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Karen Rivo Application PackageRivo Karen T Last Name First Name Middle Initial 4566 Prairie Ave.Miami Beach Home Address City Florida 33140 State Zip Code (305) 674-9480 HomeWork karenrivo@gmail.com Email Address 305.283.3897 Cellular Business Address City State Zip Code Occupation:Business Name: RN Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3) choices will be observed by the City Clerk’s Office. (Regular Boards of City) Choice 1: Choice 2: Choice 3: General Obligation (G.O.) Bond Oversight Committee Committee for Quality Education in Miami Beach BOARD AND COMMITTEE APPLICATION FORM Note:If applying for the At-Large position of the Historic Preservation Board, please answer the below questions: Have you ever resided in one of the City's Historic Districts for at least one year?No No Address in City Historic District submitted. Professional License No Professional Licenses Submitted. Note:If you are seeking appointment to a professional seat (e.g. attorney, architect, etc.), you must attach a copy of your currently effective corresponding professional license. Pursuant to City Code section 2-22(4) a, b and c: Members of Agencies, Boards, and Committees shall be affiliated with the city. This requirement shall be fulfilled in the following ways: YesResident of the City for a minimum of six (6) months: Demonstrate an ownership interest in a business established in the City for a minimum of six (6) months:No AFFILIATION WITH THE CITY OF MIAMI BEACH a. ● I am resident of:Middle Beach Or b. "Ownership Interest" shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. c.Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months):No Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by a 4/7th vote of the Mayor and City Commission. NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation requirements of section 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they have met either (or both) of said affiliation requirements. The original affidavit shall be filled with the Office of the City Clerk prior to being sworn in as a member. Or No● Have you ever been convicted of a felony:If yes, please explain in detail: ● Do you currently have a violation(s) of City of Miami Beach codes:No If yes, please explain in detail: ● Do you currently owe the City of Miami Beach any money:No If yes, please explain in detail: ● Are you currently serving on any City Boards or Committees:Yes If yes, which board? Go Bond Oversight Committee ● Are you presently a registered lobbyist with the City of Miami Beach?No ● I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Neighborhood Leadership - NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO: o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459). o Prohibition from contracting with the city (Miami-Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26) o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1). o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most meetings of Boards, Commissions, and other governing bodies of state and local governmental agencies or authorities. o Voting conflict - Form 8B is for use by any person serving at the county, city, or other local level of government on an appointed or elected Board, Council, Commission, Authority, or Committee. It applies equality to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143. Florida Statutes. ● In what organization(s) in the City of Miami Beach do you currently hold membership in? No Organization Information Submitted. ● List the address of all properties owned or in which you have an interest within the City of Miami Beach: Property 4566 Prairie Ave If so, which department and title?No● Are you now employed by the City of Miami Beach: ● Pursuant to City Code Section 2-25 (b): Do you have a parent, spouse, child, brother, or sister who is employed by the City of Miami Beach?No If "Yes", identify person(s) and department(s): No relative's information submitted. BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-Dade County Financial Disclosure Code Section 2-11.1(i)(2) I understand that no later than July 1, 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 Financial Disclosure Requirements. One of the following forms must be filled with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year: 1. A "Source of Income Statement;" or 2. A "Statement of Financial Interests (Form 1)¹ ;" or 3. A Copy of your latest Federal Income Tax Return. Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine of no more than $500, 60 days in jail, or both. _____________________________ ¹ Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County’s financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. DIVERSITY STATISTICS REPORT The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. WhiteRace/Ethnic Categories What is your race? No details providedOther Description: Gender:Female Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.No Physically Challenged:No I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED “STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATUTES ACCORDINGLY.” I Karen Rivo agreed to the following terms on 11/17/2022 7:09:05 AM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee. YES YES YES YES I have answered all questions fully. I have uploaded a current resume, photograph, and a copy of any applicable professional license. I have completed and attached the Board & Committee Financial Acknowledgment Statement. I have completed and attached the Diversity Statistics Report. If you have any questions, please contact the Office of the City Clerk via email: BC@miamibeachfl.gov or telephone: 305.673.7411 Note: Florida Statutes 119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public records. If your home address, telephone numbers, and/or photograph are exempt from disclosure and you do not wish your home address, telephone numbers, and/or photograph to be made public, please: 1) Use your office or other address for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a photograph. 1 Karen Rivo, RN, MSPH 4566 Prairie Avenue Miami Beach, FL 33140 Phone: (305) 674-9480 Cell (305) 283-3897 Karenrivo@gmail.com Resume Summary Registered nurse with Masters in Public Health and over 30 years of clinical, management, and leadership experience in hospitals, health centers, public schools and the community. Strong record of success in advocacy, operations, and project management. Education: Master of Science in Public Health, May 1985 University of North Carolina, Chapel Hill, North Carolina Concentration: Health Policy and Administration Thesis: Fitness Programs in the Workplace Bachelor of Science, May 1977, Cum Laude University of North Carolina- Greensboro, North Carolina Major: Nursing Award: Sigma Theta Tau, Nursing Honor Society RN License: Florida #1298582 -expires 4/30/21 VOLUNTEER SERVICE: City of Miami Beach • Chair, General Obligation Bond Oversight Committee 2019 - present • Chair, Mayor’s General Obligation Bond Advisory Panel 2018 • Vice-Chair, Health Advisory Committee 2017-2018 • Chair, Health Care Task Force 2012- 2015 • Chair, Committee for Quality Education 2010- 2012 • Chair, Governing Board, Service Partnership Grant 2008- 2009 • Chair, Committee for Quality Education 2005- 2007 • Member, Committee for Quality Education 1999- 2016 Miami-Dade County Public Schools • Member, Budget Priorities Committee 2009 - 2018 • Chair, School Health Medical Advisory Committee 2009 - 2011 • Chair, Budget Priorities Subcommittee 2009 - 2012 • Chair, Family and Community Involvement Committee 2007 – 2009 • Vice-President, Miami-Dade County Council of PTAs/PTSAs 2009 - 2010 2 • Chair, Health/Safety Committee, Dade County PTA 2006 – 2009 • Member, Wellness Advisory Committee 2006 – 2009 • Member, Miami-Dade Task Force for Bullying Prevention 2005 - 2009 • PTSA President, Miami Beach Senior High 2007 - 2009 • PTSA President, Nautilus Middle School, Miami Beach 2004 - 2006 • PTA President, North Beach Elementary School, Miami Beach 1999- 2000 Miami-Dade County • Vice-Chair, Florida KidCare Coalition of Miami-Dade County 2012- 2013 • Member, Tobacco-Free Workforce Group, 2011- 2013 Community • President, Temple Beth Sholom, Miami Beach 2016- 2018 • Board Member, Ayuda Inc, 2002 – 2003 • Member, North American Board, Union for Reform Judaism.2018 – present • Secretary, Pardes Institute of Jewish Studies 2018 - present PROFESSIONAL EXPERIENCE: Miami-Dade County Public Schools - Community Engagement 2011 – 2014 • Administrator, Florida KidCare Grant – Supervise outreach to 200 schools Home Med Solutions, Miami Beach, Florida 2009- 2012 • Home Health Nurse – Administer health care to patients in their homes Mollen Immunization Clinics, Phoenix, Arizona 2009- 2011 • Flu Vaccination Nurse - Administer influenza vaccinations in the community Election Assistance Commission, Washington, DC 2009 - 2011 • Grant Peer Reviewer – Review grants for a federal Election Agency Camp Coleman, Cleveland, Georgia, - 1999 • Staff Nurse - Responsible for health care of 600 campers and staff Miami Beach Community Health Center, Miami Beach, FL 1997 • Coordinator of Professional Services - Responsible for all health service delivery provided by medical and nursing staff, including infection control and immunizations; total quality management; credentials; and employee health. Providence Hospital, Washington, DC 1986 – 1995 • Administrative Supervisor - Administratively responsible for the Department of Nursing and hospital operations for this 400-bed hospital. • Nurse Manager and Staffing Coordinator -Supervised the float pool, per diem and agency staff; Coordinated daily staffing and scheduling 3 operations for 800+ nursing employees; implemented patient classification, recruitment, and quality assurance systems. Duke University Medical Center, Durham, North Carolina 1980- 1985 • Staff Nurse and Team Leader Supervised and administered patient care on 16 medical, surgical, and pediatric units. Traveling Nurse Corps, Boston, MA 1981 – 1982 • Traveling Nurse – Staff nurse on medical –surgical units at Tulane University Hospital, New Orleans, Louisiana; Sierra Vista Hospital, San Luis Obispo, California, and North Broward Hospital, Pompano Beach, Florida North Carolina Memorial Hospital, Chapel Hill, North Carolina 1977- 1980 • Charge Nurse - Supervised care of acutely ill neurology patients; Designed new Kardex system Professional Affiliations: • American Nurses Association • Sigma Theta Tau, National Nursing Honor Society • Florida Nurses Association Honors: • North Beach Health Clinic renamed “Karen Rivo Health Clinic” December 2015 • Karen Rivo Day, City of Miami Beach December 1, 2015 • Hannah G Solomon Award, National Council of Jewish Women, 2012 • Tobacco Recognition Award, Consortium for a Healthier Miami-Dade, 2012 • Volunteer Award, Miami-Dade County Health Department, 2010 • Adult Volunteer of the Year, Miami-Dade County Public Schools, 2008 • Honorable Mention, Miami-Dade County PTA President of the Year, 2008 • Outstanding Volunteer Award, Temple Beth Sholom, 2008 • Volunteer Hall of Fame, Miami- Dade County Public Schools, 2006 • Recipient, Woman Worth Knowing Award, City of Miami Beach, 2002