<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604215
Report Date: 06/11/2026
Date Signed: 06/11/2026 11:57:30 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
06/08/2026 and conducted by Evaluator Amy Domingo
COMPLAINT CONTROL NUMBER: 08-AS-20260608090015
FACILITY NAME:VILLA FLORENZAFACILITY NUMBER:
374604215
ADMINISTRATOR:ALVI, ZOHAIBFACILITY TYPE:
740
ADDRESS:5171 ALAMOSA PARK DRIVETELEPHONE:
(760) 295-1847
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:6CENSUS: 3DATE:
06/11/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Christopher DiazTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
 Licensee is housing a bedridden resident without the required fire clearance.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
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
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
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-20260608090015
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: 06/11/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20260608090015
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: 06/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2026
Section Cited
CCR
87202(a)(2)(c)(1)
1
2
3
4
5
6
7
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:

1
2
3
4
5
6
7
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.

8
9
10
11
12
13
14
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.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3