CODING: Words stricken are deletions; words underlined are additions.





                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    

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10                                                                

11  Senator Forman moved the following amendment:

12

13         Senate Amendment 

14         On page 84, line 1, through page 97, line 4, delete

15  those lines

16

17  and insert:

18         Section 38.  Section 400.411, Florida Statutes, is

19  amended to read:

20         400.411  Initial application for license; provisional

21  license.--

22         (1)  Application for a license shall be made to the

23  agency on forms furnished by it and shall be accompanied by

24  the appropriate license fee. The application shall contain

25  sufficient information, as required by rules of the

26  department, to establish that the applicant can provide

27  adequate care.

28         (2)  The applicant may be an individual owner, a

29  corporation, a partnership, a firm, an association, or a

30  governmental entity.

31         (3)(2)  The application must shall be signed by the

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  applicant under oath and must shall contain the following:

 2         (a)  The name, address, date of birth, and social

 3  security number of the applicant and the name by which the

 4  facility is to be known. Pursuant thereto:

 5         1.  If the applicant is a firm, partnership, or

 6  association, the application shall contain the name, address,

 7  date of birth, and social security number of every member

 8  thereof.

 9         2.  If the applicant is a corporation, the application

10  shall contain the corporation's its name and address;, the

11  name, address, date of birth, and social security number of

12  each of its directors and officers;, and the name and address

13  of each person having at least a 5-percent ownership

14  10-percent interest in the corporation.

15         (b)  The name and address of any professional service,

16  firm, association, partnership, or corporation that is to

17  provide goods, leases, or services to the facility for which

18  the application is made, if a 5-percent 10-percent or greater

19  ownership interest in the service, firm, association,

20  partnership, or corporation is owned by a person whose name

21  must be listed on the application under paragraph (a).

22         (c)  Information that provides a source to establish

23  the suitable character, financial stability, and competency of

24  the applicant and of each person specified in the application

25  under subparagraph (a)1. or subparagraph (a)2. who has at

26  least a 10-percent interest in the firm, partnership,

27  association, or corporation and, if applicable, of the

28  administrator, including The name and address of any long-term

29  care facility with which the applicant, or administrator, or

30  financial officer has been affiliated through ownership or

31  employment within 5 years of the date of this license the

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  application for a license; and a signed affidavit disclosing

 2  any financial or ownership interest that the applicant, or any

 3  person listed in paragraph (a) principal, partner, or

 4  shareholder thereof, holds or has held within the last 5 years

 5  in any other facility licensed under this part, or in any

 6  other entity licensed by this the state or another state to

 7  provide health or residential care, which facility or entity

 8  closed or ceased to operate as a result of financial problems,

 9  or has had a receiver appointed or a license denied, suspended

10  or revoked, or was subject to a moratorium on admissions, or

11  has had an injunctive proceeding initiated against it.

12         (d)  A description and explanation of any exclusions,

13  permanent suspensions, or terminations of the applicant from

14  the Medicare or Medicaid programs. Proof of compliance with

15  disclosure of ownership and control interest requirements of

16  the Medicaid or Medicare programs shall be accepted in lieu of

17  this submission.

18         (e)(d)  The names and addresses of other persons of

19  whom the agency may inquire as to the character, and

20  reputation, and financial responsibility of the owner

21  applicant and, if different from the applicant, applicable, of

22  the administrator and financial officer.

23         (e)  The names and addresses of other persons of whom

24  the agency may inquire as to the financial responsibility of

25  the applicant.

26         (f)  Identification of all other homes or facilities,

27  including the addresses and the license or licenses under

28  which they operate, if applicable, which are currently

29  operated by the applicant or administrator and which provide

30  housing, meals, and personal services to residents adults.

31         (g)  Such other reasonable information as may be

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  required by the agency to evaluate the ability of the

 2  applicant to meet the responsibilities entailed under this

 3  part.

 4         (g)(h)  The location of the facility for which a

 5  license is sought and documentation, signed by the appropriate

 6  local government official, which states that the applicant has

 7  met local zoning requirements.

 8         (h)(i)  The name, address, date of birth, social

 9  security number, education, and experience of the

10  administrator, if different from the applicant.

11         (4)(3)  The applicant shall furnish satisfactory proof

12  of financial ability to operate and conduct the facility in

13  accordance with the requirements of this part. A certificate

14  of authority, pursuant to chapter 651, may be provided as

15  proof of financial ability. An applicant applying for an

16  initial license shall submit a balance sheet setting forth the

17  assets and liabilities of the owner and a statement projecting

18  revenues, expenses, taxes, extraordinary items, and other

19  credits or charges for the first 12 months of operation of the

20  facility.

21         (5)(4)  If the applicant is a continuing care facility

22  certified under offers continuing care agreements, as defined

23  in chapter 651, a copy of the facility's proof shall be

24  furnished that the applicant has obtained a certificate of

25  authority must be provided as required for operation under

26  that chapter.

27         (6)(5)  The applicant shall provide proof of liability

28  insurance as defined in s. 624.605.

29         (7)(6)  If the applicant is a community residential

30  home, the applicant must provide proof that it has met the

31  requirements specified in chapter 419 shall apply to community

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  residential homes zoned single-family or multifamily.

 2         (8)(7)  The applicant must provide the agency with

 3  proof of legal right to occupy the property.  This proof may

 4  include, but is not limited to, copies of recorded warranty

 5  deeds, or copies of lease or rental agreements, contracts for

 6  deeds, quitclaim deeds, or other such documentation.

 7         (9)(8)  The applicant must furnish proof that the

 8  facility has received a satisfactory firesafety inspection.

 9  The local fire marshal or other authority having jurisdiction

10  or the State Fire Marshal must conduct the inspection within

11  30 days after the written request by the applicant. If an

12  authority having jurisdiction does not have a certified

13  firesafety inspector, the State Fire Marshal shall conduct the

14  inspection.

15         (10)  The applicant must furnish documentation of a

16  satisfactory sanitation inspection of the facility by the

17  county health department.

18         (11)  The applicant must furnish proof of compliance

19  with level 2 background screening as required under s.

20  400.4174.

21         (12)(9)  A provisional license may be issued to an

22  applicant making initial application for licensure or making

23  application for a change of ownership.  A provisional license

24  shall be limited in duration to a specific period of time not

25  to exceed 6 months, as determined by the agency.

26         (13)(10)  A No county or municipality may not shall

27  issue an occupational license that which is being obtained for

28  the purpose of operating a facility regulated under this part

29  without first ascertaining that the applicant has been

30  licensed to operate such facility at the specified location or

31  locations by the agency.  The agency shall furnish to local

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                                                  SENATE AMENDMENT

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    Amendment No.    





 1  agencies responsible for issuing occupational licenses

 2  sufficient instruction for making such the above-required

 3  determinations.

 4         Section 39.  Section 400.414, Florida Statutes, is

 5  amended to read:

 6         400.414  Denial, revocation, or suspension of license;

 7  imposition of administrative fine; grounds.--

 8         (1)  The agency may deny, revoke, or suspend any a

 9  license issued under this part, or impose an administrative

10  fine in the manner provided in chapter 120, for. At the

11  chapter 120 hearing, the agency shall prove by a preponderance

12  of the evidence that its actions are warranted.

13         (2)  any of the following actions by an assisted living

14  a facility, any person subject to level 2 background screening

15  under s. 400.4174, or facility or its employee shall be

16  grounds for action by the agency against a licensee:

17         (a)  An intentional or negligent act seriously

18  affecting the health, safety, or welfare of a resident of the

19  facility.

20         (b)  The determination by the agency that the facility

21  owner or administrator is not of suitable character or

22  competency, or that the owner lacks the financial ability, to

23  provide continuing adequate care to residents, pursuant to the

24  information obtained through s. 400.411, s. 400.417, or s.

25  400.434.

26         (c)  Misappropriation or conversion of the property of

27  a resident of the facility.

28         (d)  Failure to follow the criteria and procedures

29  provided under part I of chapter 394 relating to the

30  transportation, voluntary admission, and involuntary

31  examination of a facility resident.

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                                                  SENATE AMENDMENT

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    Amendment No.    





 1         (e)  One or more class I, three or more class II, or

 2  five or more repeated or recurring identical or similar class

 3  III violations that are similar or identical to violations of

 4  this part which were identified by the agency within the last

 5  2 years during the last biennial inspection, monitoring visit,

 6  or complaint investigation and which, in the aggregate, affect

 7  the health, safety, or welfare of the facility residents.

 8         (f)  A determination that a person subject to level 2

 9  background screening under s. 400.4174(1) does not meet the

10  screening standards of s. 435.04 or that the facility is

11  retaining an employee subject to level 1 background screening

12  standards under s. 400.4174(2) who does not meet the screening

13  standards of s. 435.03 and for whom exemptions from

14  disqualification have not been provided by the agency.

15         (g)(f)  A confirmed report of adult abuse, neglect, or

16  exploitation, as defined in s. 415.102, which has been upheld

17  following a chapter 120 hearing or a waiver of such

18  proceedings where the perpetrator is an employee, volunteer,

19  administrator, or owner, or otherwise has access to the

20  residents of a facility, and the owner or administrator has

21  not taken action to remove the perpetrator. Exemptions from

22  disqualification may be granted as set forth in s. 435.07. No

23  administrative action may be taken against the facility if the

24  perpetrator is granted an exemption.

25         (h)(g)  Violation of a moratorium.

26         (i)(h)  Failure of the license applicant, the licensee

27  during relicensure, or failure of a licensee that holds a

28  provisional an initial or change of ownership license, to meet

29  minimum license standards or the requirements of rules adopted

30  under this part or related rules, at the time of license

31  application or renewal.

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1         (j)(i)  A fraudulent statement or omission of any

 2  material fact on an application for a license or any other

 3  document required by the agency, including the submission of a

 4  license application that conceals the fact that any board

 5  member, officer, or person owning 5 percent or more of the

 6  facility may not meet the background screening requirements of

 7  s. 400.4174, or that the applicant has been excluded,

 8  permanently suspended, or terminated from the Medicaid or

 9  Medicare programs that is signed and notarized.

10         (k)(j)  An intentional or negligent life-threatening

11  act in violation of the uniform firesafety standards for

12  assisted living facilities or other firesafety standards

13  established by the State Fire Marshal, that threatens the

14  health, safety, or welfare of a resident of a facility, as

15  communicated to the agency by the State Fire Marshal, a local

16  fire marshal, or other authority having jurisdiction or the

17  State Fire Marshal.

18         (l)  Exclusion, permanent suspension, or termination

19  from the Medicare or Medicaid programs.

20         (m)  Knowingly operating any unlicensed facility or

21  providing without a license any service that must be licensed

22  under this chapter.

23

24  Administrative proceedings challenging agency action under

25  this subsection shall be reviewed on the basis of the facts

26  and conditions that resulted in the agency action.

27         (3)  Proceedings brought under paragraphs (2)(a), (c),

28  (e), and (j) shall not be subject to de novo review.

29         (2)(4)  Upon notification by the State Fire Marshal,

30  local fire marshal, or other authority having jurisdiction or

31  by the State Fire Marshal, the agency may deny or revoke the

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  license of an assisted living a facility that fails to correct

 2  cited fire code violations issued by the State Fire Marshal, a

 3  local fire marshal, or other authority having jurisdiction,

 4  that affect or threaten the health, safety, or welfare of a

 5  resident of a facility.

 6         (3)  The agency may deny a license to any applicant or

 7  to any officer or board member of an applicant who is a firm,

 8  corporation, partnership, or association or who owns 5 percent

 9  or more of the facility, if the applicant, officer, or board

10  member has or had a 25-percent or greater financial or

11  ownership interest in any other facility licensed under this

12  part, or in any entity licensed by this state or another state

13  to provide health or residential care, which facility or

14  entity during the 5 years prior to the application for a

15  license closed due to financial inability to operate; had a

16  receiver appointed or a license denied, suspended, or revoked;

17  was subject to a moratorium on admissions; had an injunctive

18  proceeding initiated against it; or has an outstanding fine

19  assessed under this chapter.

20         (4)  The agency shall deny or revoke the license of an

21  assisted living facility that has two or more class I

22  violations that are similar or identical to violations

23  identified by the agency during a survey, inspection,

24  monitoring visit, or complaint investigation occurring within

25  the previous 2 years.

26         (5)  The agency may deny a license to an applicant who

27  owns 25 percent or more of, or operates, a facility which,

28  during the 5 years prior to the application for a license, has

29  had a license denied, suspended, or revoked pursuant to

30  subsection (2), or, during the 2 years prior to the

31  application for a license, has had a moratorium imposed on

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                                                  SENATE AMENDMENT

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 1  admissions, has had an injunctive proceeding initiated against

 2  it, has had a receiver appointed, was closed due to financial

 3  inability to operate, or has an outstanding fine assessed

 4  under this part.

 5         (5)(6)  An action taken by the agency to suspend, deny,

 6  or revoke a facility's license under this part, in which the

 7  agency claims that the facility owner or an employee of the

 8  facility has threatened the health, safety, or welfare of a

 9  resident of the facility, shall, upon receipt of the

10  facility's request for a hearing, be heard by the Division of

11  Administrative Hearings of the Department of Management

12  Services within 120 days after receipt of the facility's the

13  request for a hearing, unless that time limitation period is

14  waived by both parties.  The administrative law judge must

15  render a decision within 30 days after receipt of a proposed

16  recommended order the hearing.

17         (6)(7)  The agency shall provide to the Division of

18  Hotels and Restaurants of the Department of Business and

19  Professional Regulation, on a monthly basis, a list of those

20  assisted living facilities that which have had their licenses

21  denied, suspended, or revoked or that which are involved in an

22  appellate proceeding pursuant to s. 120.60 related to the

23  denial, suspension, or revocation of a license.

24         (7)  Agency notification of a license suspension or

25  revocation, or denial of a license renewal, shall be posted

26  and visible to the public at the facility.

27         Section 40.  Section 400.417, Florida Statutes, is

28  amended to read:

29         400.417  Expiration of license; renewal; conditional

30  license.--

31         (1)  Biennial licenses issued for the operation of a

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  facility, unless sooner suspended or revoked, shall expire

 2  automatically 2 years from the date of issuance. Limited

 3  nursing, extended congregate care, and limited mental health

 4  licenses shall expire at the same time as the facility's

 5  standard license, regardless of when issued. The agency shall

 6  notify the facility by certified mail at least 120 days prior

 7  to the expiration of the license that a renewal license

 8  relicensure is necessary to continue operation.  Ninety days

 9  prior to the expiration date, an application for renewal shall

10  be submitted to the agency. A license shall be renewed upon

11  the filing of an application on forms furnished by the agency

12  if the applicant has first met the requirements established

13  under this part and all rules promulgated under this part. The

14  failure to file a timely renewal application shall result in a

15  late fee charged to the facility in an amount equal to 50

16  percent of the current fee. in effect on the last preceding

17  regular renewal date.  Late fees shall be deposited into the

18  Health Care Trust Fund as provided in s. 400.418.  The

19  facility shall file with the application satisfactory proof of

20  ability to operate and conduct the facility in accordance with

21  the requirements of this part.

22         (2)  A license shall be renewed within 90 days upon the

23  timely filing of an application on forms furnished by the

24  agency and the provision of satisfactory proof of ability to

25  operate and conduct the facility in accordance with the

26  requirements of this part and adopted rules, including An

27  applicant for renewal of a license must furnish proof that the

28  facility has received a satisfactory firesafety inspection,

29  conducted by the local fire marshal or other authority having

30  jurisdiction or the State Fire Marshal, within the preceding

31  12 months and an affidavit or compliance with the background

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  screening requirements of s. 400.4174.

 2         (3)  An applicant for renewal of a license who has

 3  complied on the initial license application with the

 4  provisions of s. 400.411 with respect to proof of financial

 5  ability to operate shall not be required to provide further

 6  proof of financial ability on renewal applications unless the

 7  facility or any other facility owned or operated in whole or

 8  in part by the same person or business entity has demonstrated

 9  financial instability as provided under s. 400.447(2)

10  evidenced by bad checks, delinquent accounts, or nonpayment of

11  withholding taxes, utility expenses, or other essential

12  services or unless the agency suspects that the facility is

13  not financially stable as a result of the annual survey or

14  complaints from the public or a report from the State

15  Long-Term Care Ombudsman Council.  Each facility must shall

16  report to the agency any adverse court action concerning the

17  facility's financial viability, within 7 days after its

18  occurrence.  The agency shall have access to books, records,

19  and any other financial documents maintained by the facility

20  to the extent necessary to determine the facility's financial

21  stability carry out the purpose of this section.  A license

22  for the operation of a facility shall not be renewed if the

23  licensee has any outstanding fines assessed pursuant to this

24  part which are in final order status.

25         (4)(2)  A licensee against whom a revocation or

26  suspension proceeding is pending at the time of license

27  renewal may be issued a conditional license effective until

28  final disposition by the agency of such proceeding.  If

29  judicial relief is sought from the final disposition, the

30  court having jurisdiction may issue a conditional license for

31  the duration of the judicial proceeding.

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1         (5)(3)  A conditional license may be issued to an

 2  applicant for license renewal if when the applicant fails to

 3  meet all standards and requirements for licensure.  A

 4  conditional license issued under this subsection shall be

 5  limited in duration to a specific period of time not to exceed

 6  6 months, as determined by the agency, and shall be

 7  accompanied by an agency-approved approved plan of correction.

 8         (6)  When an extended care or limited nursing license

 9  is requested during a facility's biennial license period, the

10  fee shall be prorated in order to permit the additional

11  license to expire at the end of the biennial license period.

12  The fee shall be calculated as of the date the additional

13  license application is received by the agency.

14         Section 41.  Section 400.4174, Florida Statutes, is

15  amended to read:

16         400.4174  Background screening; exemptions; reports of

17  abuse in facilities.--

18         (1)(a)  Level 2 background screening must be conducted

19  on each of the following persons, who shall be considered

20  employees for the purposes of conducting screening under

21  chapter 435:

22         1.  The facility owner if an individual; the

23  administrator; and the financial officer.

24         2.  An officer or board member if the facility owner is

25  a firm, corporation, partnership, or association, or any

26  person owning 5 percent or more of the facility if the agency

27  has probable cause to believe that such person has been

28  convicted of any offense prohibited by s. 435.04. For each

29  officer, board member, or person owning 5 percent or more who

30  has been convicted of any such offense, the facility shall

31  submit to the agency a description and explanation of the

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                                                  SENATE AMENDMENT

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    Amendment No.    





 1  conviction at the time of license application. This

 2  subparagraph does not apply to a board member of a

 3  not-for-profit corporation or organization if the board member

 4  serves solely in a voluntary capacity, does not regularly take

 5  part in the day-to-day operational decisions of the

 6  corporation or organization, receives no remuneration for his

 7  or her services, and has no financial interest and has no

 8  family members with a financial interest in the corporation or

 9  organization, provided that the board member and facility

10  submit a statement affirming that the board member's

11  relationship to the facility satisfies the requirements of

12  this subparagraph.

13         (b)  Proof of compliance with level 2 screening

14  standards which has been submitted within the previous 5 years

15  to meet any facility or professional licensure requirements of

16  the agency or the Department of Health satisfies the

17  requirements of this subsection, provided that such proof is

18  accompanied, under penalty of perjury, by an affidavit of

19  compliance with the provisions of chapter 435. Proof of

20  compliance with the background screening requirements of the

21  Department of Insurance for applicants for a certificate of

22  authority to operate a continuing care retirement community

23  under chapter 651, submitted within the last 5 years,

24  satisfies the Department of Law Enforcement and Federal Bureau

25  of Investigation portions of a level 2 background check.

26         (c)  The agency may grant a provisional license to a

27  facility applying for an initial license when each individual

28  required by this subsection to undergo screening has completed

29  the abuse registry and Department of Law Enforcement

30  background checks, but has not yet received results from the

31  Federal Bureau of Investigation, or when a request for an

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                                                  SENATE AMENDMENT

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    Amendment No.    





 1  exemption from disqualification has been submitted to the

 2  agency pursuant to s. 435.07, but a response has not been

 3  issued.

 4         (2)  The owner or administrator of an assisted living

 5  facility must conduct level 1 background screening, as set

 6  forth in chapter 435, on all employees hired on or after

 7  October 1, 1998, who perform personal services as defined in

 8  s. 400.402(16). The agency may exempt an individual from

 9  employment disqualification as set forth in chapter 435. Such

10  persons shall be considered as having met this requirement if:

11         (a)  Proof of compliance with level 1 screening

12  requirements obtained to meet any professional license

13  requirements in this state is provided and accompanied, under

14  penalty of perjury, by a copy of the person's current

15  professional license and an affidavit of current compliance

16  with the background screening requirements.

17         (b)  The person required to be screened has been

18  continuously employed in the same type of occupation for which

19  the person is seeking employment without a breach in service

20  which exceeds 180 days, and proof of compliance with the level

21  1 screening requirement which is no more than 2 years old is

22  provided. Proof of compliance shall be provided directly from

23  one employer or contractor to another, and not from the person

24  screened. Upon request, a copy of screening results shall be

25  provided by the employer retaining documentation of the

26  screening to the person screened.

27         (c)  The person required to be screened is employed by

28  a corporation or business entity or related corporation or

29  business entity that owns, operates, or manages more than one

30  facility or agency licensed under chapter 400, and for whom a

31  level 1 screening was conducted by the corporation or business

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                                                  SENATE AMENDMENT

    Bill No. CS for CS for SB 714

    Amendment No.    





 1  entity as a condition of initial or continued employment.

 2         (3)  When an employee, volunteer, administrator, or

 3  owner of a facility is the subject of has a confirmed report

 4  of adult abuse, neglect, or exploitation, as defined in s.

 5  415.102, or child abuse or neglect, as defined in s. 415.503,

 6  and the protective investigator knows that the individual is

 7  an employee, volunteer, administrator, or owner of a facility,

 8  the agency shall be notified of the confirmed report.

 9         Section 42.  Section 400.4176, Florida Statutes, is

10  amended to read:

11         400.4176  Notice of change of administrator.--If,

12  during the period for which a license is issued, the owner

13  changes administrators, the owner must notify the agency of

14  the change within 10 45 days thereof and must provide

15  documentation within 90 days that the new administrator has

16  completed the applicable core educational requirements under

17  s. 400.452.  Background screening shall be completed on any

18  new administrator to establish that the individual is of

19  suitable character as specified in s. 400.4174 ss.

20  400.411(2)(c) and 400.456.

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31

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    8:44 PM   04/24/98                              s0714c2b-32k7g