Inspection Reports for
Good Sam‘s Assisted Living Residence
1 Pebble Wood Lane, Palm Coast, FL 32164, Palm Coast, FL, 32164
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Inspection Report — Sep 4, 2025
Annual Inspection
Date: Sep 4, 2025
Visit Reason
The page covers the inspection history of Good Sam's Assisted Living Residence, LLC, including 14 visits from May 8, 2013 to September 4, 2025.
Findings
Across 14 inspections, 5 visits ended with deficiencies cited and 4 with none. There were 39 deficiencies recorded, none in the two most serious classes, and 1 legal action with fines totaling $500.
Citations (39)
Resident Care - Social & Leisure Activities — cited June 25, 2025, corrected September 4, 2025
Medication - Assistance With Self-admin — cited June 25, 2025, corrected September 4, 2025
Food Service - Dietary Standards — cited June 25, 2025, corrected September 4, 2025
Records - Facility — cited June 25, 2025, corrected September 4, 2025
Staffing Standards - Staff — cited September 28, 2018, corrected December 3, 2018
Staffing Standards - Levels — cited September 28, 2018, corrected December 3, 2018
Training - Hiv/aids — cited September 28, 2018, corrected December 3, 2018
Training - Do Not Resuscitate Orders — cited September 28, 2018, corrected December 3, 2018
Records - Staff — cited September 28, 2018, corrected December 3, 2018
Records - Resident — cited September 28, 2018, corrected December 3, 2018
Emergency Environmental Control — cited September 28, 2018, corrected December 3, 2018
Admissions - Health Assessment — cited January 25, 2017, corrected April 25, 2017
Medication - Assistance With Self-admin — cited January 25, 2017, corrected February 24, 2017
Medication - Administration — cited January 25, 2017, corrected February 24, 2017
Staffing Standards - Staff — cited January 25, 2017, corrected February 4, 2017
Training - Staff In-service — cited January 25, 2017, corrected March 17, 2017
Training - Hiv/aids — cited January 25, 2017, corrected March 17, 2017
Training - Do Not Resuscitate Orders — cited January 25, 2017, corrected April 25, 2017
Food Service - Dietary Standards — cited January 25, 2017, corrected January 26, 2017
Records - Resident — cited January 25, 2017, corrected March 8, 2017
Background Screening; Prohibited Offenses — cited January 25, 2017, corrected January 26, 2017
Resident Care - Rights & Facility Procedures — cited March 5, 2015, corrected June 1, 2015
Medication - Assistance With Self-admin — cited March 5, 2015, corrected June 1, 2015
Medication - Records — cited March 5, 2015, corrected June 1, 2015
Staffing Standards - Administrators — cited March 5, 2015, corrected June 1, 2015
Staffing Standards - Staff — cited March 5, 2015, corrected June 1, 2015
Training - Staff In-service — cited March 5, 2015, corrected June 1, 2015
Training - Hiv/aids — cited March 5, 2015, corrected June 1, 2015
Training - Nutrition & Food Service — cited March 5, 2015, corrected June 1, 2015
Training - Documentation & Monitoring — cited March 5, 2015, corrected June 1, 2015
Food Service - Dietary Standards — cited March 5, 2015, corrected June 1, 2015
Physical Plant - Safe Living Environ/other — cited March 5, 2015, corrected June 1, 2015
Records - Staff — cited March 5, 2015, corrected June 1, 2015
Records - Resident — cited March 5, 2015, corrected June 1, 2015
Resident Contracts — cited March 5, 2015, corrected June 1, 2015
Background Screening; Prohibited Offenses — cited March 5, 2015, corrected June 1, 2015
Medication - Assistance With Self-admin — cited May 8, 2013, corrected June 14, 2013
Medication - Labeling and Orders — cited May 8, 2013, corrected June 14, 2013
Records - Staff — cited May 8, 2013, corrected June 14, 2013
Report Facts
Inspections: 14
Visits with deficiencies: 5
Clean visits: 4
Deficiencies: 39
Serious deficiencies: 0
Legal actions: 1
Total fines: 500
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