Inspection Details

Facility ID: 11911664 | Generated: 2025-11-25

Survey DateInspection TypeTrack IDDeficiencyClassRequirement DescriptionCorrection DateRequirement Long Description
9/15/2025 12:00:00 AMMonitorI18NNoneNoneNoneNoneNone
4/9/2024 12:00:00 AMStandardKF5QNoneNoneNoneNoneNone
9/26/2022 12:00:00 AMComplaintCS6TNoneNoneNoneNoneNone
6/2/2022 12:00:00 AMStandardEHU6NoneNoneNoneNoneNone
6/11/2021 12:00:00 AMMonitorT3CSNoneNoneNoneNoneNone
4/20/2021 12:00:00 AMComplaintWE3PNoneNoneNoneNoneNone
3/6/2020 12:00:00 AMStandardV61CNoneNoneNoneNoneNone
4/5/2019 12:00:00 AMComplaintSBVVA0008Class 3ADMISSIONS - HEALTH ASSESSMENT05/29/2019
429.26 (4) If possible, each resident shall have been examined by a licensed physician, a licensed physician assistant, or a licensed nurse practitioner within 60 days before admission to the facility. The signed and completed medical examination report shall be submitted to the owner or administrator of the facility who shall use the information contained therein to assist in the determination of the appropriateness of the resident's admission and continued stay in the facility. The medical...
4/5/2019 12:00:00 AMComplaintSBVVA0025Class 3RESIDENT CARE - SUPERVISION05/29/2019
429.26 (7) The facility must notify a licensed physician when a resident exhibits signs of dementia or cognitive impairment or has a change of condition in order to rule out the presence of an underlying physiological condition that may be contributing to such dementia or impairment. The notification must occur within 30 days after the acknowledgment of such signs by facility staff. If an underlying condition is determined to exist, the facility shall arrange, with the appropriate health care pr...
4/5/2019 12:00:00 AMComplaintSBVVA0162Class 3RECORDS - RESIDENT05/29/2019
(3) RESIDENT RECORDS. Resident records must be maintained on the premises and include: (a) Resident demographic data as follows: 1. Name; 2. Sex; 3. Race; 4. Date of birth; 5. Place of birth, if known; 6. Social security number; 7. Medicaid and/or Medicare number, or name of other health insurance carrier; 8. Name, address, and telephone number of next of kin, legal representative, or individual designated by the resident for notification in case of an emergency; and 9. Name, address, and teleph...
4/5/2019 12:00:00 AMComplaintSBVVA0165Class 3RISK MGMT & QA; ADVERSE INCIDENT REPORT05/29/2019
429.23 Internal risk management and quality assurance program; adverse incidents and reporting requirements.- (1) Every facility licensed under this part may, as part of its administrative functions, voluntarily establish a risk management and quality assurance program, the purpose of which is to assess resident care practices, facility incident reports, deficiencies cited by the agency, adverse incident reports, and resident grievances and develop plans of action to correct and respond quickly ...
1/23/2018 12:00:00 AMStandardU89YA0125Class 3FISCAL - SURETY BONDS04/25/2018
429.27 (2) A facility, or an owner, administrator, employee, or representative thereof, may not act as the guardian, trustee, or conservator for any resident of the assisted living facility or any of such resident ' s property. An owner, administrator, or staff member, or representative thereof, may not act as a competent resident ' s payee for social security, veteran ' s, or railroad benefits without the consent of the resident. Any facility whose owner, administrator, or staff, or...
1/23/2018 12:00:00 AMStandardU89YA0162Class 3RECORDS - RESIDENT04/25/2018
(3) RESIDENT RECORDS. Resident records must be maintained on the premises and include: (a) Resident demographic data as follows: 1. Name; 2. Sex; 3. Race; 4. Date of birth; 5. Place of birth, if known; 6. Social security number; 7. Medicaid and/or Medicare number, or name of other health insurance carrier; 8. Name, address, and telephone number of next of kin, legal representative, or individual designated by the resident for notification in case of an emergency; and 9. Name, address, and teleph...
1/23/2018 12:00:00 AMStandardU89YA0167Class 3RESIDENT CONTRACTS04/25/2018
(1) Pursuant to Section 429.24, F.S., the facility must offer a contract for execution by the resident or the resident ' s legal representative before or at the time of admission. The contract must contain the following provisions: (a) A list of the specific services, supplies and accommodations to be provided by the facility to the resident, including limited nursing and extended congregate care services that the resident elects to receive; (b) The daily, weekly, or monthly rate; (c) A list...
12/3/2015 12:00:00 AMStandardQGH5A0162Class 3RECORDS - RESIDENT01/13/2016
(3) RESIDENT RECORDS. Resident records must be maintained on the premises and include: (a) Resident demographic data as follows: 1. Name; 2. Sex; 3. Race; 4. Date of birth; 5. Place of birth, if known; 6. Social security number; 7. Medicaid and/or Medicare number, or name of other health insurance carrier; 8. Name, address, and telephone number of next of kin, legal representative, or individual designated by the resident for notification in case of an emergency; and 9. Name, address, and teleph...
3/11/2014 12:00:00 AMStandardTWRSNoneNoneNoneNoneNone
9/17/2013 12:00:00 AMMonitorHM5VNoneNoneNoneNoneNone