6776 SW 64 ST_GREEN GROUP HOME APPRVL OCC o
FLOPEA A;Eta Y FOR HE4TH CARE AOMN61RA1174
CHARLIE CRIST HOLLY BENSON
GOVERNOR SECRETARY
ALF LOCAL ZONING FORM
This form is to be completed by the local zoning office and not by the facility applicant.
TO: The Agency for Health Care Administration
Division of Health Quality Assurance
Bureau of Long Term Care Services
Assisted Living Unit
2727 Mahan Drive
Tallahassee, Florida 32308-5403 1
REGARDING:Name of Facility
'Street Address
City, State&Zip
We have reviewed the status of the above referenced Assisted Living Facility(ALF)and find that it is
properly zoned according to local codes. 5004V,
Building#1 -Max.resident capacity (O M l Yoh k 33k`f3
Street Address City Zip
NOTE: When more than one building is being licensed on the same property, or connecting property,
each building and its resident capacity must be listed below.
Building#2—Max. resident capacity ;
Street Address City Zip
Building#3—Max. resident capacity ;
Street A SS City Zip
Add additional sheets if necessary.
Signature of Zoning Official
Printed Name of Official, /
Title
Agency Name
Street Address
City and Zip
Telephone ���
Date 101271 e)
AHCA Form 3180-1021,September 1996
2727 Mahan Drive, MS# <: Visit AHCA online at
Tallahassee, Florida 32308 "`{< http://ahca.myflorida.com
Page 1 of 1
Youkilis, Sanford
From: Youkilis, Sanford
Sent: Tuesday, October 21, 2008 11:33 AM
To: Figueredo, Luis
Cc: Soto-Lopez, Ricardo; Lightfoot, Marcus
Subject: Group Home Zoning
FYI
This office has received a zoning sign-off form for a new group home (ALF) located in the RS-1 Estate zone. It is
for 6 residents and will be State licensed. Therefore it does fall under our new definitions and regulations as a P,
"permitted use". We are checking that this location is more than 1000 linear feet from the other State listed group
homes. Pending that review this office will sign off on the attached State legal form. Any comments.
Sandy Y.
10/27/2008
FloridaHealthFinder.gov f Researchers and Professionals Page 1 of 2
Facility Locator
The following is a listing based on the Facility Locator search criteria you entered. Click on
the Map Location button of the facility you are interested in and you will be provided with a
map of the facility area as well as additional mapping and driving instruction options.
Additional details about Nursing Homes including the services they offer and their
regulatory performance can be found at the Nursing Home Guide Website.
Important: For a complete listing of current emergency actions such as moratoriums and
suspended licenses on health care facilities in Florida, please click here.
License Number Facility License Information
9650 BABY BOOMER'S II LIC. TYPE: STD LMH LNS
7650 S.W. 64TH COURT CAPACITY:OSS 0 NON-OSS 6
MIAMI, FL 33143 TELEPHONE#:(305)661-4204
OWNER: BABY BOOMERS ADULT
SERVICE, INC, COUNTY:DADE
ADMINISTRATOR: RODRIGUEZ, LIC EXPIRES:9!$/2009
SISSI
FACILITY TYPE:ASSISTED LIVING AHCA NUMBERA 1965206
FACILITY
8542 BABY BOOMERS ADULT CARE LIC. TYPE: STD LMH LNS
FACILITY
6478 SW 72nd Street CAPACITY:OSS 0 NON-OSS 6
MIAMI, FL 33143 TELEPHONE#:(305)662-6706
OWNER: BABY BOOMERS ADULT
SERVICE, INC. COUNTY:DADE
ADMINISTRATOR: ROSARIO, LIC EXPIRES:10!74/2009
AUREA
FACILITY TYPE:ASSISTED LIVING
FACILITY AHCA NUMBER:91953386
9391 D&E HOME CARE FACILITY, INC. LIC.TYPE: STD LMH
6305 SW 59TH AVENUE CAPACITY:OSS 5 NON-OSS 0
MIAMI, FL 33143 TELEPHONE#:(305)668-0586
OWNER: D &E HOME HOME CARE
COUNTY:DADE
FACILITY INC.
ADMINISTRATOR: SALMON, ENID LIC EXPIRES:9/9/2008
http://facilitylocator.floridahealthstat.com/FacilityFind.aspx?pFaclType=l 1&pFaclName=... 8/18/2008
FloridaHealthFinder.gov Researchers and Professionals Page 2 of 2
FACILITY TYPE:ASSISTED LIVING AHCA NUMBER:11964683
FACILITY
10420 GOOD FAMILY HOME LIC. TYPE:STD LMH LNS
6851 SW 79 Terrace CAPACITY:OSS 6 NON-OSS 0
MIAMI, FL 33143 TELEPHONE#:(786)268-1039
OWNER: GOOD FAMILY HOME COUNTY:DADE
ADMINISTRATOR: BURRI, LIC EXPIRES:2/4/2010
JOSEPHINE
FACILITY TYPE:ASSISTED LIVING AHCA NUMBER:11966178
FACILITY
10110 REGENCY VILLA,THE LIC. TYPE: STD LMH LNS
6230 SW 78 ST CAPACITY:OSS 0 NON-OSS 6
MIAMI, FL 33143 TELEPHONE#:(305)666-5129
OWNER: BABY BOOMERS ADULT COUNTY:DADE
SERVICE, INC.
ADMINISTRATOR: ROSARIO, LIC EXPIRES:11128/2009
AUREA
FACILITY TYPE:ASSISTED LIVING AHCA NUMBER:11965752
FACILITY
Number of
Facilities 5
http://facilitylocator.floridahealthstat.com/FacilityFi.nd.aspx?pFacIType=11&pFaclNtame=... 8/18/2008
FloridaHealthFinder.gov( Researchers and Professionals Page 1 of 2
Facility Locator
The following is a listing based on the Facility Locator search criteria you entered. Click on
the Map Location button of the facility you are interested in and you will be provided with a
map of the facility area as well as additional mapping and driving instruction options.
Additional details about Nursing Homes including the services they offer and their
regulatory performance can be found at the Nursing Home Guide Website.
Important: For a complete listing of current emergency actions such as moratoriums and
suspended licenses on health care facilities in Florida, please click here.
License Number Facility License Information
299992141 LARKIN HOME HEALTH LIC. TYPE: MEDICARE/MEDICAID
SERVICES INC CERTIFIED
6129 SW 70 ST CAPACITY:N/A
MIAMI, FL 33143 TELEPHONE*(305)284-7777
OWNER: LARKIN HOME
HEALTH SERVICES INC COUNTY:DADE
ADMINISTRATOR:ALBA LIC EXPiRES:5/15/2010
PEREIRA
FACILITY TYPE:HOME HEALTH AHCA NUMBER:19964863
AGENCY
Number of
Facilities 1
http://facilitylocator.floridahealthstat.cone/FacilityFind.aspx?pFaelType=19&pFacIName=... 8/18/2008
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