistretta, without success. Petitioner then attempted to contact Dr. Stuart Grant, a pediatrician, to no avail. Petitioner thereafter attempted to use his MAPP training first aid guide provided by the Department, but found those instructions unclear. Petitioner then sought information concerning fever and temperature taking from the internet. During the night while T.J. was asleep, Petitioner used a rectal thermometer to take T.J.'s temperature, causing him to awaken suddenly, somewhat startled. Petitioner talked with T.J., explained his concerns with his condition and the reason for taking T.J.'s temperature in that fashion. T.J. responded in a positive manner and went back to sleep. The following morning, Petitioner contacted Mistretta and explained what had happened with T.J. the night before. Mistretta took T.J. aside and privately inquired if he understood "good" touching from and "bad" touching. T.J. stated he understood the difference. When asked about Petitioner's manner of touching him while taking his temperature during the night, T.J. affirmed that Petitioner's touching was a "good" touch and not a "bad" touch. Mistretta, based upon his experience working with children who had suffered abuse, accepted T.J.'s response as true. Satisfied that no "bad" touching occurred during the rectal temperature taking process, Mistretta reported the incident to his supervisor, including his conclusion that nothing sexually or abusive had occurred and concluded his report in part as follows: "This case is closed with no indicators. There is no maltreatment that addressed a bad choice of judgment by a caretaker. There are licensing [unit] concerns regarding Mr. Marlowe's choice to use a rectal thermometer on an 11 year old child." (Emphasis Added) Mr. Mistretta testified that his understanding of the sequence of events the night T.J. was ill were: T.J. was running a high fever and had trouble falling asleep. Petitioner tried cold cloths to reduce the fever that, according to Petitioner's monitoring, was getting too high. Since T.J. was having trouble sleeping and once he did sleep, Petitioner thought a rectal thermometer would be best to try not to awaken him, Petitioner chose to use that form of temperature taking. T.J. reacted with a little bit of pain. Based on Petitioner's history of dealing with sexually abused kids, that reaction is not normal. When Petitioner talked with him about what happened, T.J. disclosed his history to Petitioner. In the process of making the decision as to the appropriate treatment, Petitioner consulted with a Johnson and Johnson book and several medical web sites. The documents from the medical web sites were subsequently provided by Petitioner. I find Mr. Mistretta's testimony credible regarding his conversation with Petitioner immediately after the T.J.'s incident. Following the above, Ms. Mistretta, in addition to his duty as T.J.'s caseworker, was also assigned by his supervisor to investigate a hotline abuse report. Mr. Mistretta investigated the alleged abuse narrative report and found no indication of maltreatment. He recommended the hotline abuse report be closed. Upon being presented with the hotline abuse report narrative with suggestions and allegations of sexual abuse, Mr. Mistretta testified: "The information generated in this narrative in the reporter page that has reporter information states that the CPI, Robert Mistretta, told reporter about allegations. So the source of this report is me. The reporters made their own clarifications, answered their own questions regarding some things instead of calling me back to clarity, talked amongst themselves, found out that they didn't like what happened, and some of the narrative is not true. It is blown out of the water, if you would. The narrative was started by a report. When Mr. Marlowe talked to me, I talked to somebody who talked to somebody, who talked to somebody. The next thing you know we have sexual abuse. The narrative is not true. I did not agree with the removal of T.J. (Emphasis Added) I find Mr. Mistretta's testimony on this issue to be consistent and credible. In making the foregoing finding, I have considered the testimony of the DCF's other witnesses, none of whom had personal knowledge of the abuse report contents. However, Mr. Mistretta is the only witness with personal knowledge of events acquired in his positions as T.J.'s initial caseworker, his placement agent, the interviewer of T.J. and Petitioner, and the originator of the initial report. I have considered the fact that this incident occurred during the week of August 6-12, 2000. Petitioner's license expired on August 10, 2000. However, the DCF did not remove T.J. from Petitioner's home until September 6, 2000, almost a month later. I have also considered Ms. Daniels' testimony that during Petitioner's unlicensed period, DCF's placement unit continued to place children in Petitioner's home. I have also considered the deposition of Dr. Patricia Buck, M.D., pediatrician and Child Protection Team member for District 14 [Polk, Highland and Hardee counties], who was qualified as an expert in pediatrics and child abuse. After her review of documents provided by DCF and given the circumstances by DCF's counsel and Petitioner, Dr. Buck opined that use of a rectal thermometer would not have been her recommendation, had she been the care provider. According to Dr. Buck, anal temperature taking as a medical procedure is not abuse. Adding that the more medical history one has on a patient, the less likely a mistake in patient treatment. The evidence as a whole, including Mistretta's testimony and Dr. Buck's opinion, is persuasive as it relates to the issue of the circumstances and the "appropriateness" of the rectal temperature taking procedure. Accordingly, the testimony of Ms. Daniels, the licensing unit informs placement and other Department units of those parents who were licensed, parents who were not licensed or parents whose licenses had expired. She recalled attending the staffing meeting regarding the T.J. temperature incident and recalled informing staff that Petitioner was not a licensed foster care home after August 10, 2000. According to Ms. Daniels, placing children in a non-licensed home is not permissible. However, its her testimony that in this case, DCF's placement unit placed children in Petitioner's home during a period of time he was not licensed, and during the time T.J. was in Petitioner's home because of [DCF] "it being in a crisis situation with the number of homes we had." In making this finding, I have considered both the DCF's need for foster care beds and its concern for the safety of foster care children. I have also considered the DCF's use of Petitioner's home when they were "in a crisis situation with the number of homes we had." Screening of Ms. Scott Regarding the screening of Ms. Scott, Ms. Daniels testified Petitioner informed her that the screening application papers for Ms. Scott were submitted to the Department and had apparently come up missing. Ms. Daniels acknowledged that she had no evidence to support her conclusion that Ms. Scott was a respite sitter for Petitioner's foster care children; that she had never checked with the DCF to ascertain whether or not Ms. Scott had been screened. Not inquiring whether Ms. Scott had been screened renders Ms. Daniels' testimony questionable. I find Ms. Daniel's testimony regarding Petitioner's failure to provide the Department with Ms. Scott's application for screening not credible. Unwillingness to Provide Information on Mary Poe At some unspecified date, Ms. Daniels recalled she had a conversation with Petitioner regarding his next door neighbor, Ms. Poe, someone who would "check" on the foster children from time to time when Petitioner was late returning from work. Ms. Daniels did not recall if Ms. Poe entered Petitioner's home or gave the key to the children to enter in the home on days he was late returning from work. Ms. Daniels recalled only that, Petitioner's attitude regarding screening Ms. Poe was "uncooperative" and "defiant." During cross-examination Ms. Daniels could not recall the conversation with Petitioner when she was informed that Petitioner's condominium covenants required the manager to have a key to his apartment in case of emergencies. She did recall that Petitioner told her Ms. Poe was the mother of the condominium manager. Ms. Daniels recalled when she voiced concern with the situation Petitioner retrieved his key from Ms. Poe and returned it to the condominium manager for pick up by the children when they returned from school. I find Ms. Daniel's testimony regarding Petitioner's unwillingness to provide information concerning Mary Poe evasive, inconsistent and not credible. In making the foregone finding, I have considered Ms. Daniel's inability to recall facts, dates, times, places, regarding the matter to which she testified. I have considered the fact that Petitioner, when Ms. Daniels voiced concern, corrected the situation by removing the key from Ms. Poe's possession, thereby removing the need for screening by the Department. I have also considered Ms. Daniels' inability to recall facts regarding an incident the DCF considered an intentional refusal by Petitioner to "cooperate" and "communicate" with Department's staff. Confidentiality in Keeping a Life Book on Foster Care Children Ms. Daniels testified that Petitioner informed her the foster care children had a computer life book (photo album) website. After being directed to the website by Petitioner and after viewing the website, Ms. Daniels concluded Petitioner had "released" the names and photos of the foster children on the websites. Without providing a rational basis, she testified that keeping required foster child life books in an electronic format is, in and of itself, inappropriate. She further testified that placing the names and photos on the web site violated DCF's rule of confidentiality. Rule 65C.010(1)(c)4., Florida Administrative Code, requires the foster care parent to maintain the children's records which ensures confidentiality for the child and the biological parents. Petitioner maintained that each child made an individual and personal decision to use the computers he made available in his home. To his knowledge each child placed his personal information, name, foster care status, photos, etc., on the web sites during chats and exchange of information with others users in various chat-room conversations. Ms. Daniels never inquired of the foster children whose names and status were found on the book of life web sites to ascertain whether they or Petitioner placed personal information on the web site. I find her testimony on this issue to be questionable, but reliable. In making the foregoing findings, I have considered Ms. Daniels' testimony and the absence of evidence in support thereof. I find Petitioner's testimony that he never divulged any confidential information on the web sites regarding foster children in his care credible, but not persuasive. As the custodial parent, Petitioner has the ultimate responsibility to maintain and protect the confidentiality of the children in his care and under his supervision. Permitting children of divulge personal/confidential and potentially endangering information on the web site is a breach of Petitioner's parental responsibility. Removal of G.K. from medication prescribed by a Doctor DCF alleged that Petitioner removed G.K. from prescribed medication in violation of Rule 65C-13.010(1)(b)7.a, Florida Administrative Code, which imposes on the foster parent the responsibility for dispensing the medication as prescribed by the physician and recording the exact amount prescribed. In support of this allegation, the Department offered the testimony of Ms. Daniels. Ms. Daniels, by her admission, had no personal knowledge regarding G.K. and Petitioner's actions with G.K.'s medication. Her testimony was based upon what she had previously read in the file prepared by Stephanie Gardner, DCF's Representative and Petitioner's caseworker before the case reassignment to Ms. Daniels. When Ms. Daniels initially inquired of Petitioner about G.K.'s medication, he informed her that before he discontinued G.K.'s medication, he consulted with a nurse who in turn consulted with the prescribing doctor about the matter. Based on the response received from this consultation he discontinued G.K.'s psychotropic medication. Ms. Daniels based her conclusion of unauthorized discontinuance of medication on her conversations with Ray Mallette, a Department mental health counselor. In his letter to Petitioner, Mr. Mallette stated, in pertinent part: "To my knowledge, G.K. was not taking any psychotropic medication while under my care. Treatment was terminated in June of 1999, by mutual agreement, as no further care needed." Ms. Daniels testified that during her conversations with Mr. Mallette she recalled his stating that he did not authorize discontinuation of G.K.'s medication. Ms. Daniels could not state with any certainty if Mr. Mallette's use of the term "medication" included psychotropic medications or other medications. Petitioner provided Ms. Daniels the name of the Broward County physician with whom Petitioner had conferred through his nurse and who authorized taking G.K. off medication. There is no evidence that Ms. Daniels attempted to verify whether the medical persons provided by Petitioner had given instructions to take G.K. off psychotropic medications. I find Ms. Daniels' testimony on the issue of G.K.'s medication to be incomplete, confused and, not creditable. In making the foregoing finding, I have considered Mr. Mallette's letter reflecting that he is not a medical doctor or dentist; therefore, he cannot prescribe nor discontinue a prescribed medication to a patient. I. Use of profanity and general unwillingness to work cooperatively with the Department Rule 65C-13.010(1)(c)1., Florida Administrative Code, requires foster care parents to "work" cooperatively with the counselor as a member of a treatment team in seeking counseling, participating in consultation, and preparing and implementing the performance agreement or permanent placement plan for each child. In support of the above allegations, the DCF offered only the testimony of Ms. Daniels who stated: ". . . [A]lso during a conversation Mr. Marlowe used profanity. As far as [sic] concerned as just being uncooperative and maybe someone being uncooperative meaning there's something else behind it as far as, you know, not one to follow the rules that are set by the Department." I find the above testimony of Ms. Daniels to be vague and questionable. In making the foregoing finding, I have taken into consideration the fact that Ms. Daniels could not recall the date, time, place, words, or the circumstances of her conversation with Petitioner in which the alleged profanity was uttered. I have also taken into consideration the testimony of Ms. Stephanie Gardner, regarding Petitioner's uncooperativeness. Ms. Gardner, acknowledging that she did not know, did not remember nor did she recall; then went on to state: " . . . that at some unknown time and date, Petitioner stated, mentioned or indicated some information about a child or foster child that he had parented before. I don't know if it was Gary or one of the children that were actually at the Broward County at the Outreach Broward facility where he worked, but it was some information, and it was kind of alarming." I find the testimony of Ms. Daniels and the testimony of Ms. Gardner regarding the alleged profanity and regarding alleged uncooperativeness of Petitioner with the DCF questionable. Excluding the foregone evidence, other testimony regarding Petitioner and his conduct addressing matters that are related to those specific issues raised in DCF's denial letter of October 30, 2000, is neither material nor relevant to issues under consideration in this cause and disregarded.
Recommendation Upon the foregoing Findings of Fact and Conclusions of Law, it is
The Issue The issue for determination at final hearing is whether Respondent's foster care license should be revoked.
Findings Of Fact On July 1, 1995, Mildred Sands (Respondent) was issued a provisional foster home license by the Department of Health and Rehabilitative Services (Petitioner), with an effective period of July 1, 1995 - June 30, 1996. Her license number is 0795-06-3. A provisional license is issued when all requirements for a license are not met and the licensee is given a specific time period to comply with the remaining requirements. Due to a court action involving a minor child, J. F., who was born on May 7, 1983, the court placed J. F. with Respondent. In order for the minor child to live with Respondent, Petitioner issued Respondent a provisional license. Prior to the placement, Respondent knew J. F.'s mother for several years on a personal basis. The mother and her children were at one time living with Respondent. Respondent is J. F.'s godmother and has interacted with her since J. F.'s birth. Prior to licensing, on June 12, 1995, Respondent signed a "Bilateral Service Agreement" (Bilateral Agreement) with Petitioner, agreeing to abide by or with several conditions. The Bilateral Agreement provides in pertinent part: 2. We are fully and directly responsible to the Department for the care of the child. * * * 8. We will accept dependent children into our home for care only from the Department and will make no plans for boarding other children or adults. We will notify the Department if any adult relative or family members returns to live in the home. * * * 10. We will notify the Department immediately of any change in our address, employment, living arrangements, arrest record, health status or family composition, as well as any special needs for the child (i.e. health, school problems, emotional problems). * * * 16. We will comply with all requirements for a licensed foster home as prescribed by the Department. * * * 18. We understand that any breach of the Agreement may result in the immediate removal of the child(ren) and revocation of the license. Respondent signed a "Discipline Policy Agreement" (Discipline Agreement) on July 19, 1993, when she was initially licensed as a foster care provider and on June 12, 1995, during her re-licensure process. The Discipline Agreement signed on July 19, 1993, provides in pertinent part: The following disciplinary practices are FORBIDDEN in caring for your foster child. Failure to comply may result in an investigation and possible closure of your home. * * * Hitting a child with an object. Slapping or spanking a child, or ANY OTHER physical discipline. The Discipline Agreement signed on June 12, 1995, provides in pertinent part: [T]he following disciplinary practices are FORBIDDEN on our children. FAILURE OF THE FOSTER PARENT(S)... TO COMPLY MAY RESULT IN THE REMOVAL OF THE CHILD(REN) FOR AN INVESTIGATION AND RESULT IN THE CLOSURE OF YOUR HOME. * * * Hitting a child with ANY object. Slapping, smacking, whipping, washing mouth out with soap, or ANY other form of physical discipline. On February 14, 1995, Petitioner waived placement requirements in order for J. F.'s siblings to be placed with Respondent to keep the family unit together. J. F.'s siblings had been living with her grandmother who had become ill and was unable to care for the children. On September 1, 1995, Petitioner received a report of alleged child abuse allegedly committed by Respondent against J. F., who was 12 years old, at Respondent's foster home. Respondent was allegedly disciplining J. F. Within a short span of time that same day, Petitioner began an investigation. The minor child, J. F., had raised bruises, swelling, abrasions, and redness on the lower part of her legs. Also, J. F. had a small scratch on one of her legs and a scratch on her left arm. The injuries were purportedly inflicted by a ruler. No expert opinion was presented to confirm that the injuries were consistent with such an instrument, and no attempt was made to obtain the instrument used to commit the alleged abuse. Petitioner removed all the children from Respondent's home. Petitioner notified Respondent that it was revoking her foster home license due to the alleged excessive corporal punishment. The minor child, J. F., did not testify at the hearing. 1/ Respondent did not inflict the injuries to the minor child, J. F. 2/ Respondent did not use corporal punishment of any kind on the minor child, J. F. Respondent did not violate the Discipline Agreement. Respondent was responsible for the supervision and care of the minor child, J. F. Respondent was not aware of J. F.'s injuries and was, therefore, unable to notify Petitioner of the injuries or to obtain medical attention for J. F.'s injuries. Respondent had allowed the children's adult sibling, who was 19 years old, to live with her and the children. Respondent failed to notify Petitioner that the adult sister would be and was living in her home. In failing to notify Petitioner, Respondent violated the Bilateral Agreement, paragraph numbered 8.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the foster home license of Mildred Sands not be revoked. DONE AND ENTERED this 1st day of August 1996, in Tallahassee, Leon County, Florida. ERROL H. POWELL, 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 1st day of August, 1996.
The Issue The issue in this case is whether Petitioner should deny the application for renewal of Respondent's foster home license because “skinny dipping” with a foster child at the foster home violates Section 409.175, Florida Statutes (2001), and Florida Administrative Code Rule 65C-13. (All section references are to Florida Statutes (2001). All references to rules are to rules promulgated in the Florida Administrative Code in effect on the date of this Recommended Order.)
Findings Of Fact Petitioner is the state agency responsible for licensing and regulating foster homes in Florida. A foster home license is valid for a period of one year and must be renewed annually. Various privatized entities supervise licensed foster homes, review applications for foster home licenses, and make recommendations to Petitioner regarding the applications. However, the recommendations are not binding on Petitioner. Petitioner, rather than the private entity, is the licensing agency. For example, Petitioner rejected the recommendation from the private entity with responsibility for reviewing the application at issue in this proceeding. Petitioner first issued a foster home license to Respondent on January 28, 2000. Petitioner licensed Respondent to operate a therapeutic foster home. A therapeutic license authorized Respondent to operate a foster home for children with psychological or emotional disorders and for children without such disorders. Therapeutic foster homes operate under the auspices of a private entity known as Personal Enrichment through Mental Health, Inc. (PEMHS). PEMHS recommended that Petitioner issue the original foster home license on January 28, 2000, and a renewal license that Petitioner issued on January 28, 2001, for the second year. The second therapeutic foster home license expired on January 27, 2002. Petitioner never took action to discipline or revoke Respondent’s therapeutic foster home license. In July 2001, Respondent applied for a non- therapeutic foster home license. The non-therapeutic license that Respondent seeks authorizes a licensee to operate a foster home only for children without psychological or emotional disorders. Non-therapeutic foster homes operate under the auspices of a private entity known as Family Continuity Programs (Family Continuity). Family Continuity recommended that Petitioner approve the application for a non-therapeutic foster home license. However, Petitioner did not follow the recommendation of Family Continuity and denied the application. Petitioner's denial of Respondent's application for a non-therapeutic foster home license is the proposed agency action that is at issue in this proceeding. Respondent's application for a non-therapeutic foster home license is not an application for a new license. Rather, it is an application for renewal of an existing license. Both the therapeutic license that Respondent held at the time of the application and the non-therapeutic license that Respondent seeks authorize the licensee to operate a foster home for children without psychological or emotional disorders. By applying for a non-therapeutic foster home license before the expiration of his therapeutic foster home license, Respondent sought to renew his license to operate a foster home for children without psychological and emotional disorders. The non-therapeutic license that Respondent seeks does not impose any requirements in addition to those that Respondent had already satisfied when Petitioner granted the therapeutic license to Respondent. The requirements for the therapeutic license are more stringent than those that must be met to qualify for a non-therapeutic license. The requirements for a therapeutic license are more comprehensive, and Petitioner requires an applicant for a therapeutic license to have more training than an applicant for a non-therapeutic license. A non-therapeutic license does not impose requirements in addition to those imposed for a therapeutic license. Petitioner proposes to deny the application for renewal of Respondent's foster home license on the sole ground that Respondent went "skinny dipping" with two minor males. One of those males was a foster child assigned to Respondent. The foster child is a victim of past sexual abuse and has psychological and emotional disorders. The child suffers from oppositional defiance disorder and mood disorder. The symptoms of the disorders include self-injury, such as head banging, aggression, anger, and low self-esteem. However, many of the behavioral problems diminished during the 15 months that the foster child was in Respondent's care. The "skinny-dipping" events occurred between six and nine times during the 15 months that the foster child was in Respondent's care. During that time, the foster child was between 12 and 14 years old. The foster child swam nude in the swimming pool at Respondent's residence and bathed nude in the hot tub adjacent to the pool. On some of those occasions, Respondent was nude in the hot tub and swimming pool with the foster child and at other times the two were in the swimming pool and hot tub independently of each other while both were nude. The local sheriff's office investigated the foster home and found no indicators of abuse. Once PEMHS learned of the "skinny dipping" events, neither PEMHS nor Petitioner sought to revoke Respondent's therapeutic foster home license or to provide Respondent with remedial training. Rather, PEMHS removed the foster child from the foster home and refused to assign any more foster children to Respondent's foster home. At the administrative hearing, Petitioner sought the post-hearing deposition testimony of Dr. Cotter for several purposes. One of those purposes was to show the impact on the foster child from the "skinny dipping" events. Another purpose was to show that the "skinny dipping" was "grooming behavior" for future pedophilia. The ALJ sustained Respondent's objection to the admissibility of the expert deposition testimony for the purpose of showing the impact on the foster child and for the purpose of showing that the "skinny dipping" was "grooming behavior" for future pedophilia. Dr. Cotter could not render an opinion concerning the actual impact on the foster child from the "skinny dipping" events or whether those events were actually intended by Respondent as "grooming behavior" for future pedophilia. Dr. Cotter did not intend to evaluate either the foster child or Respondent before rendering his opinions and, in fact, never evaluated either individual. Any expert opinion by Dr. Cotter concerning "grooming behavior" for pedophilia was not relevant to the grounds stated in the Notice of Denial. That expert opinion was relevant only to grounds not stated in the Notice of Denial. Nudity in a swimming pool and hot tub are not synonymous with "grooming behavior" for pedophilia. Nudity and "grooming behavior" for pedophilia are separate grounds for denying the application for renewal of Respondent's license to operate a foster home. Petitioner failed to provide adequate notice prior to the administrative hearing that Petitioner sought to deny the renewal of Respondent's license on the separate ground that Respondent engaged in "grooming behavior" for pedophilia. Fundamental principles of due process prohibit a state agency from notifying a regulated party of the allegations against the party and then, at the hearing, proving-up other allegations. One of the primary functions of an ALJ is to assure that an administrative hearing is a fair hearing. Respondent was not prepared at the administrative hearing to submit evidence, including expert testimony, to refute any allegation not stated in the Notice of Denial. The admission of evidence relevant to allegations not stated in the Notice of Denial would have required a continuance of the administrative hearing to provide Respondent with an opportunity to refute the allegation. A continuance would have denied Respondent a remedy during the period of continuance, increased the economic burden on Respondent, and frustrated judicial economy. Nothing prevents Petitioner from bringing a separate proceeding against the licensee based on the allegation that Respondent engaged in "grooming behavior" for pedophilia. The ALJ limited the testimony of Dr. Cotter to those grounds for denial that Petitioner stated in the Notice of Denial. In relevant part, the Notice of Denial states: After careful review and consideration, your application has been denied. Our decision is based on the following: Your admission that you and two minor boys, one of which was a foster child under your supervision, participated in several "skinny dipping" incidents during your recent licensure as a foster parent for Pinellas Enrichment Through Mental Health Services (PEMHS). As you are aware, the nature of a boy's early experiences may affect the development of his sexual attitudes and subsequent behavior. Therefore, foster parents are expected to provide opportunities for recreational activities appropriate to the child's age. "Skinny dipping" in a hot tub with two minor boys violates the intent of this rule. These incidents reflect poor judgment for a person who is a licensed foster parent. Respondent's Exhibit 1. The Notice of Denial essentially states four grounds for denying the application for renewal of Respondent's license. One ground is the impact on the development of the foster child's sexual attitudes and subsequent behavior. Another ground is nudity between a foster parent and a foster child. A third ground is that Respondent exercised poor judgment. The remaining ground is that Respondent provided recreational activities that were not appropriate to the foster child's age. No evidence shows that the "skinny dipping" events had any adverse impact on the development of the foster child's sexual attitudes and subsequent behavior. Dr. Cotter did not evaluate the foster child to determine the actual impact of the events on the foster child. Contrary to the statements in the Notice of Denial, Petitioner's representative testified at the hearing that Petitioner did not consider the impact on the child that resulted from skinny dipping with Respondent. The preponderance of evidence shows that the actual impact of the foster care provided by Respondent during the 15 months in which the "skinny dipping" events occurred was positive. Many of the foster child's behavioral problems greatly diminished. The foster child made remarkable progress in his behavior both at home and at school. The foster child bonded with Respondent, and Respondent was an exemplary foster parent. The placement of the child with Respondent was so successful that Family Continuity published an article in their magazine about the successful match between the foster child and Respondent. Family Continuity considers Respondent to be an exemplary foster parent and wishes to have Respondent in its foster care program. If Petitioner grants the application for renewal, Family Continuity intends to return the foster child to Respondent for adoption. The second ground stated in the Notice of Denial is nudity between the foster parent and foster child. Without considering the impact on the foster child, Petitioner determined that being naked in the presence of a foster child, without more, was sufficient to close a foster home, remove a child, and revoke a foster home license. Petitioner cited no written statute or rule that prohibits nudity between a foster parent and foster child; or that establishes intelligible standards for regulating such nudity. Petitioner failed to submit competent and substantial evidence to explicate an unwritten policy that prohibits or regulates nudity. Rather, some evidence shows that nudity between foster parents and foster children is generally unavoidable and common. The third ground stated in the Notice of Denial is that Respondent exercised poor judgment. Several witnesses at the hearing and Dr. Cotter opined that Respondent exercised poor judgment. It is unnecessary to determine whether Petitioner exercised poor judgment because Petitioner cited no written rule or policy that defines or prohibits "poor judgment." For reasons stated in the Conclusions of Law, Petitioner must base a denial of a license application on a finding that the applicant violated a specific statute or rule. Petitioner cannot use the Notice of Denial to invent requirements that are not authorized by statute or rule. Petitioner cited no statute or rule that defines "poor judgment" or that establishes intelligible standards to guide the discretionary determination of whether an applicant has exercised poor judgment. In the absence of intelligible standards, the determination of whether an applicant has exercised poor judgment is necessarily an exercise of unbridled agency discretion. The use of unbridled agency discretion to make findings of fact violates fundamental principles of due process. Unbridled agency discretion creates the potential that agency decision-makers may define poor judgment by relying on their personal predilections rather than on those standards authorized by the legislature. Even if it were determined that poor judgment is a standard authorized by the legislature and that Respondent violated that standard, the determination is not dispositive of whether Petitioner should renew Respondent's license to operate a foster home. For example, representatives for Family Continuity and PEMHS agreed in their testimony that Respondent exercised poor judgment. However, Family Continuity recommends that Petitioner issue the non- therapeutic foster home license while PEMHS recommends against renewal of the license. The remaining allegation in the Notice of Denial is that "skinny dipping" is not an age-appropriate recreational activity. Rule 65C-13.010(1)(b)8a. states: 8. Recreation and community. a. The substitute parents are expected to provide opportunities for recreational activities for children. The activities must be appropriate to the child's age and abilities. Swimming in a swimming pool and bathing in a hot tub are recreational activities within the meaning of Rule 65C- 13.010(1)(a)8a. Swimming nude and bathing nude in a hot tub with a nude adult are not appropriate for a child who is between 12 and 14 years old and whose psychological and emotional abilities are diminished by past sexual abuse.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Petitioner enter a final order finding that Respondent violated Rule 65C-13.010(1)(b)8 and granting Respondent’s application for a therapeutic foster home license. DONE AND ENTERED this 8th day of May, 2002, in Tallahassee, Leon County, Florida. ___________________________________ DANIEL MANRY 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: Frank Nagatani, Esquire Department of Children and Family Services 11351 Ulmerton Road, Suite 314 Largo, Florida 33778-1630 Gary A. Urso, Esquire 7702 Massachusetts Avenue New Port Richey, Florida 34653 Paul 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 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.
Findings Of Fact At all times material hereto, Berta Cabral and Cabral Adult Foster Home were certified by the Department of Health and Rehabilitative Services to operate as an adult foster home. On October 2, 1985, Freda Aliber was released as a patient from Coral Gables Hospital and was placed in Cabral Adult Foster Home. When she arrived at the Cabral Adult Foster Home she had with her personal papers including bank statements for accounts which she held at Coral Gables Federal and at City National Bank. On October 3, 1985, Berta Cabral's daughter Odalys Ibarra telephoned Coral Gables Federal to advise that she would be coming to the bank that day with Freda Aliber. Later that same day Odalys Ibarra, Julie Ibarra, and Freda Aliber came to Coral Gables Federal at which time Odalys Ibarra attempted to have her name added to Aliber's bank account. Further, Odalys Ibarra made her requests of the bank personnel in Spanish although Freda Aliber does not understand Spanish. Bank employees refused to add Odalys Ibarra's name to Freda Aliber's account. On or about October 3, 1985, Odalys Ibarra telephoned City National Bank, identified herself as Berta Cabral's daughter, and asked a number of personal questions regarding Freda Aliber's account at that bank. Odalys Ibarra's attempts to gain access to Freda Aliber's personal funds were done with the full knowledge and consent of Berta Cabral. Freda Aliber did not understand what Berta Cabral, Odalys Ibarra, and Julie Ibarra were attempting to do and did not understand why she was taken to the bank.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is, RECOMMENDED that a Final Order be entered revoking Berta Cabral's certification as Cabral Adult Foster Home. DONE and RECOMMENDED this 31st day of July, 1986, at Tallahassee, Florida. LINDA M. RIGOT, Hearing Officer Division of Administrative Hearings 2009 Apalachee Parkway Tallahassee, Florida 32399 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 31st day of July, 1986. COPIES FURNISHED: William Page, Jr., Secretary Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, Florida 32301 Leonard Helfand, Esquire Department of Health and Rehabilitative Services 401 N.W. 2nd Avenue Miami, Florida 33128 Berta Cabral Cabral Adult Foster Home 2331 N.W. 31 Street Miami, Florida 33142
The Issue Whether the Petitioner is entitled to renewal of a foster care license.
Findings Of Fact Petitioner, Betty Stewart, was licensed by the Department to operate a foster care home on August 5, 1991. Thereafter, until the instant matter arose, Petitioner received a renewal of this license. On August 18, 1997, the Department notified Petitioner that her license would not be renewed. The decision was based upon Petitioner's alleged failure to meet the minimum standards for foster parenting. More specifically, the denial alleged concerns with Petitioner which included: Standard housekeeping standards. Counselors have reported that your home was not kept clean. They noted a stale odor, and observed clothes piled up and roach infestations. Lack of stability in housing. The licensing record indicates that you have had at least five different residences since you were licensed in 1991. Constant moving does not provide stability for the children placed with you. Inadequate medical care for a child in our home. The counselor for a child who had been in your home indicated that you failed to get timely dental care for a child in your home that resulted in the child needing to have a tooth extracted. Additionally it was reported that you did not follow-up with getting a dermatologist's prescription filled for this same child. Concerns that your son was dealing in illegal drugs. While your son did not live with you, he was in and out of your home and having contact with the foster children in your home, which in fact could have a potentially negative impact on them. You did admit to Laura Williams, the foster parent liaison, that you were aware that he was dealing drugs. During the time of Petitioner's licensure, she was licensed at five different locations. That is, she moved from one property to another and relicensed the new location, five times in six years. Additionally, during the time of licensure, Petitioner received a "provisional license" on four occasions. A provisional license is issued when the applicant must take additional measures to comply with all licensure requirements. On four occasions the Department worked with the Petitioner so that she would obtain licensure. For each license, Petitioner executed an agreement to provide substitute care for dependent children as prescribed by the Department. This agreement required Petitioner to comply with all rules implemented for foster care homes and specifically required Petitioner to report any illness of a child to the Department. In one instance, the Petitioner failed to seek immediate dental care for a child placed in her home. The dental problem was made known to the Department when the child was caught shoplifting Oragel, an over-the-counter product used to relieve toothache. Petitioner also did not compel a child to attend counseling sessions with a licensed therapist. Petitioner was responsible for assuring that the child be given transportation to and from such sessions. Although limited to two children by license restriction, Petitioner typically had more than two children placed in her home. Given the shortage for foster care homes, the Department routinely waived the limit and placed additional children with Petitioner even though she was ill-equipped to deal with the extra children. The Petitioner's son, who is now deceased, did not reside with Petitioner during the final licensure period. Although he resided in the community near her home, there is no evidence to support a finding that he was dealing drugs from the licensed premises.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department enter a Final Order denying Petitioner's request for license renewal as a foster care home. DONE AND ENTERED this 13th day of March, 1998, in Tallahassee, Leon County, Florida. J. D. Parrish 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 Filed with the Clerk of the Division of Administrative Hearings this 13th day of March, 1998. COPIES FURNISHED: Gregory D. Venz, Agency Clerk Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Richard A. Doran, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Colleen Farmsworth Assistant District Legal Counsel Department of Children and Family Services 111 South Sapodilla Avenue Suite 201 West Palm Beach, Florida 33401 Betty Stewart, pro se 812 Foresteria Drive Lake Park, Florida 33403
The Issue Whether the Petitioner is entitled to an award of attorney's fees and costs pursuant to Section 57.111, Florida Statutes.
Findings Of Fact Based on the oral and documentary evidence presented at the final hearing and on the entire record of this proceeding, the following findings of fact are made: The Department is the state agency responsible for licensing and regulating foster homes. Mrs. Sampson operated a Childrens' Medical Services ("CMS") medical foster home for children with special medical, emotional and physical needs, and was licensed by the Department as either a CMS medical foster home or as a regular foster home from 1990 until November 1997. At some point in 1996 or 1997, Mrs. Sampson voluntarily ceased operating as a CMS medical foster home, but continued to operate as a regular foster home. There was conflicting evidence as to the precise date of this change, but the date is not relevant to this phase of the bifurcated proceeding. On March 2, 1998, the Department filed an Administrative Complaint that sought to revoke Mrs. Sampson's foster care license. On October 6, 1999, the Department filed an Amended Administrative Complaint. The Department also denied Mrs. Sampson's application to adopt one of the foster children in her care. Mrs. Sampson requested a formal administrative hearing on both the revocation of her foster care license and the denial of her adoption application. The cases were consolidated, and a formal administrative hearing was held over several dates in April, May, and June 2000. Mrs. Sampson prevailed on all issues in the consolidated cases. A Recommended Order in her favor was entered on August 11, 2000. A Final Order adopting the findings of fact and conclusions of law in the Recommended Order was entered on October 2, 2000. Mrs. Sampson contends that she is a "small business party" as defined in Subsection 57.111(3)(d)1.a, Florida Statutes, which provides that the term "small business party" includes: A sole proprietor of an unincorporated business, including a professional practice, whose principal office is in this state, who is domiciled in this state, and whose business or professional practice has, at the time that action is initiated by a state agency, not more than 25 full-time employees or a net worth of not more than $2 million, including both personal and business investments. . . . At all times relevant to this case, Mrs. Sampson was domiciled in the State of Florida. At all times relevant to this case, Mrs. Sampson was licensed as a Licensed Practical Nurse ("LPN"). The determinative issue is whether Mrs. Sampson's operation of a foster home establishes her as the sole proprietor of an unincorporated business or professional practice. Mrs. Sampson initially operated her medical foster home for the benefit of one child, who was admitted to Tampa General Hospital while Mrs. Sampson worked there as a contract nurse. The child was born prematurely and was not expected to live longer than six weeks. Mrs. Sampson became a licensed foster parent to take this child home and care for him. Under her care, the child thrived. Though he survived the initial crisis, the child continued to require full-time nursing care. Mrs. Sampson was not able to return to full-time employment as a contract nurse outside the home. Mrs. Sampson testified that she advised the Department's case workers that she would need to take in additional medical foster children to supplement her income while she worked at home caring for the children. Over a period of eight years, the Department placed at least 14 medically needy foster children in Mrs. Sampson's home. The Department establishes foster home care board rates, which are standard reimbursements to foster parents for the expenses incurred for the foster children, such as food, clothing, medical care, and transportation. The board rates are minimums that can be increased by the Department if the needs of the foster child cannot otherwise be met. Mrs. Sampson received an enhanced board rate for at least some of the children in her care. The Department conducts orientation meetings for and training of prospective foster parents. The Department emphasizes that the purpose of foster parenting is to provide temporary surrogate parenting for the foster children. The prospective parents are informed that they are considered volunteers and will not be paid for their services. The parents are told that the board payments are for the childrens' expenses. Foster parents sign an agreement acknowledging that the board payments are "on behalf of the child." Rule 65C-13.011(4), Florida Administrative Code, expressly provides that substitute care parents must have sufficient income to assure the stability and security of their own families without reliance on the board payments, and that the substitute family must have sufficient income to absorb four to six weeks of a foster child's care before receiving a board payment. If the Department removes a child from a foster home, the board payment to the foster payment ceases. If the child is placed with a new foster parent, then the board payment goes to the new foster parent. In addition to the regular and enhanced board payments, a CMS medical foster parent may receive payments from Medicaid as reimbursement for medically necessary services rendered to the foster children. Mrs. Sampson was a designated Medicaid provider from April 1992 through March 1997. Mrs. Sampson contended that these Medicaid payments were for the nursing services she provided to the children, just as physicians receive Medicaid payments for treatment of eligible patients. However, medical foster parents are not required to be licensed medical professionals. Mrs. Sampson offered no evidence that the Medicaid payments were for her services as an LPN, or that private, residential LPN services even qualify for Medicaid reimbursement absent prior authorization. CMS-administered medical foster care services are authorized for Medicaid reimbursement, and the best evidence is that Mrs. Sampson was reimbursed as a medical foster care provider, not as an LPN. The Department established that Mrs. Sampson did not hold herself out as running a business, nor did she report as income on her federal tax return the payments received in connection with providing foster care. Mrs. Sampson testified that she hired part-time employees to assist her in caring for the children, but she did not withhold federal income tax or Social Security taxes from their pay and did not file W-2 wage statements for them. Mrs. Sampson explained her failure to report her board payments as income by reference to 26 U.S.C. s. 131, which excludes foster care payments from reportable gross income. This citation justifies her failure to report, but also supports the Department's contention that foster care payments should not be considered business income. Mrs. Sampson implicitly conceded that her foster home did not possess any of the common indicia of a business. Her chief contention was that from 1970 to 1990, she worked as an LPN through nursing agencies, caring for sick children in hospitals or in their homes, and that from 1990 to 1997, she worked as an LPN caring for medical foster children in her own home. In other words, Mrs. Sampson contended that by operating the foster home, she was continuing to practice her profession in a different setting. She gave up the income from her practice as an LPN through nursing agencies in favor of the income she received as an LPN acting as a medical foster parent.
The Issue Are Respondents entitled to have Petitioner renew their license to provide foster home care?
Findings Of Fact Petitioner licenses and re-licenses persons who provide residential care to children. This process is in accordance with Chapter 409, Florida Statutes, and Chapter 65C-13, Florida Administrative Code. Respondents have held a foster home license pursuant to those laws. On March 16, 1998, Petitioner advised Respondents that Respondents would not be re-licensed for the upcoming year for reason that: "A recent investigation of neglect resulted in a confirmed report against you." As was revealed at the hearing, the more specific basis for the denial was in accordance with Section 409.175(8)(b)1, Florida Statutes, in which Petitioner accused Respondents, in the person of Sherrie Rund, of a negligent act which materially affected the health and safety of a child in her home. That child is J.V., date of birth July 15, 1995. Moreover, the basis for non-renewal of the foster home license was premised upon the further allegation that Sherrie Rund was found by Petitioner's counselor to be unable to secure the "Abuse Registry" prior to issuance of a new foster home license, as provided in Rule 65C- 13.006(3), Florida Administrative Code. On January 6, 1998, Respondents were caring for three foster children in their home in Inverness, Florida. In addition to J.V. there was M.V., who was 3½ years old, and J.S., who was 12 months old. J.V. and M.V. are brothers. The day before Petitioner had asked Respondent, Sherrie Rund, to take two additional children into her home to receive foster care. On the day before, Mrs. Rund had also suffered a miscarriage. Mrs. Rund left her home on the morning of January 6, 1998, to run some errands and to eventually drive to Brooksville, Florida, to pick up the newest foster children. At some point in time in her travels on January 6, 1998, with J.V. and J.S. in her car, Mrs. Rund noticed a loud knocking sound in her car and decided to have an automobile mechanic with whom she was familiar check the status of her car, in anticipation of her trip to Brooksville. Upon arriving at the mechanic's shop, the mechanic told Mrs. Rund that she was not going anywhere in the car, and that something was not right with the car. The mechanic got into the car with Mrs. Rund and they made a test drive. When they returned to the mechanic's shop, the mechanic pointed out a block that was part of the suspension system, referred to as a lift kit in the area of the rear axle. That block had shifted over and the mechanic told Mrs. Rund that all that would be necessary to correct the problem was to adjust two bolts. When Mrs. Rund, the mechanic, and her children had returned to the shop, the children were asleep. As a consequence, Mrs. Rund asked the mechanic if it would be acceptable to leave the children in the car while the mechanic made repairs to the automobile. Apparently, the mechanic was not opposed to that arrangement. The mechanic told Mrs. Rund that it would only take a couple of minutes to tighten the parts that were causing the problem. With that assurance, Mrs. Rund allowed the mechanic to lift the car off the concrete floor in the shop by the use of a hydraulic lift. Once the car had been lifted, the distance from the car to the shop floor was approximately 3 to 4 feet. The mechanic began his work and noticed that threads in the bolts that were being tightened had become stripped. At that time Mrs. Rund was sitting on a stool by the car door. The mechanic summoned her and asked to show her what was wrong. As Mrs. Rund walked around the car she heard a slight noise. It was J.V. J.V. had been strapped in his car seat attached to the back seat of the automobile, but he had awakened from his nap in the back seat of the car, gone between the seats in the front of the car, opened the door and stepped out onto the platform that supported the car on the lift. Before anyone could intervene, J.V. fell from the platform to the floor of the shop fracturing his skull. The skull fracture was of the temporal bone. In addition, J.V. also suffered an abrasion of one ear and split his lip in the fall. The automobile in question was a Jeep vehicle with tinted windows, that created a condition in which Mrs. Rund could not see into the automobile while it was on the lift. After the accident Mrs. Rund immediately picked the child up and noted that he appeared "a little incoherent." She could not drive her car. But she knew that her father was about two miles away. Mrs. Rund's father immediately responded to her request for assistance. They drove J.V. to the emergency room at the Citrus Memorial Hospital in Inverness, Florida, for treatment. Later that day, J.V. was taken to Shands Hospital at the University of Florida, in Gainesville, Florida, for additional treatment. Mrs. Rund and her father managed to transport J.V. to the emergency room at Citrus Memorial Hospital within 10 minutes of the accident. Upon arrival Mrs. Rund attempted to advise Petitioner about the accident by contacting the case worker responsible for her foster children. Four of the people who were on the list of possible contacts were unavailable. Mrs. Rund also wanted to inquire about the status of the two new children who were going to be left in her care that day. Eventually, Mrs. Rund explained to a case worker the circumstances of J.V.'s accident. In answer to her question, the case worker told Mrs. Rund that the two additional children were going to be brought to Mrs. Rund's home in any event. The children were brought to Mrs. Rund's home on January 6, 1998, and were kept for the moment by Mrs. Rund's mother. The two additional children were siblings 2½ and 5 years old. Mrs. Rund spent about 6 to 7 hours at the Citrus Memorial Hospital attending J.V. and making certain of his care. Beyond that time, Mrs. Rund felt the need to return home and take a shower because of her miscarriage the day before and because she had blood on her shirt resulting from J.V.'s injuries. Mrs. Rund also had concern about the welfare of the two additional children that were being brought to her home. There had been some discussion between Mrs. Rund and a nurse at the Citrus Memorial Hospital, who insisted that Mrs. Rund should accompany J.V. to Shands Hospital. Mrs. Rund replied that she needed to check the situation at home and then she would go to Shands. Eventually, the nurse contacted someone from the Child Protective Service. Mrs. Rund spoke to that person and having decided that it would be acceptable for J.V. to ride to Shands unaccompanied by her, Mrs. Rund allowed J.V. to be transported to Shands Hospital without her. A short time later, Mrs. Rund's parents picked her up at the Citrus Memorial Hospital and took her home. By that time Christopher Rund, Mrs. Rund's husband, had arrived at their home and was available to take care of the other four children. After spending a little time with the children in her home and taking a shower, Mrs. Rund called Shands Hospital to check on the well-being of J.V. Mrs. Rund went to Shands Hospital the following day to see J.V. The two newest children were removed from Respondents' home. J.S., one of the original three children cared for by Respondents, was also removed from their home. The brothers J.V. and M.V. were returned to the Respondents on January 9, 1998, where they have remained. M.V. and J.V. were eventually adopted by the Respondents on May 22, 1998. As Mrs. Rund acknowledges, she momentarily neglected the needs of J.V. when he fell from her automobile to the floor of the mechanic's shop. Her response to his needs beyond that point was not neglectful given the circumstances that have been described. She immediately arranged for his care and treatment. The failure to accompany J.V. to Shands Hospital was not neglectful. Petitioner instituted an investigation identified as Abuse Report 98-001853, involving the incident on January 6, 1998, in which J.V. was injured when falling from the automobile to the floor of the repair shop. That report is referred to as institutional abuse-neglect, involving the conduct of Sherrie Rund and her foster home. Through the investigation, the report was verified for inadequate supervision or care pertaining to the accident, as well as the verification of other physical injuries associated with neglect. Richard V. Perrone, Adoptions and Related Services Counselor for Petitioner, worked with the Respondents from March of 1997 through May of 1998 as an adoption counselor. In correspondence for the record, he indicates that he has seen the family, and the children in their care on a monthly basis and that the home was always appropriate and the children well cared for. In particular, Mrs. Rund was observed by Mr. Perrone to be active with children's care and appropriate services. Mr. Perrone notes the adoption of the children that he visited.
Recommendation Upon consideration of the facts found and the conclusions of law reached, it is RECOMMENDED: That the foster home license held by Christopher Rund and Sherrie Rund be renewed. DONE AND ENTERED this 29th day of October, 1998, in Tallahassee, Leon County, Florida. CHARLES C. ADAMS 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 Filed with the Clerk of the Division of Administrative Hearings this 29th day of October, 1998. COPIES FURNISHED: Joseph Sowell, Esquire Department of Children and Family Services Post Office Box 220 Sumterville, Florida 33585 Christopher Rund Sherrie Rund 13059 East Shawnee Trail Inverness, Florida 34450 John S. Slye, General Counsel Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Gregory D. Venz, Agency Clerk Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700
