Provider Profile
BELLA LUNA RETIREMENT HOME II INC
Assisted Living Facility
FACILITY PROFILE
Street Address
- 11511 SW 128TH ST
MIAMI, FL 33176-4484
County: Miami-Dade - Phone: (786) 768-3132
Mailing Address
- 11511 SW 128TH ST
MIAMI, FL 33176-4484
County: Miami-Dade - Phone: (786) 768-3132
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Facility Information:
| Facility/Provider Type: | Assisted Living Facility | ||||||
| Administrator: | DIANA SANTOS | ||||||
| Financial Officer: | JORGE BRITO | ||||||
| Owner/Licensee: | BELLA LUNA RETIREMENT HOME II, INC. | ||||||
| Owner/Licensee Since: | 7/18/2011 | ||||||
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| Profit Status: | For-Profit | ||||||
| Management Company: | Not Available | ||||||
| Manager Since: | Not Available | ||||||
| Licensed Beds: | 6 | ||||||
| Bed Types: | Extended Congregate Care: 0 Private: 0 Optional State Supplement: 6 Total Capacity: 6 | ||||||
| AHCA Number (File Number): | 11965711 | ||||||
| AHCA Field Office: | 11 | ||||||
| License Number: | 10054 | ||||||
| Current License Effective: | 1/5/2022 | ||||||
| Current License Expires: | 1/4/2024 | ||||||
| License Status: | IN REVIEW | ||||||
Services/Characteristics
| Medicaid Services: | Assistive Care Services |
| Specialty License: | Limited Mental Health |
| Activities: | Arts and CraftsDancingExercise ClassesGames/CardsGardeningMusic ProgramsOtherShoppingSocial Events/OutingsTheater and Movies |
| Bed Hold Policy: | Facility will hold beds during a temporary absence |
| Adult Day Care Services: | Yes |
| Continuing Care Retirement Community: | No |
| Languages Spoken: | EnglishSpanish |
| Nurse Availability: | None |
| Payment Forms Accepted: | CHAMPUSInsurance and/or HMOMedicaidMedicareOtherVAWorkers Compensation |
| Special Programs and Services: | Occupational TherapyOtherPhysical TherapySpeech Therapy |
| Community Residential Home | Yes |
Please be advised that local zoning authorities may have additional restrictions or requirements not under the jurisdiction of the Agency for Health Care Administration. Contact your local zoning authorities for any specific requirements. See also 419.001 F.S.
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Entire Facility |
| Plan Approval: | 8/6/2018 |
| Implementation Date: | 5/24/2018 |
| Cooling Method: | Air Conditioner |
| Areas Cooled: | Entire Facility |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 2300 |
| Number of People to use Cooled Space: | 8 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 3/28/2023 | 2023005347 | Fine | Survey | $4,000.00 | 7/25/2023 |
| 9/5/2019 | 2020000827 | Fine | Survey | $500.00 | 5/4/2021 |
| Change of ownership occurred 7/18/2011 | |||||
| 5/18/2009 | 2009006539 | Fine | Survey | $2,800.00 | 4/21/2009 |
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.