Inspection·September 15, 2025

K0000 INITIAL COMMENTS K0000 Bldg. 01 An unannounced Fire & Life Safety recertification survey was conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida. The Facility is in compliance with 42 CFR 483.90 (a), and National Fire Protection Association (NFPA) 101 (2012 edition), NFPA 99 (2012) requirements for nursing homes. Initial Plan Review: 2008 Existing NFPA 220 Construction Type: I (332) Number of beds: 27 Census: 23 106080 09/15/2025 VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST , HIALEAH GARDENS, Florida, 33018 PREFIX TAG ID PREFIX TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) COMPLETION DATE

E0000 Initial Comments

E0000 During an unannounced Fire & Life Safety recertification survey conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida, Emergency Preparedness was reviewed. Villa Maria West Skilled Nursing Facility is in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 483.73, Requirement for Long-Term Care Facilities. Florida Department of Health 09/15/2025 VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST , HIALEAH GARDENS, Florida, 33018 PREFIX TAG ID PREFIX TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) COMPLETION DATE

K0000 INITIAL COMMENTS

K0000 A re-licensure survey was conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida in accordance with National Fire Protection Association (NFPA) 1 and 101 (2021 edition) and applicable requirements of Florida State Marshal's Rules and Regulations, Florida Administrative Code (F.A.C.) 69A-3, F.A.C. 69A-53, F.A.C. 59A-4, and Florida Statutes (F.S.) 400 Part II, and F.S. 633.0215, adopting National Fire Protection Association (NFPA) 1 and 101 (2021 edition) known as the Florida Fire Prevention Code and all NFPA referenced standards and requirements adopted per NFPA 101, Chapter 2. There were no deficiencies found at the time of the visit. Office of Primary Care and Health Systems Management STATE FORM Florida Department of Health VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST , HIALEAH GARDENS, Florida, 33018 PREFIX TAG ID PREFIX TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) COMPLETION DATE

K0000 INITIAL COMMENTS

K0000 Bldg. 05 A re-licensure survey was conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida in accordance with National Fire Protection Association (NFPA) 1 and 101 (2021 edition) and applicable requirements of Florida State Marshal's Rules and Regulations, Florida Administrative Code (F.A.C.) 69A-3, F.A.C. 69A-53, F.A.C. 59A-4, and Florida Statutes (F.S.) 400 Part II, and F.S. 633.0215, adopting National Fire Protection Association (NFPA) 1 and 101 (2021 edition) known as the Florida Fire Prevention Code and all NFPA referenced standards and requirements adopted per NFPA 101, Chapter 2. There were no deficiencies found at the time of the visit. Office of Primary Care and Health Systems Management STATE FORM 106080 09/15/2025 VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST., HIALEAH GARDENS, Florida, 33018 PREFIX TAG ID PREFIX TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) COMPLETION DATE

K0000 INITIAL COMMENTS

K0000 Bldg. 01 An unannounced Fire & Life Safety recertification survey was conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida. The Facility is in compliance with 42 CFR 483.90 (a), and National Fire Protection Association (NFPA) 101 (2012 edition), NFPA 99 (2012) requirements for nursing homes. Initial Plan Review: 2008 Existing NFPA 220 Construction Type: I (332) Number of beds: 27 Census: 23 106080 09/15/2025 VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST , HIALEAH GARDENS, Florida, 33018 PREFIX TAG ID PREFIX TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) COMPLETION DATE

E0000 Initial Comments

E0000 During an unannounced Fire & Life Safety recertification survey conducted on 09/15/2025 at Villa Maria West Skilled Nursing Facility, a nursing home in Hialeah Gardens, Florida, Emergency Preparedness was reviewed. Villa Maria West Skilled Nursing Facility is in compliance with Emergency Preparedness per Code of Federal Regulations (CFR) 42, Part 483.73, Requirement for Long-Term Care Facilities.