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Aviata At Orange Park

1215 KINGSLEY AVE, Orange Park, FL, 32073

Type
Nursing home
State-licensedCMS certified · CCN 105653Nonprofit

Federal Quality Data

Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.

Full report →

CMS Star Ratings

Overall4/5
Health inspections4/5
Staffing2/5
Quality measures4/5

Facility & Staffing

Ownership
Non profit - Corporation · Chain: Aviata Health Group
Certified beds
120 · avg 108 residents/day
Administrators who left
3 departednear the Florida averageFlorida avg: 0.7 · National avg: 0.5 · per CMS Care Compare

State licensing & capacity

License number
1016095
Service type
Nursing Home
Licensed capacity
120 beds
Current license effective
December 1, 2025
Current license expires
November 30, 2027

Florida AHCA licensing registry · as of April 18, 2026

Ownership & operations

Licensee
1215 Kingsley Ave Opco Llc
Administrator
Samira Khazravan

Florida AHCA licensing registry · as of April 18, 2026

Federal ownership record

For-profitLlc

Chain affiliation

Part of the Aviata Health Group chain — 52 facilities. Chain-wide average overall rating 2.2 / 5.

Parent entity

1215 Kingsley Ave Opco Parent Llc

Disclosed owners (9 on record)

  • (unnamed Owner)

    Adp of The Snf · since 2025

  • (unnamed Owner)

    Adp of The Snf · since 2025

  • (unnamed Owner)

    Adp of The Snf · since 2025

  • Kalisha Rose Boese

    Operational/managerial Control · since 2024

  • Samira Khazravan

    Operational/managerial Control · since 2024

  • 1215 Kingsley Ave Opco Holdco Llc

    Indirect Ownership Interest · 100% · since 2023

+ 3 additional owners on the federal record.

Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures, as of April 2026.

Federal inspection record

11 health citations on file3 from complaints

Recent health-deficiency citations (most recent 8 of 11)

  • E0812·Nov 20, 2025

    Nutrition and Dietary Deficiencies

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

  • D0803·Nov 20, 2025

    Nutrition and Dietary Deficiencies

    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

  • D0600·Jul 24, 2025Complaint

    Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

  • F0812·Nov 9, 2023

    Nutrition and Dietary Deficiencies

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

  • D0727·Sep 28, 2023Complaint

    Nursing and Physician Services Deficiencies

    Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

  • D0761·Mar 9, 2023Complaint

    Pharmacy Service Deficiencies

    Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

  • D0755·Jan 21, 2022

    Pharmacy Service Deficiencies

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

  • D0695·Jan 21, 2022

    Quality of Life and Care Deficiencies

    Provide safe and appropriate respiratory care for a resident when needed.

View the full inspection history on CMS Care Compare →

Fire-safety citations

8 Life-Safety-Code citations on file. Most recent: Nov 20, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.

Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.

Where this information comes from

  • License, capacity, ownership, administrator: Florida AHCA licensing registry, snapshot as of April 18, 2026.
  • Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.

Read our methodology for how this information is collected and verified.