Villa Florenza

Allegation investigated: Licensee is housing a bedridden resident without the required fire clearance.

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced visit to initiate a complaint investigation regarding the above-mentioned allegation. LPA identified herself and met with Christopher Diaz, caregiver, to discuss the purpose of the visit and elements of the complaint. LPA spoke to Javed Talukder, Administrator, regarding the reason for the visit The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review. On 6/8/26, it was alleged that the licensee is housing a bedridden resident without the required fire clearance. Review of resident records revealed that 1 of 3 residents are documented as bedridden. Review of the facility's fire clearance and license revealed that the facility does not have a fire clearance for retaining bedridden residents. The Department has investigated the above-mentioned allegation, and based on observation and record review, the preponderance of the evidence has been met; therefore, this allegation is deemed substantiated. The following deficiency is cited per CA Code of Regulations Title 22 and noted on the attached LIC9099-D page. A civil penalty in the amount of $500 has been assessed during today's visit. An exit interview was conducted with Caregiver Christopher Diaz, and a copy of this report, the LIC421IM (7/17), and the Licensee Appeal Rights (LIC9058 01/16) were provided to Christopher Diaz via hard copy. Substantiated The Department has investigated the above-mentioned allegation, and based on observation and record review, the preponderance of the evidence has been met; therefore, this allegation is deemed substantiated. The following deficiency is cited per CA Code of Regulations Title 22 and noted on the attached LIC9099-D page. A civil penalty in the amount of $500 has been assessed during today's visit. An exit interview was conducted with Caregiver Christopher Diaz, and a copy of this report, the LIC421IM (7/17), and the Licensee Appeal Rights (LIC9058 01/16) were provided to Christopher Diaz via hard copy.the state’s words, verbatim · CDSS document, Jun 11, 2026 · control 08-AS-20260608090015

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a)(2)(c)(1) · Plan of correction due date: Jun 12, 2026

FIRE CLEARANCE - ...bedridden persons may be admitted to, and remain in, residential care facilities for the elderly that secure and maintain an appropriate fire clearance. This requirement is not met as evidenced by: LPA observed resident #1, and reviewed resident #1's physician report all of whom state resident #1 is bedridden. LPA confirmed that the current fire clearance does not include bedridden satus. This poses an immediate safety risk ro re care.the state’s words, verbatim · CDSS document, Jun 11, 2026

Plan of correction: Licensee advises they will submit an LIC 9054, LIC 200 and LIC 610 by POC date to CCL via fax or email (forms were provided to licensee). Final bedridden clearance pending fire department approval.

Allegation investigated: Licensee does not ensure sufficient staffing Facility staff are not following infection control guidelines

Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings regarding the above complaint allegation(s). LPA introduced themselves and disclosed the purpose of the visit to Licensee Dr. Mohammad Rahman. On 02/10/2026 it was alleged that "Licensee does not ensure sufficient staffing" and that "Facility staff are not following infection control guidelines." The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, and records review. Regarding the allegation, "Licensee does not ensure sufficient staffing," it was alleged that licensee did not accommodate staff schedules to allow for absence of staff due to sickness. (Continued on LIC9099C, Page 2) Substantiated (Continued from LIC9099, Page 1) Regarding the allegation, "Facility staff are not following infection control guidelines" it was alleged that facility staff did not follow the infection control plan in the plan of operations of the facility by allowing a staff to provide care during an infectious period. Interviews with staff revealed that S1 was working with residents during the week of February 6th - February 13th 2026. S1 stated they had a doctor's note excusing them from work. Interviews with S1 and S2 confirmed S1 was working with residents during the infectious period and as part of their tasks, preparing meals for residents. Staff unanimously said they tried to contact the administrators to find relief but stated administrators were absent, did not respond to calls, and when they did respond, made promises to get coverage but ultimately did not or fell through. Records review revealed that S1 had a doctor's note excusing them from work for one week and allowing them to return to normal work duties on February 14, 2026. A handwritten schedule of shifts for the week showed that S1 worked four of the seven days they were sick and excused from work. Review of the infection control plan included in the plan of operation states that "Any care staff who are known to be affected with any illness in a communicable stage should not be allowed to have direct contact with residents or resident food." Regulation review of California Code of Regulations, Title 22 states that facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. As evaluated by a physician, S1 was deemed not "competent" to work during the time period they were infected. Based on relevant interviews and records review, the preponderance of evidence has been met that alleged violations occurred and are therefore substantiated. Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Licensee Dr. Mohammad Rahman, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, May 5, 2026 · control 08-AS-20260210111209

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: May 5, 2026

87411-Personnel Requirements - General: (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. Based on observation, interview, and record review, the licensee did not ensure working staff were competent to work during the alleged time period, which posed a potential Health, Safety, and Personal rights risks to 6 of 6 persons in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: Licensee shall develop updated policy concerning workplace sickness absenses with an emphasis on facility management's role in ensuring coverage . All staff shall sign as proof of review. Proof of corrections shall be submitted to CCLD Offices by 05/22/2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87208(a)(12) · Plan of correction due date: May 5, 2026

87208 Plan of Operation: (a) The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so… The plan and related materials shall contain the following: (12) The Infection Control Plan.... Based on observation, interview, and record review, the licensee did not ensure staff with communicable diseases were not allowed contact with resident's or their food, which posed a potential Health, Safety, and Personal rights risks to 6 of 6 persons in care.the state’s words, verbatim · CDSS document, May 5, 2026

Plan of correction: LIcensee and facility staff shall review infection control plan and have all staff sign as proof of review. Proof of corrections shall be submitted to CCLD Offices by 05/22/2026..

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Caregiver Emma Hamto and Licensee Zebi Alvi. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and over. The facility has an approved hospice waiver for six (6). During today’s inspection there were five (5) residents in care. LPA and Caregiver toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to Residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and residents, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Licensee Zebi Alvi to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to and discussed the purpose of the visit with Caregiver Emma Hamto. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. Hospice waiver for six (6). During today’s inspection there were four (4) residents in care with three (3) residents on hospice. Administrator Zohaib Alvi arrived later during the visit. LPA with Caregiver Hamto toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Caregiver Hamto, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Alvi to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 4, 2024

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Mark Mandel and Daniel Pena conducted an unannounced visit to the facility. The purpose of the visit was to complete a One-year Required Annual inspection. LPA Mandel reviewed the facility file prior to inspection. LPAs were granted entry into the facility by Nian Hamto, Caregiver after identifying themselves and stating the purpose of the inspection. Administrator, Muhammad Alvi later joined LPAs. All staff present received criminal history clearance. Per the license, the facility is approved to serve six (6) non-ambulatory elderly adults, age range 60 and over. Hospice waiver for six (6). At the time of the visit, the facility had six (6) residents in care and two (2) staff present. The facility sketch was reviewed and is consistent with the layout of the facility. The fire inspection requirements for non-ambulatory residents is in accordance with the approved fire inspection. LPAs, accompanied by Caregiver, Roy Antes, conducted a tour of the facility, inside and out. During today’s inspection, the facility’s ambient temperature was measured at 73 degrees F. Carbon monoxide detector and smoke alarms were operational and met statutory standards. No pools or bodies of water were observed. Exterior and interior passageways were free from obstructions. According to Administrator Alvi, there are no weapons and/or ammunition stored on the premises. Disinfectants and cleaning solutions are inaccessible to residents, and poisons are locked. Each resident had clean linen in good repair and sufficient hygiene products for personal use. All residents’ rooms were equipped with required furnishings to meet their needs. There are sufficient lamps or lights in all rooms. Resident bathrooms contain the required furnishings and were in a safe, sanitary, and operational condition. Hot water temperature at faucets for residents’ use were measured at 105.5 degrees and 110. degrees Fahrenheit. Facility has a two-day supply of perishable and a seven-day supply of nonperishable food items. Food was observed to be properly stored. Medications were stored in a safe and locked place and were labeled and kept in compliance with label instructions. Employee records review verified that all staff have Criminal Record Clearance, Criminal Record Statement, and required training. Resident records reviewed for a current Physician's Report, Resident Appraisal, Needs & Services Plan (IPP), Admissions Agreement, and Centrally Stored Medication. The facility conducts emergency drills regularly and the last one was conducted on November 27, 2023. The emergency disaster plan was observed and reviewed. Based on today’s inspection, no deficiencies were observed in the areas evaluated. An exit interview was conducted and a copy of this report and Licensee Rights - LIC 9058 (rev. 01/16) were provided to Administrator, Alvi, whose signature on this form acknowledges receipt of these documents.the state’s words, verbatim · CDSS document, Dec 28, 2023