HAVEN OF PHOENIX
4202 NORTH 20TH AVENUE
PHOENIX, AZ, 85015
6022643824
CCN: 035107
4
Overall3
Health2
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
POWER OF HOPE LLC
1128a1
Excluded 2025-07-20
Ownership
| Name | Role | % |
|---|---|---|
| HAVEN HEALTH GROUP LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| ROBERTSON, BRETT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, ROBERT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, SPENCER | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, STEPHEN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| WEST, CHRISTIAN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| HAVEN PHOENIX REAL ESTATE LLC | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| HAVEN HEALTH PROPERTIES LLC | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| ESPINOSA, STEPHANIE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| FRAGOSO, LINDSAY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| GANDHI, HEMANG | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| GREINER, RUSSELL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| IVANCICH, CASEY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SEASTRAND, JASON | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WEST, CHRISTIAN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HEALTH GROUP MANAGEMENT LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| AHMED, BAHALEDIN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (19)
2025-12-16 · Health
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2025-01-24 · Health
E
F680 · Quality of Life and Care Deficiencies
Ensure the activities program is directed by a qualified professional.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2024-09-13 · Health
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
2024-08-20 · Health
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
2023-09-08 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F813 · Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2022-07-28 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F825 · Quality of Life and Care Deficiencies
Provide or get specialized rehabilitative services as required for a resident.
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
D
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
E
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.27
RN Hrs/Resident/Day0.54
0.42
LPN Hrs/Resident/Day0.81
0.95
CNA Hrs/Resident/Day2.33
1.90
PT Hrs/Resident/Day0.12
0.04
Data as of 2026-03-01