Floradale Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Wednesday November 5, 2025 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Parks reviewed resident (5) and staff files (2). All resident files contained the required paperwork. Staff files contained the required paperwork and training. Administrator produced a copy of their current Administrator Certificate. LPA Parks and Administrator toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, living room, kitchen, garage and backyard. In the areas toured, there were no health or safety violations observed. Facility was clean and well organized. All required posting were observed. All knives/sharps were kept locked and inaccessible to residents. First Aid kit was fully stocked. Carbon monoxide detectors were observed. Water temperature was within the required range. Fire extinguisher was observed near the entry way. LPA obtained a copy of the current liability insurance. No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the facility.the state’s words, verbatim · CDSS document, Nov 5, 2025

Allegation investigated: Staff handled resident in a rough manner Staff retaliated against resident for reporting concerns Staff do not ensure that resident's hygiene needs are met Staff are interfering with resident's hospice care

Licensing Program Analyst (LPA) Graham Gunby arrived unannounced on 09/18/2025 to complete and deliver findings to a complaint received on 05/19/2025. LPA met with Administrator, Emil Tif and explained the purpose of the visit. Throughout the course of the investigation, the department conducted interviews and record reviews. Please continue to LIC9099C.. Unfounded Allegation: Staff handled resident in a rough manner The Department investigated the allegation of staff handling resident in a rough manner. LPA interviewed staff, and all staff denied hitting and/or handling resident in a rough manner. LPA interviewed F1 who denies staff handled R1 in a rough manner. LPA reviewed hospice notes, which did not indicate any mishandling of the resident. During the investigation, LPA conducted interview with (1) reporting party, (1) staff, (1) resident, and (1) family member. LPA also reviewed R1’s resident records and hospice reports. Based on interviews and record reviews, LPA finds allegation to be Unfounded. Allegation: Staff retaliated against resident for reporting concerns The Department conducted interviews that did not reflect any concerns that staff retaliated against residents for reporting concerns. Staff are aware about Residents Rights and are aware about their Mandatory Abuse Reporting requirements as needed. On 05/21/2025 LPA observed complaint hotline posters posted in the facility. From this gathered information, Department did not observe that staff were discouraging residents from filing any complaints while in care, therefore, this allegation was Unfounded. Allegation Staff do not ensure that resident's hygiene needs are met Utilizing record review, interviews and observations to investigate this allegation. Staff interviews indicated that staff were providing all ADL assistance, including toileting and bathing to residents per their needs and service plan. Staff interviews indicated that staff were assisting residents for their toileting needs every 2 hours or as needed. Resident interviews reflected that their care needs were met by staff and there were no issues to address. F1 stated they are happy with the hygiene care at the facility. LPA observed residents in care to be clean and odor free, therefore, this allegation was Unfounded. Allegation: Staff are interfering with resident's hospice care Through interviews with F1, it was discovered that the hospice agency had trouble initially contacting staff. R1 was on hospice when they were transferred to this facility and during this transition in December of 2024. After the initial miscommunication F1 stated they do not have any problems with their hospice agency and have been very happy with their experiences with them. Due to miscommunication and not intentionally interfering with the residents’ services, this allegation was Unfounded. Based on records reviewed, interviews and observations, LPA finds the above allegations to be Unfounded- meaning that the allegations were false, could not have happened and/or is without reasonable basis. Exit interview conducted with the Administrator. Copy of report was given to facility. Exit interview was conducted with Administrator. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Sep 18, 2025 · control 59-AS-20250519094652

Allegation investigated: Staff do not provide daily activities for residents in care

Licensing Program Analyst (LPA) Graham Gunby arrived unannounced on 09/18/2025 to complete and deliver findings to a complaint received on 05/19/2025. LPA met with Administrator, Emil Tif and explained the purpose of the visit. Throughout the course of the investigation, the department conducted interviews and record reviews. Please continue to LIC9099C.. Substantiated Allegation: Staff do not provide daily activities for residents in care During the investigative process it was reported that staff were not providing a variety of activities for the residents. Staff could not provide a calendar with a variety of activities for the residents. LPA observed board games and puzzles in the living room. Per the regulations, the licensee is to provide an extensive list of activities to include games, sports, exercise, community service activities, community events to include concerts, tours, dances, celebrations of special events, etc. The clients have not been provided with a variety of activities as required by the regulations, therefore, this allegation was Substantiated. Based on investigation observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC 9099D. Exit interview was conducted with Administrator. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Sep 18, 2025 · control 59-AS-20250519094652

From the deficiency page — Deficiency type: Type B · Section cited: CCR 85079((a)(2)(c)) · Plan of correction due date: Sep 25, 2025

85079((a)(2)(c) Activities - The licensee shall ensure that planned activities... provided for the clients: Physical activities... games, sports, and exercise. The licensee shall ensure that clients are given the opportunity to attend and participate in community activities...This requirement is not met as evidenced by: Based on observation and interviews conducted, the administrator did not ensure that there is a planned activity program that includes a variety of activities for the clients. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 18, 2025

Plan of correction: The administrator agrees to develop a planned activity program, encouraging all residents to contribute to the planning, preparation, and evaluation of the activities. Documentation of the planned activity program shall be submitted to the licensing agency by 09-25-25

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Graham Gunby and Cheyenne Ratajczak arrived on Wednesday October 2, 2024 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPAs reviewed client (3) and staff (1) files. All client files contained the required paperwork. All staff files contained the required paperwork and training. LPAs and Administrator Emil toured the facility together to ensure the health and safety of clients in care. The areas toured included bedrooms, office, kitchen, bathrooms, back yard and common areas. All chemicals, toxins and knives were kept locked and inaccessible to clients. Facility has one (1) fire extinguishers, in the entry. In the areas toured, there were no health or safety violations observed. No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the Administrator.the state’s words, verbatim · CDSS document, Oct 2, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Melissa Parks arrived on Tuesday November 14, 2023 to conduct the unannounced annual inspection. During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Parks reviewed resident (1) and staff files (2). Resident file contained the required paperwork. All staff files contained the required paperwork. First aid kit was fully stocked. Facility had a full supply of PPE including face shields, surgical masks, N95s, and gowns. Facility was clean and well organized. All required posting were observed. LPA Parks and Emil toured the facility together to ensure the health and safety of resident in care. The areas toured included resident rooms (occupied and unoccupied), bathrooms, kitchen, garage, and backyard. In the areas toured, there were no health or safety violations observed. Administrator will email LPA a copy of the current liability insurance. No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the facility.the state’s words, verbatim · CDSS document, Nov 14, 2023