Provider Profile
A BANYAN RESIDENCE AT WILDWOOD LLC
Assisted Living Facility
FACILITY PROFILE
Street Address
- 12427 COUNTY ROAD 101
OXFORD, FL 34484
County: Sumter - Phone: (352) 268-3535
Mailing Address
- 3940 BAY SHORE RD
SARASOTA, FL 34234-5209
County: Sarasota - Phone: (941) 249-0456
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: | BRANDON ANDERSON | ||||||
| Financial Officer: | GREG A ANDERSON | ||||||
| Owner/Licensee: | A BANYAN RESIDENCE AT WILDWOOD LLC | ||||||
| Owner/Licensee Since: | 1/27/2021 | ||||||
| |||||||
| Profit Status: | For-Profit | ||||||
| Management Company: | Not Available | ||||||
| Manager Since: | Not Available | ||||||
| Licensed Beds: | 100 | ||||||
| Bed Types: | Extended Congregate Care: 0 Optional State Supplement: 0 Private: 100 Total Capacity: 100 | ||||||
| AHCA Number (File Number): | 11969813 | ||||||
| AHCA Field Office: | 03 | ||||||
| License Number: | 13557 | ||||||
| Current License Effective: | 2/6/2022 | ||||||
| Current License Expires: | 2/5/2025 | ||||||
| License Status: | IN REVIEW | ||||||
Services/Characteristics
| Medicaid Services: | Assistive Care Services |
| Activities: | Arts and CraftsCooking ClassesDancingExercise 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: | None |
| Payment Forms Accepted: | MedicaidOtherVA |
| Special Programs and Services: | Memory CarePet Therapy |
Emergency Power Plan Summary
| Onsite Alternate Power Source: | Fixed Generator |
| Emergency Power Supports: | Air ConditioningHeating SystemsLife Safety SystemsLightsRefrigeration |
| Plan Approval: | 1/28/2021 |
| Implementation Date: | 12/1/2020 |
| Cooling Method: | Air Conditioner |
| Areas Cooled: | Common AreasDining Room |
| Areas Cooled Location: | Within Facility |
| Square Footage Cooled: | 16,000 |
| Number of People to use Cooled Space: | 100 |
Legal Actions
| Date Initiated | Case # | Case Type | Violation | Fine Amount | Date Imposed |
|---|---|---|---|---|---|
| 3/27/2023 | 2023005242 | Fine | Survey | $5,000.00 | 6/12/2023 |
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.