20-003572 Afily8 Government Solutions vs. Agency For Health Care Administration Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Friday, October 2, 2020.

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is entitled to judicial review, which shall be instituted

by filing one copy of a notice of appeal with the Agency Clerk of AHCA, and a second copy, along with

filing fee as prescribed by law, with the District Court of Appeal in the appellate district where the Agency

maintains its headquarters or where a party resides. Review of proceedings shall be conducted in

accordance with the Florida appellate rules. The Notice of Appeal must be filed within 30 days of

rendition of the order to be reviewed.

CERTIFICATE OF SERVICE

I CERTIFY that a true and correct.-C£PY_9f _this Final Order was served on the below-named

persons by the method designated on this of , 2020.

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: [phone]

Facilities Intake Unit Warren J. Bird, Assistant General Counsel

Agency for Health Care Administration Office of the General Counsel

(Electronic Mail) Agency for Health Care Administration

(Electronic Mail)

1 ack Plagge, Manager Jean Frantz Guillaume

Hospital and Outpatient Services Unit Afily8 Government Solutions, LLC

Agency for Health Care Administration 5371 Northwest 32nd Court

(Electronic Mail) Margate, Florida 33063

(U.S. Mail)

RON DESANTIS

GOVERNOR

MARY C. MAYHEW

SECRETARY

Certified Article Number

72bb 0553 b7

August 21,2019 CERTIFIED

SENDER'S RECORD

Jean Frantz Guillaume File Number: 12667

Afily8 Government Solutions, LLC Application Number: 57743

5371 NW 32nd Ct Provider Type: Health Care Clinic

Margate, Florida 33063

RE: Complaint Number 2019011262

Notice of Intent to Deem Application Incomplete

and Withdrawn from Further Consideration

Afily8 Government Solutions, LLC's application for initial licensure has been deemed incomplete and

therefore the Agency intends to withdraw it from further consideration. The Agency notified the

applicant in writing of apparent errors or omissions and requested additional information. The requested

information was not filed with the Agency within 21 days after the Agency's request or, iffiled, did not

satisfactorily address the errors and omissions. Thus, the application shall be deemed incomplete and

withdrawn from further consideration in accordance with Section 408.806(3)(b), Florida Statutes (F.S.).

The specific basis to withdraw this application is:

• The applicant has not met the statutory and rule filing requirements for proof of financial ability to

operate in accordance with s. 408.8065(1) and 408.810(8)-(9), F. S. and s. 59A-35.062 and 59A-

33.002(2)(d), Florida Administrative Code (F.A.C.) as detailed on the attached memo.

• The applicant is not in compliance with health care clinic licensing requirements due to failure to

appoint a qualified medicaVclinic director in accordance with s. 400.9905(5), 400.991(3)-(5),

400.9935(1), 408.809(l)(e) and 435.06, F.S. and s. 59A-33.008(1)- (2), F.A.C.

• The applicant is not in compliance with background screening licensing requirements due to failure to

maintain a roster of all individuals required to have current level 2 background screening in

accordance with s. 435.12(2) and 408.809, F.S. and s. 59A-35.090, F.A.C.

• The mailing address of the licensee submitted with the application does not match that as filed with the

Florida Department of State, Division of Corporations in accordance with s. 59A-35.060(4), F.A.C.

• The applicant did not provide the name, address and federal employer identification number or

taxpayer identification number of each controlling interest of the licensee and management company

in accordance with s. 408.806(1), F.S. This information must be the same as that registered with the

Division of Corporations in accordance with section 59A-35.060(4), F.A.C. The information provided

on the application for licensure must match that provided on the addendum, along with each

individual's social security number, as required per section 59A-35.060(1 ), F.A.C.

EXPLANATION OF RIGHTS

Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing. In order to

obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1 ), F.S., !:: co

2727 Mahan Drive • MS#53 Face book. co m/AH CAFiorida J: w X

Tallahassee, FL 32308 Youtube. com/AHCAFI orida

AHCA. MyFiorida. com Twitter. com/AHCA_FL

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Afily8 Government Solutions, LLC

August 21,2019

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your request for an administrative hearing must conform to the requirements in Section 28-106.201,

Florida Administrative Code (F.A.C), and must state the material facts you dispute.

SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS.

If you need further assistance, please contact the General Counsel's Office at [phone].

Jack Plagge, Manager

Hospital and Outpatient Services Unit

cc: Legal Intake, Mail Stop 3

McCalister, Marvin

From: jfrantz wesendfast.com

Sent: Friday, October 2, 2020 10:25 AM

To: Bird, Warren

Subject: [External] AHCA case number, 2019011262, DOAH case number 20-3572

Mr. Bird,

On behalf of Afily8 Government Solutions, LLC, we hereby withdraw our pending application.

Kindly,

Jean Frantz Guillaume, CEO/AGENT

Afily8 Government Solutions LLC

305.896.3236

afily8.com

Govarn10ant Solutions

From: Bird, Warren

Sent: Friday, October 2, 2020 10:15 AM

To: jfrantz wesendfast.com

Subject: RE: [ External] Re: Notice- Petition will submit a Motion Request for Summary Judgment -Indicate your

objection within 1 hour starting at 0900;

Mr. Guillaume,

I'll keep what you emailed, however as I asked in my earlier email, please send me just the simple statement that I put in

my email. The reason is that when you write 14 pages, it implies that there are many conditions to the withdrawal of

the application. For the withdrawal to be sufficient for settlement purposes, it is necessary that the statement be a

clean and simple one, which states, as I requested:

Mr. Bird, on behalf of Afily8 Government Solutions, LLC, we hereby withdraw our pending application", and include

the AHCA case number, 2019011262 and the DOAH case number 20-3572, in the subject line of the email.

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