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07/21/1989 AgreementBAYSHORE MANOR A/K/A MONROE COUNTY HOME ADULT CONGREGATE LIVING FACILITY FOR THE ELDERLY - LEVEL II A G R E E M E N T This agreement entered into this 14th day of June , 1989 , by and between the County of Monroe, State of Florida, hereinafter called "County" and Elena B. McCoy , hereinafter called "Resident", and Charles "Sonny" McCoy , hereinafter called "Responsible Party." WITNESSETH• WHEREAS, the resident desires to use the facility of the county known as the Monroe County Home, a/k/a Bayshore Manor, and WHEREAS, the County has reviewed the application of the resi- dent for admission to the Monroe County Home and has determined that the resident is eligible for admission to said home, now therefore, In consideration of the mutual covenants, promises and premis- es herein contained, the parties agree as follows: A. BAYSHORE MANOR 1. To furnish room, board, linens, prescribed medicines and general personal care. 2. To arrange for the transfer of the resident to the hospital of the resident's choice when ordered by the attending physician or the health of the resident requires same, and to immediately notify any responsible party (as designated herein) of such transfer. 3. To make refunds on a per diem basis in accord with date of discharge from the home. Refunds cannot be made as long as personal belongings remain in the resident's room. Refunds cannot be made as long as there are outstanding expenditures for services received by the resident. 4. In the event of closure of the facility for reason, a pro -rated per diem refund shall be made: in accord with date of closure within seven (7) days. 5. Residents will be notified in writing thirty (30) days in advance of any basic rate change. 6. Bayshore Manor is not affiliated with any religious organization. 7. Other: B. THE RESIDENT OR RESPONSIBLE PARTY 1. To provide such personal clothing and effects as needed or desired by the resident. 2. To pay the monthly rate agreed upon and such charges as determined by the Monroe County Home to be necessary for the operation of the home. 3. That, upon certification by a physician or the administrator of the home, the resident is no longer capable of meeting the requirements for occupancy in this facility, the resident, next of kin, legal representative or agency acting on the resident's behalf, will have to make arrangements for the immediate transfer to an appropriate facility. In the event a resident has no person to represent him/her, this facility shall assist resident in contracting an appropriate Social Service Agency for place- ment. Applicant agrees to vacate the facility within forty-eight (48) hours after disquali- fication. 4. To comply with all requirements as set forth in the application made by the resident. 5. To comply with all rules and regulations esta- blished by the County for operation and control of said home. 6. Agrees, if not paying the maximum rate, to pay any increase in income during the course of residency, up to the maximum rate. The maximum rate as established October 1, 1985, is $1,195.00 per month. 7. Individual monthly rents not to exceed the maximum rate, will be established by evaluation of the applicant's income, asset, resources and need. 8. Other: Will pay Blue Cross/Blue Shield and Medicare premiums and deduptib es and any other medical costs not covered by insurance, including all medications. C. FINANCIAL ARRANGEMENTS The resident County $ 1,195.00 facilities. and/or responsible party agrees to pay per month as rent for use of the PAYMENT WILL BE FROM THE FOLLOWING SOURCES: 1. Personal funds of resident $ N/A 2. Responsible party will pay 3. Unearned income of resident will pay: Social Security Civil Service Annuity V.A. Pension Other • 11 $ N/A $ N/A $ N/A $ N/A 2 D. STANDARD ADMISSION WAIVER The County, through its employees, has agreed to exercise such reasonable care toward the resident as his or her known condition may require. However, this home is in no sense an insurer of his or her safety or welfare and assumes no liability as such. The management of this home will not be responsible for any valuables or money left in the possession of this person while he or she is a resident of this home. E. TERMINATION If resident is absent from the home in excess of fourteen (14) continuous days, such absence shall automatically terminate this agreement and the resident shall remove all of his or her property or belongings immediately. If resident fails to remove same, the resident does hereby authorize the County to remove said property or belongings and deliver same to responsible party. F. MEDICAL SERVICES The parties agree that Monroe County shall not be responsible for or assume any responsibility for payment of any medical or hospital services unless specifically agreed to by the parties or their representatives at the time of the rendering of service. G. DURATION OF AGREEMENT Either party may terminate this agreement on thirty (30) days written notice. Otherwise, it will remain in effect until a different agreement is executed. However, this does not mean that a resident will be forced to remain in the facility against his/her will for any length of time. This agreement may be amend- ed by written and executed approval of such amendment by both parties or their representatives at the time of the amendment. GNATURE OF RESIDENT SIGNATURE OF/'RFAPONSIBLE PARTY WI S ES A TO ESPONSIBLE PARTY 3 DATE • 3 d APPROVED: Z. ��W Signature o Representative of Monroe C unty Home a/k/a Bayshore Manor Signature of Executive Director - Monroe County Social Services -q32��47' I f� Signature of(pjunty Administrator This is to certify that this Admission Agreement as approved by the County Home and the County Administrator was ratified by the Monroe County Board of Count Commissioners at their meeting held on the 4,5-t day of 19012. (SEAL) ATTEST DANNY L. ROLMGE, Clerk Cler Signature of a airman Monroe County Board of County Commissioners APPROVED AS TO FOAM AND EC:AL SVFFI /FNCY. 6Y Attwi MCNROE CCU,NTY HC.'•1E JU,VICR COLLEGE 1,70AD KEY NEST, FLCRIVA ArMISSIC.N C17ITEPIA. AND POLICIES The MonAoe County Home, Adu�t Congi•tegAate Li.v-i►tg FaciCit(f jon the EL&Vbey, Levee II, heneinajten Ae6etned to cos the Fac,iUty, .i.s ticc;L6ed thAough the State 05 FEoti,da Depa,,Ltment o i Heatth and Rehab,iUtative Sehv.ices, henein- at.ten ne6epfted to as HS, and operated by .the Boated of Counttf Commiss.ionelcs o6 MmLoe County, Feo-,Lida. The. FacUUy .is governed in accordance with .the AequiAe.ments 05 ChapteA 400, Paxt 11, Feoti.da Statues and the RAn and Regu- Qations as adopted by .the BoaAd oU ho;moe County Comm,issioneles heAe.i.na6teA u6eAAed to as County, contained herein. Resident o6 Monno e County, Fen ida, :six-ty (60) yea'cs o6 age oA oUe t, ambu.tato,,Ly, .in Aeasonabee heaeth, in steed o5 a home and haviitg no 'amity abee to meet thei r needs, abee to carte bon ,themsetves to a ceAtain degree and not .in need o6 nuns.ing cane, eonvateseatit cane, tempo.tatuj of emeAgeney sheCteA shaft be eCc:g.ibte loot admission to the 6ac U i.ty in aeeondanee with .the teews and conditions i.ons contained hene.ut. Appe.icati.onvs are accepted on a non- disen,iminotoAy basis inetuding but not t m.cted to sex, coeon, Aace oA cteed. The 6aeieity shaft pnov.ide a homee.ike atmosphere (room and board), peAzonat seAv,ices and a eompnehens.ive ptogrcam to meet day to day needs o6 the ambueatony aged on an indiv-iduat basis - conducive to group Ziv.ing. Personae SeAv,ices mearvs s eAv.ices p in addition to housing and Good senv.ice which inctude but are not t mited to: personat assistance with bathing, dness.ing, ambu.tati.on, housekeeping, suPeAv.cs.icH, emoti.onat s ecuh itu, and any otheA tetated services which the 6acitity may de6ine. Pensonat seAv,ice does not .inc u de m edieat s eAv.ic es . ELIGIBILITY AND AMISSION POLICIES The adm.css.ion o6 each tes.idelt to this 6aciCity shaft be under the supeA- vi6ion o6 the Adm.iit st aton o� the FaeiCity within ,the con6.ines o6 the boeeow.ing g enenat poucies : (1) A neh.ident/appUcant mast: (a) Not have a comma► icab e e di-s ease ,in a ,t to n s - 5 vLabee stage. (b) Have a chest x-nay oA sh.,i.n test (TB) Within ninety (90) days pni.oA ,to admis,s-ion to the 6 aci Ci,t y. (c) Bc a ,e.side�lt c,6 ,Monroe Cotuitti, Feotida at. feast Orate (1) tfeat and 6mnn s11 Vehi6-icat(Unl U6 same. (d) Funntisll pnoo6 o6 deed Son .the 6acUity and that there tis No 6am.Utu able .to meet -theist needs bot adequate cane. (e) FtvLnish wn,ittca med.ieat examination 64om a Yi.Cen�sed physician (6onm wiU be 6uAnti6hed) which shaU ceht.i6y that theiA medica.t condition is such .that .they wZU meet .the n.e- gmiAcments o6 the 6acil,%ty and ,that setv.icn beyond .that a,`ce penm.itted in .the 6aci.Uty are not n.equ, Aed. (6) Be ambutatony - .that ,is the condition o6 being phya.ica.f;2y and emot ionaUy ab.te ,to ants e 6nom a hon,itizon.tat on sitting position, and in an emengenetf ,to exit .the building to a point o6 sa6ety. Th%s wou.td . ne.2ude -those .indiv.iduaes who may be ab.te ,to ambulate with the cuss.is.tance o6 pnos.thet c devices such ass ou tehe,6, wa keu on wheet chai)us . (g) Be sixty (60) yeau o6 age ort o.tden and 6u.uLni6h age veni6.i- cation by eithett proem identti6.icati.0n, documenLts, on. by .in6onmati.on 6nom other public agencies such as the Social Secuh,ity Adm.in i�st t.ation. (h) Futcnush pnoo6 o6 hospitat.izati.on and me.dicat invsuAance which is equat ,to on. b etteh than cove, -Loge o 6 6 erred by Medieane. (.i) Execute a wnittei1 eonttnaet with ,this 6ac Uty at .the time o6 admission, on ption thereto, between the 6aci,U: y and .the n.ezident ot hips designee on. legal n.epAe/senttative. A copy o6 contitAact .to be executed ,us attached hmeto and made a pant thehe06. (2) THE AfMINISTRATOR SHALL: (a) Maintain a wx tten keco-td in ,the knident'/s pmsonat 6ae o6 a.0 6inanciat wftangemen-ts tvith the nes.ideat, his next o6 kin, oh bpon/soA, with copies executed by and 6tvtntizhed to each pahty. Thus shaU -include detailed neconds o6 anttf 6unds on ponopeuety hetd 6on..the ,Les.ident 60,'. /sa6e keeping in aecortdance with Chapters 400 F.S. Pa,.t II. (1) The 6ac.0 ity my hold pnAontat 6unds bon. the An identt not to exceed $100.00. (2) The 6ac.i.l.ity shalt not accept anti othm 6unds o,7 .tcpcttu ,xccpt as set 6wLth i,t 1 above_. (b) As:s es s ,to additicnae chalg e.s , expenses o-t c theA j.urajtci L �.iab.teetieis ('it excess o6 the ptr V4'ls,i.ojts inceuded .i„ the adma s.ion coatAact. (c) Dete;.m.ine, and .inceude as a Minimum, the 60eeow,in9 p.tov-is.ions and .setcv.ice.s in .the basic admi,5.6ion contttcact with each :tes.idejtt, next o6 kin on spoMM: ( 1 ) The daiZu, weehey, m monthly -Tate, and tLe6und p,tovision 6 otL unused potc,t ienz theAeo 6 . (2) A t'.,i,sti ng o6 s eAv.ices to be ptcov.ided. (3) Soc,iae components appncptuate to the needs o6 .the testidejtts . (d) Appi-y .the 6 u e ecw inq tr ens ttuctio,vs to admi's s.io n and .tetent.ion c ,Ses.idents : 1. A ,tn idejit who mani6ests such degtcee o6 behay.iotL that he Zs a dang etL to hZns ee6 wL o•thexs , otc whose b ehay.ion ,ins so unaeeeptabte otL cUztutLbiag as to .interc6 ere with .the adequate cane on. com6oAt o6 othetL Ae�s.idertts in the 6a&iZe ty shale not be admitted otL tcetai.ned, and shale be removed Strom the 6aciZity. 2. No tes.idejtt shaU possess otL consume aeehoeie beverages o,t any contAotted substance .in the 6acit ty tv.i.thout hips phys,ic,i.an ' s otcdetL . 3. No-tesidejtt shale be heed in the 6accZ ty agaijvst hi6 wiee, u teess undetL CeLvc t OtcdeA. 4. No tes.ident s ha.0 be admitted to etc Aeta.ined in a 6 aeil ty who .,Lequites s eAv,ices beyond those ,the 6ac i.ei ty is e cenz ed to ptov.ide. This 6ac ti ty may not ptcov.ide nursing cane ua- Bess 6otL a tempotcatcy ;iUnas, not to exceed seven (7) days. 5. A a.esidejLt ab.s ejtt 6tLom .this 6aciUty .in excess 06 6ou tteen (14) days, due to hospitat i.zatiou on abandonment shale be teton.i,tated a.,5 a t me dent in this 'ac.i Uty. Such .Ln ident may toe-appey 6m adm.i,s,sion 6oUow.ing .the same ptcoeedutce as that o6 a ,tew appUcant. (3) The monthey state 6a.t appeicants/tces.idea,ts shalX be ac ju:sted to .the ab.iUty e6 .the appt.ica,Lt/.tesidcat to pay. Appei.cants/tces.ideats with incomes less than the max.imun may be MQued to ;oay that amount as thcit mvmthfy .rate, th.iswoued Oceude any .i_ncieases In them 4wcme duning the course 06 thMA W ideney, up .to the maximum ,late. (a) The monLthey basic Hate shall be es.tabe.ishe.d at the beginning o6 .the 6isea.l yeah and AM pnevai , through out .the yeah. (b) Monthfif ,ia,tes shall be nevilaved and Amended by ,the Board o6 Monroe County Comm.iss.ionem (e) [!'hen Applicant/Resident neeeives income and has assets less than .the maximum monthly ante, supple- inental support will. be accepted 6nom .the A 6amity, o.then assistance agencies on nepnes entativ es . A 16 thene is no supplemental suppont available, each appOcatit/nes.ident wilt then be eons,idened on an .in- div.idua.l basis . (e) Al.l nes.idents except .those paying .the maximum nate on .those who do have o.theA assets on nes ounces , wiIi be neimbumed -ten (10.00) doll= pelt month by .the County bon .thein pewonat. use. (4) Upon cetti6ication by .the Adm.inis.tnaton o6 the 6aci cry with .the concunnance o6 the Fxecutive Dinecton o6 .the Monroe County Depant- me.nt o6 Social Senv,ices, that all cni,teflia and nequiwnemV set 6ohth heln.ein have been complied with anidlon met, .the appf- cant shall. be admitted to .the 6aci i ty. Subject ,to adequate 6aci,l i ties being available and execution o6 the admission. agneement by .the nes.ident and the County. OPFRA.TIONAL STANDARDS The 6aeieity shall 066en close supenv.is.ion and living conditions as its necessahy to the condition o6 .the nesidenLt. This iaceudes supenv lion, o6 diets as to quality and qua.nUty, watchfulness ovan ,the gnienal health, satiety and well being o6 .�es-idents. Vim shall be a daily wateness o6 the nes-idents by designated s.ta66 o6 the 6ac.ility as to the appa nt well being 06 the individuals with su66ieie, pnov_is.ion bon contacting the nes.ident'.s physicLut, i' the ,tcsl.dont has not aeteady dontc so, It anu, t-(111C t;ie-�e. appears to be s.igai.6.icaat deviation 6Aom his nno.tmae appeatanncc c.t state o6 heatth and weee being. Appnop,ti.ate ntotice os such .6Lsta;nce5 shall be hecmded in the pensonnae AeeoAds o6 .the .iadiv.iduae. (fti,tten agteements between the Saeieity and each o6 ,tts .tes.tdents shall ptov.ide that, upon cmti.6icat on by a physician .that the :tei ident tis no tongeA eapaeb.ee o6 meeting -the ,tequitements pon occupancy inthis Saci,uty, ,the tes.id_ent, next o6 kin, t.egat tepees entc tiv e, m agency acting on .the neh.ident's behat6, w.i U be noti6.ied that .the to ident wife have to make a,'Aang ements Got immediate trans 6eA to an apptopt.iate cane s etttnng . In the event a tes.ideit has no person to teptnent him, .this 6aei.uty shaU be tapons.ibte 6oA te6e rAae .to an appnop)niate socia.e seAvice agency Son ptae em ent. The admizzion o6 a Aes.ideLt to this 6aci,ei,ty and his pAesenee thetetn shaU not eon6eA on ,the 6acii tL/, its adm,inis;0Latot, emp.eoyees oA Aep,tesen.toti.ves any authoA.ity to manage, use oA dispose o6 any p,topetcty o6 .the nesident; noA shaU such admizs.ion oA pAesenee eon6eA on anti o6 such pmsons any autho.tUy otL Aesponsib.i,eitU Sot the personae a66aiAs o6 .the-tes,ide;Lt, except what may be neeessaty 6oA the sa6e and otdetey management os the 6ac t ty of 6o)L the 6a6ety o6 .the to ident. Thus 6aeit ty, adm.inistnaton, emp.eoyee of teptesentative theteo6, may not act as the eouAt appointed guardian, tAustee, oA cons eAvatotL Sot any tces.ident o6 the 6acct ty oA any o6 such tes.ident's pAopettty. Thin 6aec,e-ity sha t be oAgart,ized on a pto6ess.iona.e basks cons,&stelLt with good business ptactiees . This 6aec,e,ity shaU be kesponzibte 6oA pAov.idintg setv.icn 6oA Aes.idents as Aequ,ined conzi.6tent with the. eeve.e o6 setv.ices oS6eted. This 6aei.tity shaU empeoy oA otheAwZse aAAannge Got the svwice c6 such pemonnet as aAe AequiA.ed to pAopetey sta66 ,the 6aet.e.tty. AmfINISTRATIVE STANI'ARI-S Tha 6aciUty shaU be undeA..the eontAoe o6 an adnn.ut,,EstAatoA. (1) The 6aeteity of .its duey designated .iepAzn entative :shale maintain the SoFecw.iing cu:t-ttt.ent ,aCcMc�s and antti o.thct necoAd AeouiAed bti the COunLtti OA Hoc in a peace, 6oAm and .sasteln -o- ,duza.titzi c,ripccc(cd 61 9ecd busi;z:,ss p.tact.i.ccs. (a) An a�iriss.La and d.Lcha.,�3c . qis tc,7 t'.is.ti;zq ;zaIncs c6 .tes.idents aad c -Lte ac5n.it'ed, ide.►iti;�y�;zg .(U,6o."ation about cacti, the peace 6hom which .the 2esedent cva5 admZtted; 'lie date and tea6on Jon di s chatcg e, adequate .iden,t.i6ication o 6 the 6 aci,P i,ty to which the ncs.iden,t .is di s ehatcg ed on ,ttcanz 6 eAned. (b) A pets o►zae bite Gott, each te�s.iden,t cons.ust i.ng o6 app,toptz,i.ate data, ,inc adiag .identi6.ieation o6 next o6 kin, and ate data ,tequi,-Led 6oh .the Ftot,ida Ce,tti6.ieate o6 Death. DetaLes o6 .the ne6e.nra,e, adm.vss.ion, petztine►ut non-rnedieat and medieae in- 6otzmation eonevuung .the-Les.ident shall be main- tained with .the g enena.e 6.us eae . tzeeond o6 each, .inceuding eopia o6 ate agreements on eon tAacts , account records and a cu,-vtent .invento�uj o6 peA,sonae pnopenty hetd 6or sa6e-keeping. (e) A 6aciLity accident/ -incident record 6dee, containing a ceear deh etz ipt io n o6 each accident/incident and any o.theA incident invotving hazardous oh de6.cant behavior o6 a .tee ident or s.ta66 membeA with nana o6 .indiv-idua.es .iavotved, deg ni.ption o6 medieat or o.then seAv.ices pnov.ided and .the steps when i6 any to prevent recuAAance. (d) Pelusonnee neeond o6 each s,ta6' member.. This tecotd whitt be kept updated and contain or.ig.inae emp.eoyment apptieation zvcth re6enenees 6unwushed_. (e) A recotcd o6 pemonnee poe-ieies , .i;iceuding statements o6 poZieieis and wottk assignmeji,ts 6o,t each pos.ut.ion. (6) A record o6 monthey 6.ute dt,i tes , indicating .the date, hour and genenae. deisctCption o6 each dAiee, the extent o6 ,the s,ta66 invoeved a;zd .the name o6 pe,"on in change. (g) Financ.iae tz.econds which .ide►zti6y ate .i;zceme o6 the 6ac U. ty by-sounce and desc.tib-i►zg ate expenditures by category in such a ma;z;ze-t as to be auditab.ee by basic accounting p.tocedune�s . FINANCIAL STANt'APDS The a6n,ijiis.t.latoA c6 thus jaciUtef shai.e ma iLta(;t 6.i,Scae .records iji accordance cvith .the rcqui,temejits o6 ChapteA 400, F.S. Pant 11. There .shaee be a recogjuzed sus.tem o6 accounting cbsed to aeeunateeu ne6Yect de.taiZs o6 the business. The 6aci.P.i,ty shale: (l) Be adm.in s.teAed on a sound 6.inaneiae basZs eojvsi/s,tejvt with good business practices. (2) Spec i "y its ,te6und pot i.ci.es as pahut o6 .the ac6m i ss-ion con t,7a.ct. (3) Speci6y .that no adm,iju:s•OLator, eonsu.etavt, s-ta66 member on .tepAes ejLtat iv e s h aee : (a) Pay any eomm.uss.ion, bonus, rebate oA gnatu,ity to any arganizati.on, agency, physician, sta66 oA other pennon bon .te6mn ae o6 auiu Aes.ident to the 6acie.ity. (b) Request or accept any tenumeAcztton, rebate, g.i6,t bene6.it on advantage o6 any poem 6Aom any vendor oA othetc supptietc because o6 ,the putLchase, rentae oA Zoan o6 equ,ipmejvt, suppt-ia on setv.ices bon the 6aciLUy on tes.ide;- t not consistent with nonunaf'_ bu,s,iness pnoaetice. PERSONNEL STANDARDS The administAaton o6 th.is 6aci,Q,ity shale operate the 6aci. y ,in accordance with the existing Monroe County PeAzonnee PoZieies and Procedures. DI ETA Py STANDARDS This 6aciUty shae.e have written po.-%ci.es and procedures bon pnov,id.ing proper nut,titi.onae care o6 its re6 iden.-ts. (1) The 6oteowing nequiAement6 shate be met: (A) The adm-iniis. atoA oA a pnsoji designated by .the adm-iruis-trato.,c shaee be Aespojjsibee 6oA .the .to-tae dieta7y seAv.iee and the day to dau supehv.('s.ion 06 dietvuj seAv.ice. The designated pehson shaU be Aespojjs.ibte 6oncooAdcjjatbig dietahy s envices with other seAv.ices; deve.eoping wo.gf, as-s.iq)imejLts. - 5- ThC' (icy oiiatc(l bti irli i((J^(ll(St`iat`l' Slla(_l' t'c.'ISl'hJ11 ll(.S�IIe't d(LtLeS (ll �L Sa,�c d11d 5a11,(.tctiU 1'lallllc'c. (B) ThenapeutCc dc.ets as pnesc -�Lbcd by the phI/s•(.cCan sl,a,et be .('.►I .the. tes.ident's 'ceco.ld alld 'se'tved a's o.7 dencd. (C) Feclu.cut diets shah meet heeds oh t.es.idel,ts .in aeeotdalce Leith the eu:-Ircent recommended r.ieta'u( A.Umanee 06 .the Food and ,Nu.t'I ition BoaAd, Nati,oaae Res ecAch Coune i i_, ad',s-ted ;)ot age, :sex, and activity. Thetapewt,ic diets sha t meet .thes e nut, ,.i t(.onae .s,tanda7ds to the extent .that Zs med.icaUy poss.ibte. (D) The dieta7y allowance shaeTT be met by .the uses o6 s.tanda,tized tecipn o66vLi.lig a va'Li.ety o6 tioods adapted .to .the Good habits, pte6etenees and physceae abZUti.es o6 the tesidents . (F) An up ,to date manual, app,-Loved by HRS -s haU be ws ed as the s.tandaAd ,Le6 eterice in panning negu,eat and thellarewtce diets. (F) Dated menus shae.e be planned at teas-t one week in advance Got tegutoA and .theAapeut.ie diets; and contested as served and pert on 0'ae Got s.ix mon.tll,s. SuppX-in o/ non-pe i,5habZe jood .to meet au.ttiti.ona,e needs o6 te/siden z Got one (1) week pen.iod .sha t be on hand. (G) Food shaU be se)Lved attno_eteveecl at sa'e and paeatabte -tempe/,Latutes . AU tesidents s hae,e be en- eounag ed to eat at tabt es in airing w teas . A s upp e y o6 app-topt.iate eating wate shai,e be on hand .to serve ale nes,iden.a . (H) Ate mattcA5 pentai.lullg .to good-se.-Lv.ice shae'.e compey with the pnov.is ions o6 Cllaptet 10- 13, Feot da SanitcL-ey Code. -9- RIGHT TO HFARING Any app.Ucant who Zs di s,sa,ti s 6.ied tuith the dec, ,s.ion nendeAed by the Department 06 ,klonnoe County Soci.at Sesw.ices, hah .the tight to ,tequnt a .tev.iew o6 .the,it ease by .the Soeiae Se,tv.ices Exeeu,tive Dilecton. Th,i,d nev,iew shall be done within 6.ive (5) comk%ng days a6-te,t .the request is neeeived 6nom ,the app.-icaLt. 16 ,the D,Aeeton'.s-tev,iao does ► of ,'LMoZve ,the app.Ucal.t'-s eompiaint, .the appZicaLt .then has the tight .to .teques.t a Faist. Heating. FAIR HEARING PROCEVURE Within ,ten (10) wo t icng dates a6,ten a compZaint Zs ,Leceived 'um an appYican.t, a heating tui,Q,P, be held .in the o66.iee o6 the County AdminU6ttatoA. The purpose o6 th.is heating tuitt be ,to avow .the appZicant a 6auv oppottunity to voice W/hest comptaint be6one a heah,ing committee. Thiseomm ttee w.c,U consist o6 .the County Adm.inistAotoh, ,the Ctett.h- o6 .the BoaAd o6 Montoe County Commizs.ionens and one (1) County Comm.css.ionen. The 6.inat decision .shall be made by .the heating committee within ten (10) days and a copy o6 same shaU be 6utnished. to .the appZieant by united States MaiZ on puusonat deZive ty. AS o6 th.iz date, I have head the Admission Ctt.i,ten.ia and PoZicies : d,iAlfLo ?k)*# tignatutLe o es.c enda��yps AaAWW *,,L(-n 64 Date 54% ISAA g haw 10 e. f� ctn es s Date