Inspection Reports for
Good Sam‘s Assisted Living Residence
1 Pebble Wood Lane, Palm Coast, FL 32164, Palm Coast, FL, 32164
Back to Facility ProfileDeficiencies (last 9 years)
Deficiencies (over 9 years)
4.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
7% better than Florida average
Florida average: 4.6 deficiencies/yearDeficiencies per year
16
12
8
4
0
Inspection Report
Deficiencies: 0
Date: Sep 4, 2025
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State-compiled facility profile showing multiple inspections from 2013 to 2025 with deficiency history and status updates.
Findings
Across all inspections, the facility had periods with deficiencies cited and later corrected, as well as several inspections with no deficiencies found. The most recent inspections in 2025 show deficiencies cited and subsequently corrected.
Report Facts
Inspections on page: 14
Inspection Report
Routine
Deficiencies: 4
Date: Jun 25, 2025
Visit Reason
Multiple Class 3 deficiencies related to resident care, medication assistance, food service, and records were identified.
Findings
Multiple Class 3 deficiencies related to resident care, medication assistance, food service, and records were identified.
Deficiencies (4)
Tag A0026 — RESIDENT CARE - SOCIAL & LEISURE ACTIVITIES
Tag A0052 — MEDICATION - ASSISTANCE WITH SELF-ADMIN
Tag A0093 — FOOD SERVICE - DIETARY STANDARDS
Tag A0160 — RECORDS - FACILITY
Inspection Report
Routine
Deficiencies: 0
Date: Mar 23, 2023
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No deficiencies noted.
Findings
No deficiencies noted.
Inspection Report
Routine
Deficiencies: 0
Date: Nov 18, 2021
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No deficiencies noted.
Findings
No deficiencies noted.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jul 21, 2020
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No deficiencies noted.
Findings
No deficiencies noted.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Dec 17, 2019
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No deficiencies noted.
Findings
No deficiencies noted.
Inspection Report
Routine
Deficiencies: 7
Date: Sep 28, 2018
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Multiple Class 3 and Class 4 deficiencies related to staffing standards, training, and records.
Findings
Multiple Class 3 and Class 4 deficiencies related to staffing standards, training, and records.
Deficiencies (7)
Tag A0078 — STAFFING STANDARDS - STAFF
Tag A0079 — STAFFING STANDARDS - LEVELS
Tag A0082 — TRAINING - HIV/AIDS
Tag A0090 — TRAINING - DO NOT RESUSCITATE ORDERS
Tag A0161 — RECORDS - STAFF
Tag A0162 — RECORDS - RESIDENT
Tag A0200 — EMERGENCY ENVIRONMENTAL CONTROL
Inspection Report
Routine
Deficiencies: 10
Date: Jan 25, 2017
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Multiple Class 3 and Class 4 deficiencies related to admissions, medication, staffing, training, records, and background screening.
Findings
Multiple Class 3 and Class 4 deficiencies related to admissions, medication, staffing, training, records, and background screening.
Deficiencies (10)
Tag A0008 — ADMISSIONS - HEALTH ASSESSMENT
Tag A0052 — MEDICATION - ASSISTANCE WITH SELF-ADMIN
Tag A0053 — MEDICATION - ADMINISTRATION
Tag A0078 — STAFFING STANDARDS - STAFF
Tag A0081 — TRAINING - STAFF IN-SERVICE
Tag A0082 — TRAINING - HIV/AIDS
Tag A0090 — TRAINING - DO NOT RESUSCITATE ORDERS
Tag A0093 — FOOD SERVICE - DIETARY STANDARDS
Tag A0162 — RECORDS - RESIDENT
Tag CZ815 — BACKGROUND SCREENING; PROHIBITED OFFENSES
Inspection Report
Routine
Deficiencies: 15
Date: Mar 5, 2015
Visit Reason
Multiple Class 3 and Class 4 deficiencies related to resident care, medication, staffing, training, records, physical plant, and background screening.
Findings
Multiple Class 3 and Class 4 deficiencies related to resident care, medication, staffing, training, records, physical plant, and background screening.
Deficiencies (15)
Tag A0030 — RESIDENT CARE - RIGHTS & FACILITY PROCEDURES
Tag A0052 — MEDICATION - ASSISTANCE WITH SELF-ADMIN
Tag A0054 — MEDICATION - RECORDS
Tag A0077 — STAFFING STANDARDS - ADMINISTRATORS
Tag A0078 — STAFFING STANDARDS - STAFF
Tag A0081 — TRAINING - STAFF IN-SERVICE
Tag A0082 — TRAINING - HIV/AIDS
Tag A0085 — TRAINING - NUTRITION & FOOD SERVICE
Tag A0091 — TRAINING - DOCUMENTATION & MONITORING
Tag A0093 — FOOD SERVICE - DIETARY STANDARDS
Tag A0152 — PHYSICAL PLANT - SAFE LIVING ENVIRON/OTHER
Tag A0161 — RECORDS - STAFF
Tag A0162 — RECORDS - RESIDENT
Tag A0167 — RESIDENT CONTRACTS
Tag AZ815 — BACKGROUND SCREENING; PROHIBITED OFFENSES
Inspection Report
Routine
Deficiencies: 3
Date: May 8, 2013
Visit Reason
Class 3 deficiencies related to medication assistance, medication labeling, and staff records.
Findings
Class 3 deficiencies related to medication assistance, medication labeling, and staff records.
Deficiencies (3)
Tag A0052 — MEDICATION - ASSISTANCE WITH SELF-ADMIN
Tag A0056 — MEDICATION - LABELING AND ORDERS
Tag A0161 — RECORDS - STAFF
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