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CONVIVIAL JACARANDA TRACE, LLC in VENICE, FL

3600 WILLIAM PENN WAY, VENICE, FL 34293

(941) 260-3922

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Active License
Last Updated: 4/22/2026
Sourced from state & federal public records

Facility Intelligence Overview

Safety & Inspections
No recent CMS citations reported
Questions to ask on your tour

• Ask if they have had any state or federal inspections recently.

• Ask how they ensure a safe environment for residents.

Staffing Adequacy
Federal staffing data not filed
Questions to ask on your tour

Smaller residential facilities are often not required to file daily payroll records with the federal CMS. This is common and does not indicate a violation.

• What is your staff-to-resident ratio during the day and at night?

• How do you handle staff call-outs or shortages?

Capacity
63 Beds
Institutional Care Setting. Larger facility with comprehensive 24/7 staffing.
Legal Sanctions
4
State disciplinary actions on record

Health Inspections & Citations

Rule Violation2022-07-01

Sanction Applied: Change of ownership occurred

Survey2018-06-22

Sanction Applied: Fine

Fine: $500
Survey2013-10-29

Sanction Applied: Fine

Fine: $500
Survey2009-02-20

Sanction Applied: Fine

Fine: $500

Location & Contact Information

Operational History

Originally Licensed
7/1/2022
Current Management Since
6/9/2022

Room & Unit Types

Private Rooms63 units
Semi-Private Rooms0 units
Extended Congregate Care Beds63 capacity
Optional State Supplement Beds0 capacity
Private Beds63 capacity
Total Capacity Beds63 capacity

Amenities & Services

Payment Forms Accepted

  • Other

Languages Spoken

  • English

Activities

  • Arts and Crafts
  • Exercise Classes
  • Games/Cards
  • Gardening
  • Music Programs
  • Social Events/Outings
  • Theater and Movies

Nurse Availability

  • Direct 24hr

Staffing Snapshot

The CMS staffing levels for RNs, LPNs, and CNAs assigned to handle the resident capacity.

Executive Roster

Ownership Entity

CONVIVIAL JACARANDA TRACE, LLC Not-For-Profit

Management Company

LIFESTAR MANAGEMENT JACARANDA TRACE LLC

CFO

JEFFEREY DUNKLE

Administrator

MARYLIN HAYWARD-BULLOCH

Individual Stakeholders

  • SRQ FAMILY HOLDING LLC — 43%
  • DAVID FALKBOARD MEMBER/OFFICER — 20%
  • ROBERT BLEVINSBOARD MEMBER/OFFICER — 15%
  • MARK STEVENSBOARD MEMBER/OFFICER — 3%
  • JOEL L ANDERSONBOARD MEMBER/OFFICER

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