374604215-5-5-2026-08-AS-APAO-DUA7CL-20260520213255

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604215
Report Date: 05/05/2026
Date Signed: 05/05/2026 11:19:55 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/10/2026 and conducted by Evaluator Ramin Hashemi

COMPLAINT CONTROL NUMBER: 08-AS-20260210111209

FACILITY NAME:	VILLA FLORENZA		FACILITY NUMBER:	374604215
ADMINISTRATOR:	ALVI, ZOHAIB		FACILITY TYPE:	740
ADDRESS:	5171 ALAMOSA PARK DRIVE		TELEPHONE:	(760) 295-1847
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92054
CAPACITY:	6	CENSUS: 3	DATE:	05/05/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Caregiver Christopher Diaz Licensee Dr. Mohammad Rahman		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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

INVESTIGATION FINDINGS:

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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

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 08-AS-20260210111209

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VILLA FLORENZA	FACILITY NUMBER: 374604215
	VISIT DATE: 05/05/2026

NARRATIVE

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(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.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20260210111209

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VILLA FLORENZA	FACILITY NUMBER: 374604215
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/05/2026 Section Cited CCR 87411(a)	1 2 3 4 5 6 7	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.	1 2 3 4 5 6 7	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.
	8 9 10 11 12 13 14	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.	8 9 10 11 12 13 14
Type B 05/05/2026 Section Cited CCR 87208(a)(12)	1 2 3 4 5 6 7	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....	1 2 3 4 5 6 7	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..
	8 9 10 11 12 13 14	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.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026

LIC9099 (FAS) - (06/04)

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