Provider Profile
LAKEWOOD RETIREMENT CENTER
Assisted Living Facility
FACILITY PROFILE
Street Address
- 1220 JIMMY ANN DR
DAYTONA BEACH, FL 32117
County: Volusia - Phone: (386) 872-3003
Mailing Address
- 1220 JIMMY ANN DR
DAYTONA BEACH, FL 32117
County: Volusia - Phone: (386) 872-3003
AHCA Reports
Inspection ReportsInspection Details
Consumer Guides
Assisted Living in FloridaLong-Term Care
Patient Safety
Health Care Advance Directives
Facility Information:
| Facility/Provider Type: | Assisted Living Facility | ||||||
| Administrator: | MARIA C. WARE | ||||||
| Financial Officer: | MARIA C. WARE | ||||||
| Owner/Licensee: | LAKEWOOD PARK INVESTMENTS, INC. | ||||||
| Owner/Licensee Since: | 3/18/2005 | ||||||
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| Profit Status: | For-Profit | ||||||
| Management Company: | Not Available | ||||||
| Manager Since: | Not Available | ||||||
| Licensed Beds: | 32 | ||||||
| Bed Types: | Private: 30 Total Capacity: 32 Optional State Supplement: 2 Extended Congregate Care: 0 | ||||||
| AHCA Number (File Number): | 11953272 | ||||||
| AHCA Field Office: | 04 | ||||||
| License Number: | 8471 | ||||||
| Current License Effective: | 6/9/2023 | ||||||
| Current License Expires: | 6/8/2025 | ||||||
| License Status: | IN REVIEW | ||||||
Services/Characteristics
| Medicaid Services: | Assisted Living Waiver |
| Activities: | Arts and CraftsDancingExercise ClassesGames/CardsGardeningMusic ProgramsShoppingSocial Events/OutingsTheater and Movies |
| Bed Hold Policy: | Facility will hold beds during a temporary absence |
| Adult Day Care Services: | No |
| Continuing Care Retirement Community: | No |
| Languages Spoken: | EnglishSpanish |
| Nurse Availability: | 3rd Party 24hr |
| Payment Forms Accepted: | CHAMPUSInsurance and/or HMOMedicaidVA |
| Special Programs and Services: | Occupational TherapyPhysical Therapy |
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Entire Facility |
| Plan Approval: | 11/16/2018 |
| Implementation Date: | 11/16/2018 |
| Cooling Method: | Air ConditionerFans |
| Areas Cooled: | Entire Facility |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 7129 |
| Number of People to use Cooled Space: | 40 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 12/30/2024 | 2024016896 | Fine | Survey | $500.00 | 2/24/2025 |
| 11/26/2024 | 2024015891 | Fine | Survey | $500.00 | 2/24/2025 |
| 12/14/2020 | 2020019917 | Fine | Survey | $2,000.00 | 8/10/2021 |
| 12/14/2020 | 2020019919 | Fine | Survey | $2,000.00 | 8/10/2021 |
| 8/26/2020 | 2020015759 | Fine | Survey | $2,000.00 | 8/10/2021 |
| 8/1/2018 | 2018011183 | Fine | Licensure | $500.00 | 9/6/2018 |
| 7/1/2016 | 2017005050 | Fine | Survey | $500.00 | 10/24/2017 |
| 2/12/2016 | 2016003405 | Fine | Survey | $1,000.00 | 10/24/2017 |
| 10/29/2014 | 2014010719 | Fine | Survey | $2,500.00 | 6/9/2015 |
| 7/16/2014 | 2014006995 | Fine | Survey | $3,000.00 | 6/9/2015 |
| 1/6/2008 | 2009000778 | Fine | Survey | $3,500.00 | 6/3/2009 |
Important information and facility/provider definitions can be found in the Glossary.
Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.