How to prepare for an AHCA survey: a readiness guide for Florida assisted living facilities

The Agency for Health Care Administration (AHCA) inspects Florida assisted living facilities (ALFs) without notice: at initial licensure, every two years for license renewal, in response to complaints, and on follow-up visits to check corrections. Surveyors cite each violation as class I, II, III or IV according to its likely effect on residents, and each class carries a fine range set in section 429.19, Florida Statutes. A facility must usually correct deficiencies within 30 days, and AHCA may require a written plan of correction within 10 calendar days.

Last checked against primary sources on November 7, 2026. This guide is general information, not legal advice.

What types of AHCA survey can an ALF get?

AHCA licensure inspections are unannounced, and relicensure inspections happen every two years (s. 408.811(1)(a)-(b), F.S.). AHCA can also inspect any provider at any time to verify compliance.

Other officials can also enter an ALF unannounced, including the Department of Children and Families, the Medicaid Fraud Control Unit, state and local fire marshals, and representatives of the Long-Term Care Ombudsman Program (s. 429.34(1), F.S.).

What do AHCA surveyors look at first?

AHCA's own rule lists ten "key quality of care standards" it uses during an abbreviated survey, which is a good guide to where surveyors focus (Rule 59A-36.023(1)(b), F.A.C.):

1. Residency criteria: admission and continued residency (s. 429.26, F.S.; Rule 59A-36.006)
2. Management of resident funds and property (s. 429.27, F.S.; Rule 59A-36.013)
3. Respect for resident rights (s. 429.28, F.S.; Rule 59A-36.007)
4. Supervision, help with activities of daily living, and arranging appointments and transportation (s. 429.41, F.S.; Rule 59A-36.007)
5. Assistance with or administration of medications (s. 429.256, F.S.; Rule 59A-36.008)
6. Sufficient staffing to meet resident needs (s. 429.41, F.S.; Rule 59A-36.010)
7. Minimum dietary requirements and food hygiene (s. 429.41, F.S.; Rule 59A-36.012)
8. Community living support plans for mental health residents (s. 429.075, F.S.; Rule 59A-36.020)
9. Environmental standards and residency criteria under an extended congregate care license (s. 429.07, F.S.; Rule 59A-36.021)
10. Care and staffing under a limited nursing services license (s. 429.07, F.S.; Rule 59A-36.022)

AHCA will immediately conduct a full survey if an abbreviated survey finds fire safety violations that threaten residents' life or safety, staffing or resident care violations that adversely affect residents, staff providing services the facility is not licensed for, or medication practice violations that threaten residents (Rule 59A-36.023(1)(c), F.A.C.).

Records must be "readily available," meaning you can produce them immediately, on paper or electronically, at the licensee's address (Rule 59A-36.015, F.A.C.). The facility must give AHCA copies of required records at no cost (s. 408.811(3), F.S.).

What are AHCA deficiency classes I to IV?

AHCA classifies each violation by its nature and "the gravity of its probable effect" on residents, from class I (most serious) to class IV (least) (s. 408.813(2), F.S.). For ALFs, the fine ranges are set in s. 429.19(2), F.S.

Other rules on fines and classes:

• Background screening. Whatever the class, a facility found out of compliance with background screening requirements is fined $500 (s. 429.19(2)(e), F.S.).
• Unclassified violations. AHCA may fine up to $500 per violation, unless another law sets the amount, for things like exceeding licensed capacity or providing services beyond the scope of the license (s. 408.813(3), F.S.).
• Scope. A violation can be cited as isolated, patterned or widespread, depending on how many residents, staff or locations are affected (s. 408.813(2), F.S.).
• How AHCA sets the amount. AHCA considers the gravity of the violation, the actions taken to correct it, previous violations, any financial benefit to the facility, and the facility's licensed capacity (s. 429.19(3), F.S.).
• Continuing violations. Each day a violation continues past the date AHCA set for correction counts as a separate violation (s. 429.19(4), F.S.).

What else follows a serious citation?

• Consultants. A class I, class II or uncorrected class III deficiency tied to medication practices requires the facility to employ or contract a licensed pharmacist or registered nurse as a consultant; dietary deficiencies require a registered or licensed dietitian or licensed nutritionist (Rule 59A-36.023(3), F.A.C.).
• Specialty licenses. A class I or class II violation, or certain patterns of class III violations, in the previous two years makes a facility ineligible for an extended congregate care license (s. 429.07(3)(b), F.S.).
• More inspections. See the additional licensure inspection and monitoring visit rows in the survey table above (s. 429.34(2), F.S.).

What happens after an AHCA survey?

AHCA issues a written statement of deficiencies within 10 working days of the inspection, and you generally have 30 calendar days from notification to correct each deficiency.

Be accurate in what you report. AHCA may impose a fine, and for an owner-operated facility revoke or deny the license, when an administrator fraudulently misrepresents action taken to correct a violation (s. 429.19(5), F.S.).

How do you write a good plan of correction?

A strong plan of correction answers, for each deficiency, what you fixed, how you found everyone affected, what you changed so it won't recur, and who checks it and when. The statute does not prescribe a format, so this is common practice rather than an AHCA template:

1. Correct it for the residents or staff named. For example, obtain the missing health assessment items for the resident cited.
2. Find the others. Review every resident or staff file for the same problem, not only the ones the surveyor sampled.
3. Fix the system. Change the policy, form, schedule or training that let it happen.
4. Monitor. Say who will audit, how often, for how long, and where results are reported.
5. Name an owner and a date for each action, within the correction time frame.

Where are AHCA survey reports published?

ALF inspection reports are public in three places: in the facility itself, on AHCA's consumer website, and with the local ombudsman council and public library.

• At the facility. Every ALF must post its last AHCA inspection report in a prominent place accessible to residents and the public, and give a copy to any resident or applicant who asks (s. 429.35(3), F.S.). It must keep copies of all AHCA inspection reports as public information for 5 years (s. 429.35(1), F.S.; Rule 59A-36.015(1)(m), F.A.C.).
• Online. By law, AHCA's consumer website must list each ALF's violations from the previous 60 months, updated monthly, with a plain-language summary, any sanctions imposed by final order, the date AHCA confirmed corrective action, and links to the inspection reports on file. It must be searchable by facility name, license type, city or ZIP code (s. 429.55(1), F.S.). AHCA's consumer site for this is FloridaHealthFinder (floridahealthfinder.gov).
• Locally. Within 60 days of an inspection, AHCA sends the results to the local long-term care ombudsman council and to at least one public library in the county (s. 429.35(2), F.S.).

What do AHCA surveyors cite most often in ALFs?

We have not been able to verify a current official list of the most frequently cited ALF deficiencies, so we don't publish one. The best primary indicator of AHCA's focus is the list of key quality of care standards above (Rule 59A-36.023(1)(b), F.A.C.). Your own last three survey reports, and those of comparable facilities on FloridaHealthFinder, are the most reliable guide to local patterns.

AHCA survey readiness checklist

Use this checklist to audit your own files before AHCA arrives. Each item links to the statute or rule a surveyor would cite.

Resident records and health assessments

• Each resident had a face-to-face medical examination within 60 days before or 30 days after admission, recorded on AHCA Form 1823 or the practitioner's form (s. 429.26(5), F.S.; Rule 59A-36.006(2), F.A.C.).
• Any items missing from the examination form were obtained and documented within 30 days after admission (Rule 59A-36.006(2)(b), F.A.C.).
• When a resident showed signs of dementia or cognitive impairment, or had a change of condition, a physician was notified within 30 days (s. 429.26(7), F.S.).
• Each resident record contains what Rule 59A-36.015(3), F.A.C., requires, including demographic data, the health assessment, practitioner orders, the resident care record, a weight record (recorded at least semiannually for residents receiving help with activities of daily living), informed consent for medication assistance, medication records, the contract and any addenda, and any Do Not Resuscitate Order (DH Form 1896).
• The admission and discharge log is up to date (Rule 59A-36.015(1)(b), F.A.C.).
• Resident records are kept for 2 years after the resident leaves, and contracts for 5 years (Rule 59A-36.015(3)(q), F.A.C.).

Medication practices

• There is a documented request and written informed consent for every resident whom unlicensed staff assist with self-administration of medication (s. 429.256(2), F.S.; Rule 59A-36.006(1)(a), F.A.C.).
• Each such resident has a daily medication observation record (MOR), updated immediately each time a medication is offered or administered, showing allergies, the health care provider's name and phone number, each medication's name, strength and directions, and every dose taken, missed or refused, plus any errors (Rule 59A-36.008(5)(b), F.A.C.).
• Every change in directions is backed by a written, faxed or electronic order and recorded promptly in the MOR; telephone orders taken by a nurse are followed by a signed order within 10 working days (Rule 59A-36.008(5)(d)-(e), F.A.C.).
• Stock over-the-counter medications are labeled, stored in a locked container or secure room, and recorded in the MOR when given (Rule 59A-36.008, F.A.C.).
• Every unlicensed staff member who assists with medication completed 6 hours of training from a registered nurse or licensed pharmacist before starting, plus 2 hours of continuing education each year (s. 429.52(6), F.S.; Rule 59A-36.011(6), F.A.C.).

Staffing and training

• The administrator (and any manager) completed core training and passed the competency test within the required time, and has 12 hours of continuing education every 2 years (s. 429.52(4)-(5), F.S.; Rule 59A-36.011(1), F.A.C.).
• Every new employee without core training completed at least 2 hours of preservice orientation before interacting with residents, with a statement signed by the employee and administrator in the personnel file (s. 429.52(1), F.S.; Rule 59A-36.011(2), F.A.C.).
• In-service training (infection control, adverse incidents and emergency procedures, resident rights and abuse reporting, resident behavior and activities of daily living, food safety, elopement response) was completed on time and documented (Rule 59A-36.011(3), F.A.C.).
• Dementia training under s. 430.5025, F.S., is complete for every employee it applies to.
• A staff member with current first aid and CPR certification is in the facility at all times (Rule 59A-36.011(5), F.A.C.).
• Training certificates in personnel files show the course title, subject, agenda, hours, trainee name, dates, location and the trainer's signature and credentials (Rule 59A-36.011(12), F.A.C.).
• Written work schedules and staff time sheets are kept for the most recent 6 months (Rule 59A-36.015(2)(c), F.A.C.).
• Every week meets the minimum staff hours for your census (for example 212 hours a week for 6 to 15 residents, 253 for 16 to 25), counting only on-the-job staff, and you have enough qualified staff to meet residents' scheduled and unscheduled needs (Rule 59A-36.010(3)(a)-(b), F.A.C.).
• If you have 17 or more residents, at least one staff member is awake at all hours of the day and night (Rule 59A-36.010(3)(a)4., F.A.C.).

See Florida ALF staff training and background screening for the full requirements in tables.

Background screening

• The licensee (if an individual), administrator, financial officer, controlling interests, and staff or contractors who provide personal care or have access to residents' funds, property or living areas have Level 2 background screening through AHCA (s. 408.809(1), F.S.; s. 429.174, F.S.).
• Rescreening is tracked on a 5-year cycle (s. 408.809(2), F.S.).
• Each personnel file documents screening compliance (s. 429.275(2), F.S.; Rule 59A-36.015(2)(a), F.A.C.).

Incidents and emergency planning

• Adverse incidents (as defined in s. 429.23(2), F.S., including resident elopement that puts the resident at risk) get a preliminary report to AHCA through its online portal within 1 business day and a full report within 15 days (s. 429.23(3)-(4), F.S.).
• Suspected abuse, neglect or exploitation is reported to the Department of Children and Families under Chapter 415, F.S. (s. 429.23(6), F.S.).
• The comprehensive emergency management plan follows AHCA Form 3180-5006, is reviewed and submitted every year, and significant changes are submitted within 30 days; the county emergency management agency is the final authority on the plan (Rule 59A-36.019(1)-(2), F.A.C.).
• All staff are trained in their duties under the emergency plan, and new staff within 30 days of starting (Rule 59A-36.019(3)(a), F.A.C.).

Resident rights, contracts and safety

• Every resident has a contract signed at or before admission (s. 429.24, F.S.).
• The facility has a grievance procedure and abuse prevention policies (Rule 59A-36.015(1), F.A.C.), and staff are trained on resident rights under s. 429.28, F.S.
• Elopement response policies are in place, all staff were trained within 30 days of hire, and elopement drills are documented (Rule 59A-36.011(3)(f), Rule 59A-36.015(1)(n)-(o), F.A.C.).

Facility records

• The license is displayed in a conspicuous public place (Rule 59A-36.015(1)(a), F.A.C.).
• The emergency management plan, with the county emergency management agency's review, is on file and readily available (Rule 59A-36.015(1)(d), F.A.C.).
• Liability insurance is in force and on file (s. 429.275(3), F.S.; Rule 59A-36.015(1)(e), F.A.C.).
• AHCA survey, inspection and complaint reports from the last 5 years, and fire safety and sanitation inspection reports from the last 2 years, are on file (Rule 59A-36.015(1)(k)-(m), F.A.C.).
• Policies required by Rule 59A-36.015(1), F.A.C., are on file, including medication practices, physical restraints, assistive devices, third-party providers and visitation.

Dementia care and advertising

• If you advertise special care for people with Alzheimer's disease or related disorders, you meet the standards in s. 429.178, F.S., and keep copies of those ads (s. 429.177, F.S.; Rule 59A-36.015(1)(h), F.A.C.).
• You have checked whether you will need Florida's new Memory Care Services license. See our SB 1404 guide.

How Care Copilot helps

Care Copilot is building a Florida version of its AI file audit. It reads every resident and staff file you export, not a sample, checks each against Chapter 429 F.S. and Chapter 59A-36 F.A.C., and lists likely deficiencies with the statute or rule, a suggested class, the exact evidence and a draft plan of correction for your administrator to review. It does not observe care or interview residents or staff, so it works alongside your own rounds and mock surveys. We are opening early access to a small group of founding Florida operators; it is not yet available in the US. Learn about early access.

Sources

• Section 408.806, F.S. (2026): License application process
• Section 408.809, F.S. (2026): Background screening; prohibited offenses
• Section 408.811, F.S. (2026): Right of inspection; inspection reports; plan for correction of deficiencies
• Section 408.813, F.S. (2026): Administrative fines; violations
• Section 429.07, F.S. (2026): License required; fee
• Section 429.174, F.S. (2026): Background screening
• Section 429.177, F.S. (2026): Alzheimer's disclosures
• Section 429.178, F.S. (2026): Special care for persons with Alzheimer's disease
• Section 429.19, F.S. (2026): Violations; administrative fines
• Section 429.23, F.S. (2026): Internal risk management and quality assurance; adverse incidents
• Section 429.24, F.S. (2026): Contracts
• Section 429.256, F.S. (2026): Assistance with self-administration of medication
• Section 429.26, F.S. (2026): Appropriateness of placements; examinations of residents
• Section 429.275, F.S. (2026): Business practice; personnel records; liability insurance
• Section 429.28, F.S. (2026): Resident bill of rights
• Section 429.34, F.S. (2026): Right of entry and inspection
• Section 429.35, F.S. (2026): Maintenance of records; reports
• Section 429.52, F.S. (2026): Staff training and educational requirements
• Section 429.55, F.S. (2026): Consumer information website
• Rule 59A-36.006, F.A.C.: Admission Procedures, Appropriateness of Placement and Continued Residency Criteria
• Rule 59A-36.008, F.A.C.: Medication Practices
• Rule 59A-36.010, F.A.C.: Staffing Standards
• Rule 59A-36.011, F.A.C.: Staff Training Requirements and Competency Test
• Rule 59A-36.015, F.A.C.: Records
• Rule 59A-36.019, F.A.C.: Emergency Management
• Rule 59A-36.023, F.A.C.: Administrative Enforcement
• FloridaHealthFinder, Florida Agency for Health Care Administration