North Lake Villas Inc.

Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to complete an investigation and deliver findings of the above noted allegations. LPA met with Med-Tech and explained the reason for the visit. The Assistant Administrator later joined today’s visit During initial visit on 09/22/2025 due to the destruction of North Lake Villas, Inc. by fire, the complaint visit was conducted at 10:35 am by Licensing Program Analyst (LPA) Tihesha Smith at Encino Terrace Senior Living Adult Residential, a facility that residents from North Lake Villas were relocated. LPA Smith met with staff and disclosed the purpose of the visit. LPA Smith conducted an interview with a licensee via telephone, requesting documents relevant to the investigation to include but not limited to a copy of admissions agreement, personnel report, staff schedule, resident roster. Prior to this visit on 03/13/26 LPA Alvizar- Ettima conducted an interview with Assistant Administrator aRead the full finding— CDSS inspection report, April 21, 2026 · control 31-AS-20250917150613

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced visit for the above noted allegations. LPA met with Assistant Administrator Adam Braun. The purpose of the visit was discussed. It was reported that facility staff made resident wait in the cold basement of the facility before being moved out. To investigate this allegation on 11/09/2022, between 12:40pm and 1:30pm, staff interviews were initiated. Interviews revealed that R1 was taken to the bottom floor of the facility and not the basement. Staff interviewed do not know why R1 was taken to the bottom floor of the facility prior to being relocated. Between 1:30pm and 2:00pm, records were reviewed. A Welebhealth staff confirmed that they were made to wait in a cold basement prior to R1's exit of the facility. Continue on C 9099 SubstantiatedRead the full finding— CDSS inspection report, November 9, 2022 · control 31-AS-20221104084618

At approximately 12:00 p.m. on 06/07/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with administrator and disclosed the reason for the visit. Resident was not provided a copy of their Admissions Agreement while in care. Regarding the allegation above, it was alleged the facility did not provide resident #1 (R1) with a signed copy of their admission agreement for over 4 months. To investigate, LPA Manya Lefian interviewed R1 and LPA Nicholas Reed interviewed staff #1 (S1) and staff #2 (S2) at 12:15 p.m. on 06/07/2022. LPA Lefian suggested R1 ask again for the admission agreement, and R1 confirmed it was provided. S1 informed LPA Reed that R1 already had a copy of their admission agreement. S2 told LPA Reed that R1 was provided a copy of the agreement on the day R1 moved to the facility. Based on interviews, the facility did provide the admission agreement to R1. Although the allegation may have happened or is valid, therRead the full finding— CDSS inspection report, June 7, 2022 · control 31-AS-20200605111033

At approximately 12:00 p.m. on 06/07/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with administrator and disclosed the reason for the visit. Staff threatening resident with eviction. Regarding the allegation above, it was alleged the facility threatened to evict resident #1 (R1). To investigate the allegation, LPA Manya Lefian interviewed staff #1 (S1) at 9:49 a.m. on 06/05/2020 and LPA Reed interviewed S1 at 12:30 p.m. on 06/07/2022. LPA Reed also conducted a record review on 06/07/2022 at 12:58 p.m. S1 told LPA Lefian the facility “did not threaten [R1] with an eviction” and needed to find R1 a higher level of care due to a worsening stage 2 pressure injury. From record review, home health notes from 06/05/2020 indicated a primary diagnosis of “pressure ulcer of right buttock, stage 2” and a secondary diagnosis of “pressure ulcer of other site, stage 2”. Due to R1’s large size, S1 and S2 conducted a body scan on R1.Read the full finding— CDSS inspection report, June 7, 2022 · control 31-AS-20200527082812