Renaissance Villa ALF (operated by DL Global Management Corp), 2560 Shady Lane, Orange City, FL 32763, uses this form to collect the Florida AHCA Form 1823 Resident Health Assessment from licensed health care providers.
What we collect. The health assessment information entered by the examiner, which includes medical history, diagnoses, functional status, medications, and care needs. We also collect the examiner’s name, license number, title, and contact information.
How we use it. Only to evaluate whether a resident’s needs can be met in our facility, to plan the resident’s care, and to meet Florida assisted living licensing requirements.
How we protect it. Information is stored in systems configured for HIPAA compliance under business associate agreements. Access is limited to authorized facility staff. We do not sell this information or use it for marketing.
Who we share it with. Only as needed for the resident’s care, as required by law or by state regulators such as the Agency for Health Care Administration, or with the resident’s or their representative’s authorization.
Your rights. Residents and their representatives may request access to or a copy of the resident’s assessment by contacting us.
Contact. Dieudonne Lorgeat, Administrator, Renaissance Villa ALF, (386) 775-4453
Last updated: October 29, 2026