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1881 PALM BAY RD
PALM BAY, FL 32905
Phone: (321) 951-2989
County: Brevard

Mailing Address

1881 PALM BAY RD
PALM BAY, FL 32905
County: Brevard
Website: http://www.cristalpalaceresort.us

Emergency Actions:

None
Facility/Provider Type: Assisted Living Facility
Administrator: GEORGIANNA POWERS
Financial Officer: INGRID E. DORRA
Owner/Licensee: CRISTAL PALACE RESORT PB, LLC.
Owner/Licensee Since: 3/30/2015
NamePositionOwnership
INGRID E. DORRABOARD MEMBER/OFFICER50%
NURI DORRABOARD MEMBER/OFFICER50%
Profit Status: For-Profit
Licensed Beds: 252
Bed Types:
Private : 252
Optional State Supplement : 0
Extended Congregate Care : 252
AHCA Number (File Number): 11968825
AHCA Field Office: 07
License Number: 12660
Current License Effective: 5/1/2016
Expires: 4/30/2019
License Status: PROV LITIGATION

Services/Characteristics:

Medicaid Services :  Assisted Living Waiver
Specialty License :  Extended Congregate Care
Bed Hold Policy :  Facility will hold beds during a temporary absence
Occupancy/Occupancy Rate :  252 / 100.00 %
Continuing Care Retirement Community :  No
Adult Day Care Services :  Yes
Activities :  Arts and Crafts, Cooking Classes, Dancing, Exercise Classes, Games/Cards, Gardening, Music Programs, Other, Shopping, Social Events/Outings, Theater and Movies, Yoga
Languages Spoken :  Arabic, English, French, Hebrew, Italian, Portuguese, Spanish
Nurse Availability :  Direct 24hr
Payment Forms Accepted :  CHAMPUS, Insurance and/or HMO, Medicaid, Medicare, Other, VA, Workers Compensation
Special Programs and Services :  Memory Care, Occupational Therapy, Pet Therapy, Physical Therapy, Speech Therapy, Water Therapy

Emergency Power Plan Summary:

Implementation Extended Until :  Jan 01, 2019

Legal Actions

Date InitiatedCase #Case TypeViolationFine AmountDate Imposed
01/03/2017 2017000033 FineSurvey $300.00 08/15/2018
10/26/2016 2017000035 FineSurvey $350.00 08/15/2018
08/18/2016 2016009811 FineSurvey $300.00 08/15/2018
08/18/2016 2016009815 FineSurvey $300.00 08/15/2018
08/18/2016 2016009813 FineSurvey $300.00 08/15/2018
07/19/2016 2016008240 FineLicensure $300.00 08/15/2018
03/28/2016 2016003229 Deny License ModificationApplication N/A 05/04/2016
03/18/2016 2016004117 FineSurvey $300.00 08/15/2018
02/16/2016 2016003289 FineSurvey $300.00 08/15/2018
12/04/2015 2015012605 FineSurvey $300.00 08/15/2018
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.

Consumer Guides:



Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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