Joyce Galbut 12/31/2012 ® Nit 1 A TE A�
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.aov
4FFRrI-C-- G,'q 4b0
OFFICE OF THE CITY CLERK, Rob9441c cher, City Clerk
Tel: (305)673-7411, Fax: (305) 673-7254
06-04-2012
Joyce Galbut
10661 NE Quaybridge Ct
Miami, Florida 33138
UBJ i Production Industry Council
Congratulations! You have been appointed by Mayor Matti Herrera Bower
to the agency, board or committee named above for a term ending: 12/31/2012.
Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after
January 1, 2007, the term of board members who are directly appointed by a member of
the City Commission shall automatically expire on December 31 of the year the appointing
elected official leaves office.
If you are unable to accept this appointment or have any questions, please call the
City Clerk's Office at 305-673-7411. Please read the enclosed materials carefully.
Congratulations again and good luck.
Sincerely,
Rafael E. Granado
City Clerk
,cc: Saul Frances, Parking Director
Graham Winick
ATTACHMENTS:
Letter of Appointment
Oath
City Code/Ordinance section applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Ordinance No. 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employee
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
MIAMI EACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.cov
OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk
Tel: (3051673-741 1 , Fax: (3051 673-7254 Email: CityClerk @miamibecchfl.gov
TO: Joyce Galbut
SUBJECT: Production Industry Council
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the
United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of a
member of the above-mentioned board or committee of the City of Miami Beach to which I have
been appointed for a term ending 12/31/2012.
1 have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Code of
Ethics Ordinance), as well as the Florida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public Officers and Employees, and understand that as a
member of a City of Miami Beach Board and/or Committee, I must comply with the financial
disclosure* requirements of Miami-Dade County or the State of Florida (depending on the board or
committee on which I serve) on July 1, following losing of the calendar year on which I have
served.
Joyce Galbut
Sworn to and subscribed before me this 7`h day of June 201
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirement.
board & (}ommlttee L Uity of Me Beach • Page 1.of 3
BOARD AND COMMITTEE
APPLICATION FORM
�—^ Name
First Name UOyee
Middle Initial
Last Name
Home Address
I Apt No.
House #\Street 1Q(,�� �, Quagj0rLdgv. 4.
city Miami asacb
State Florida
Zip Code 33 15,3
Contact Information
Home/Cell 305% 778-/600
Work 305- 991-/997
Fax _30OS- 9'19-OVtO or 305-$91-194-1
E-mail Address o70t/91t46v C Qol rein
Business Information
Business Name �L� - /4&,4c-f9 r)f rwpelG
Position Ch m It Ah AU"79 O#.,c eI-
Business Address
Apt No.
House #\Street /000 Al P, &g ;-C,o41 oWAe�
City /l),Miami Beach
State Florida Ma.- 'eyle Dr l"4 rP ,�P4
Zip Code 331�:,a- Aw ex,:y SPae-A" r/or.Ge r,
Professional License (describe) )et5 fj ` ;;o A.Jtc/-f'e Expires: 3Ufq
Pursuant to City Code section 2-22(4)a and b:Members of agencies,boards,and committees shall be affiliated with the city;this requirement
shall be fulfilled in the following ways:a)an individual shall have been a resident of the city for a minimum of six months;or b)an individual shall
demonstrate ownership/interest for a minimum of six months in a business established in the city.
Resident of Miami Beach for a minimum of six (6) months:0 Yes-A No
Demonstrate an ownership/interest in.a business in Miami Beach for a minimum of six (6) months:XYesO No
Are you a registered voter in Miami Beach: J Yes 9",No
(Please circle one): I am now a resident of:C)North Beach Q South Beach O Middle Beach N. fni&nLG
Are you a politically or registered lobbyist with the City of Miami
Beach Yes O No
I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
J �r r P�'rP 8nCld �E% ,YG nQ nc�' A
ti
fPcJ(�/�e2 blLJi/]PS�tS ra-14e 44,W 6ee,7 Ctdflv4lt ein /�2aBrr �e•��e�F-Ll7�M[�er/1�
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choic6 Please note that only
three (3)choices will be observed by the City Clerk's Office. (Regular Boards of City)
Click here to view all available Boards and Committees.
i
I
http://secure.miamibeachfl.gov/bcapp/bcapplication.aspx?Application1D=3804 5/30/2012
oar d & Committee City of M. i Beach Page 2 of 3
Affordable Housing Advisory Committee Loan Review Committee
Art in Public Places Committee Marine Authority
Beautification Committee Miami Beach Commission for Women
Board of Adjustment* Miami Beach Cultural Arts Council
Budget Advisory Committee Miami Beach Human Rights Committee
Capital Improvements Projects Oversight Committee Miami Beach Sister Cities Program
Committee for Quality Education in MB Normandy Shores Local Gov't Neigh. Improvement
Committee on the Homeless Parks and Recreation Facilities Board
Community Development Advisory Personnel Board
Community Relations Board Planning Board*
Convention Center Advisory Board Police Citizens Relations Committee
Debarment Committee x Production Industry Council
Design Review Board* Safety Committee
Disability Access Committee Single Family Residential Review Panel
Fine Arts Board Sustainability Committee
Gay, Lesbian, Bisexual and Transgender(GLBT) Transportation and Parking Committee
Golf Advisory Committee Visitor and Convention Authority
Health Advisory Committee Waterfront Protection Committee
Health Facilities Authority Board Youth Center Advisory Board
Hispanic Affairs Committee
Historic Preservation Board
Housing Authority
Note:If applying for Youth Advisory Board,please indicate your affiliation with the Scott Rakow Youth Center:
I
1. Past service on the Youth Center Advisory Board: OYes G No Years of Service:
i 2. Present participation in Youth Center activities by your children O Yes O No
I
If yes, please list the names of your children,their ages,and which programs. List below:
Child's name: Age: Program:
Child's name: Age: Program:
i
Have you ever been convicted of a felony: OYes ONo If yes, please explain in detail:
Do you currently have a violation(s) of City of Miami Beach codes: OYes O No If yes, please explain in detail:
Do you currently owe the City of Miami Beach any
money: OYes ONo If yes,explain in detail
Are you currently serving on any City Boards or
Committees: OYes ONo If yes,explain in detail
What organizations in the City of Miami Beach do you currently hold membership in?
Name: Title:
Name: Title:
List all properties owned or have an interest in, which are located within the City of Miami Beach:
j
I am now employed by the City of Miami'Beach: Oyes ONo Which department?
http://secure.miamibeachfi.gov/beapp/bcapplication.aspx?ApplicationID=3804 5/30/2012
o
t.
Galbut 1
JOYCE GALBUT, R.N., B.H.S.A.
10661 N.E. Quaybridge Court (305) 891-1997 Home
Miami,Florida 33138 (305) 778-1600 Cell
PROFESSIONAL WORK EXPERIENCE
02/07—Present Chief Nursing Officer for 8 facilities in Dade County
The Plaza Health Network/Hebrew Homes Network
Corporate Office
1800 N.E. 168th Street
North Miami, Florida
04/06-2008 Director of the Department of Community Health
Mercy Hospital and Medical Center
3661 South Miami Avenue
Miami,Florida
04/06—02/07 Nursing Consultant/Hebrew Homes Health Network
Corporate Office
1800 N.E. 168th Street
North Miami, Florida
04/03—04/06 Chief Nursing Officer/Admin. E.R. Dept.
South Shore Hospital
600 Alton Road
Miami Beach, Florida
07/02—04/06 Chief Nursing Officer/Admin. E.R. Dept./U.F.A. AIDS
South Shore Hospital
600 Alton Road
Miami Beach, Florida
11/97—07/02 Administrator/U.F.A. AIDS/Prime Home Health
U.F.A. AIDS
South Shore Hospital
600 Alton Road
Miami Beach, Florida
09/94—07/97 Administrator/Prime Home Health Agency
South Shore Hospital and Medical Center
600 Alton Road
Miami Beach, Florida
1999—2006 Administrator/Nurse Liaison and Consultant
Plaza North Skilled Nursing Facilities
320 Collins Avenue
Miami Beach,Florida
Galbut 2
1992-2001 Administrator/Nurse Liaison and Consultant
Palms Skilled Nursing Facilities
999 Washington Avenue
Miami Beach, Florida
09/94—12/02 Administrator
The Plaza.South Assisted Living Facilities for Seniors
1690 Collins Avenue
Miami Beach, Florida
05/86—09/94 Administrator
The Plaza South Assisted Living Facilities for Seniors
03/84—05/94 Administrator
Regency Home Health Agency
333 Arthur Godfrey Road
Miami Beach, Florida
1981 - 1987 Intensive Care Nurse/Open Heart
Saint Francis Hospital
6300 Alton Road
Miami Beach, Florida
1979-1981 Licensed Real Estate Agent
Francesco Morella Realty—Miami Beach
1000 Arthur Godfrey Road
Miami Beach, Florida
1977- 1979 Staff Nurse/Recovery Room
Mercy Hospital and Medical Center
3663 South Miami Avenue
Miami, Florida
1976- 1977 Nurse Patient Coordinator
Care Plus Home Health Agency
4500 Biscayne Blvd.
Miami, Florida
1974- 1976 Charge Nurse and Intensive Care Unit Nurse
Mount Sinai Hospital and Medical Center
4300 Alton Road
Miami Beach, Florida
1972- 1974 Licensed Practical Nurse—Staff Nurse
Mount Sinai Hospital and Medical Center
4300 Alton Road
Miami Beach, Florida
Galbut 3
PROFESSIONAL ORGANIZATIONS/ACTIVITIES
2010—Present Board Member
Safety Board (City of Miami Beach)
1700 Convention Drive
City Hall Building
Miami Beach, Florida
2007—Present Board Member(representing Commissioner Bruno Barreiro)
Miami-Dade County Community Action Agency
701 NW 1St CT, IOt"Floor
Miami, Florida
1990—2008 Member
Miami Beach Chamber of Commerce
Chamber of Commerce Building
Miami Beach,Florida
2006—2008 Board Member
1997—2002 health Advisory Board (City of Miami Beach)
1700 Convention Drive
City Hall Building
Miami Beach, Florida
2000—Present Board Member
The University of Miami Center-on-Aging
Mental Health Hospital at Jackson Memorial Hospital Campus
Miami, Florida
1986—1988 Member/Childrens' Resource Center
8571 S.W. 112'h Street
Miami, Florida
07/1995—04/2003 Co-Executive Director-The United Foundation for AIDS
South Shore Hospital and Medical Center
Miami Beach, Florida
COMMUNITY ACTIVITIES
2001 —2003 Volunteer
Mayor's Initiative for Children
1996—04/2003 Volunteer
KIDZCARE
Galbut 4
EDUCATION AND TRAINING
(See documentation for partial listings)
WORKSHOPS/SEMINARS=CEU's 1974—2007 Required credits for nursing license
(680) hours of training including:
2010 FADONA(Florida Association Directors of Nursing Administration)
Contact Hours= 24 CEU's
2010 Western Schools
Contact Hours= 12 CEU's
(various aspects of nursing areas)
2010 FHCA (Florida Health Care Association)
Contact Hours= 15 CEU's
2009 FADONA(Florida Association Directors of Nursing Administration)
Carrying the Torch of Leadership 2009
Contact Hours=40 CEU's
2008 FHCA Clinical Updates
St. Petersburg, Florida
Contact Hours =40 CEU's
2007 AHCA In-service for Quality Improvement Survey Process for
January 2008 in Skilled Nursing Facilities(St. Petersburg, Florida)
Contact Hours=40 CEU's
2005/2006 Western Schools
Contact Hours=40 CEU's per year
(various aspects of nursing areas)
2004 Western Schools
Ambulatory Surgical Care
Contact Hours=40 CEU's
2002 National Care of Continuing Education, Inc.
Psychiatric Emergencies and Nursing Action
Contact Hours= 12 CEU's
2002 National Center of Continuing Education, Inc.
Drugs of Abuse
Contact Hours= 10 CEU's
2001 Nursing Unlimited, Inc.
AIDS-OSHA-TB= Contact Hours =4 CEU's
Domestic Violence=Contact Hours= 2 CEU
Galbut 5
1998 National Center of Continuing Education
HIV/AIDS in the 90's
Contact Hours=20 CEU
PROFESSIONAL LICENSES
1986 Administrator License for Assisted Living Facilities
State of Florida
1980 License as a Registered Real Estate Agent
State of Florida
1974 Registered Nurse License (77177-2)
State of Florida and State of Georgia
1972 Licensed Practical Nurse(licensed lapsed when received R.N.
degree)
State of Florida
EDUCATION
2007—Present Barry University
Attending Classes Completion Masters in Health Services
Administration
Miami Shores, Florida
2004—2006 Barry University
Miami Shores, Florida
(Graduated with Bachelors Degree in Health Services
Administration
1972—1974 Miami Dade College
Mount Sinai Campus
4300 Alton road
Miami Beach, Florida
1970—1972 Miami Dade College
Main Campus
Hialeah, Florida
AWARDS AND HONORS
1987 United Foundation for AIDS Event
Humanitarian Award
1989 KIDZCARE Event
Humanitarian Award
nni�DADE SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name Initial Last Name
Disclosure
For Tax Year
,D CE S� CONLUT Ending:Name•.
.�g: a011
Mailing Address:
City/State/Zip:
Social Security Number: —
Filing as a: ® County Employee:
® Municipal Employee of: C►'1•at �ns��,�., p
Position held or sought: y,g���. �cA"
Board where serving: ��hw �o(� Cp�NCil Term or Employment
Began on: SvNE Qt0
Department where employed:
HfgllfQ •Mtn
Work Address: 3 o1.D COIi:
OM MIAMI BEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.aov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel:305.673.7411 , Fax:305.673.7254
Acknowledgement of fines/suspension for Board Members for failure
to comply with Miami-Dade County Financial Disclosure Code Provision
Code Section 2-11.1(i) (2)
Board Member name:
understand that no later than July L of each year all members of.Boards and
Committees of the City of Miami Beach, including those of a purely advisory nature, are
required to comply with Miami-Dade County Disclosure Requirements. This means that the
members of City Advisory Boards, whose sole or primary responsibility is to recommend
legislation or give advice to the City Commission,must file, even though you may have been
recently appointed.
You must file one of the following with the City Clerk of Miami Beach, 1700 Convention
Center Drive, Miami Beach, Florida, by July 1 each year.
1. A"Source of Income Statement' (attached) or
2. A "Financial Statement' (attached( or]
3. A Copy of the person's current Federal Income Tax Return
Failure to file, according to the Miami-Dade County Code Chapter 1, General
Provision, Section 1-5 may subject the person or firm to a fine not to exceed
$500.00 or by imprisonment in the county.jail for a period not to exceed sixty
days, or both.
S'gna re:J Date: