i
14
Inspections
Surveyor visits
i
4
With deficiencies
Visits that cited something
i
6
Clean visits
Nothing cited
i
9
Deficiencies
Individual findings
i
0
Serious deficiencies
Class 1 and 2
2
Legal actions
Fines and sanctions
Countryside Lakes was inspected 14 times between December 26, 2012 and July 30, 2025 by Florida's Agency for Health Care Administration. 4 of those visits ended with deficiencies cited and 6 with none, and 4 were follow-up visits confirming corrections. Across that history AHCA recorded 9 deficiencies, none of them in the two most serious classes. The state has taken 2 legal actions against this license, with fines totalling $1,000.
The most recent visit is recorded as “Deficiencies Corrected”. A deficiency is a rule violation recorded by a state surveyor. Follow-up visits that confirm a correction are counted separately from the visits that cited the problem, so the same issue is never counted twice.
Provider Information
Status
Licensed
Licensee
Shepherd Csl, LLC
Administrator
Mary Kristine Williams
Management company
Port Orange AL Care Properties, LLC
Ownership
For-Profit
Phone
(386) 756-3480
Licensed since
December 19, 2016
Medicaid services
Not reported
Nurse availability
Direct Part-Time
Inspection History
14 documents across 14 visits| Visit date | Type | Outcome | Document |
|---|---|---|---|
| July 30, 2025 | Complaint | Corrected | Statement of Deficiencies |
| June 23, 2025 | Complaint | Deficiencies cited | Statement of Deficiencies |
| April 29, 2024 | Standard | No deficiencies | Statement of Deficiencies |
| August 15, 2022 | Complaint | No deficiencies | Statement of Deficiencies |
| June 15, 2021 | Standard | No deficiencies | Statement of Deficiencies |
| October 23, 2020 | Complaint | Corrected | Statement of Deficiencies |
| September 29, 2020 | Complaint | Deficiencies cited | Statement of Deficiencies |
| January 9, 2019 | Standard | Corrected | Statement of Deficiencies |
| November 15, 2018 | Standard | Deficiencies cited | Statement of Deficiencies |
| September 25, 2017 | Complaint | No deficiencies | Statement of Deficiencies |
Deficiencies
9 deficiencies - Class 3: 7 / Class 4: 2| Survey date | Severity | Requirement cited | Corrected |
|---|---|---|---|
| June 23, 2025 | Class 3 | Emergency Environmental Control | July 30, 2025 |
| September 29, 2020 | Class 3 | Emergency Management Planning | October 23, 2020 |
| November 15, 2018 | Class 3 | Do Not Resuscitate Orders (Dnros) | January 9, 2019 |
| November 15, 2018 | Class 3 | Training - Staff In-service | January 9, 2019 |
| November 15, 2018 | Class 3 | Records - Facility | January 9, 2019 |
| November 15, 2018 | Class 3 | Records - Staff | January 9, 2019 |
| November 15, 2018 | Class 4 | Background Screening-compliance Attestation | January 9, 2019 |
| January 26, 2017 | Class 3 | Resident Care - Elopement Standards | April 11, 2017 |
| January 26, 2017 | Class 4 | Background Screening Clearinghouse | April 11, 2017 |