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6 beds - very small home

Good Sam's Assisted Living Residence, LLC

1 Pebble Wood Ln, Palm Coast, FL 32164 - Flagler County

Call (386) 447-8145View on mapState record

Findings by severity

Florida sorts every inspection deficiency into a severity class, Class I being the most serious. These counts cover the state's current review period.

4
Class III
Indirect threat to resident health, safety or security

Inspection history

9 published surveys since May 2013, 2 of them complaint investigations. This is the full record, so it reaches further back than the review-period counts above.

  1. Standard
    4 deficiencies cited
    • Class 3Resident Care - Social & Leisure ActivitiesCorrected Sep 4, 2025
    • Class 3Medication - Assistance with Self-adminCorrected Sep 4, 2025
    • Class 3Food Service - Dietary StandardsCorrected Sep 4, 2025
    • Class 3Records - FacilityCorrected Sep 4, 2025
  2. Standard
    No deficiencies cited
  3. Standard
    No deficiencies cited
  4. Complaint investigation
    No deficiencies cited
  5. Complaint investigation
    No deficiencies cited
  6. Standard
    7 deficiencies cited
    • Class 3Staffing Standards - StaffCorrected Dec 3, 2018
    • Class 3Staffing Standards - LevelsCorrected Dec 3, 2018
    • Class 3Training - HIV/AidsCorrected Dec 3, 2018
    • Class 3Training - Do Not Resuscitate OrdersCorrected Dec 3, 2018
    • Class 4Records - StaffCorrected Dec 3, 2018
    • Class 3Records - ResidentCorrected Dec 3, 2018
    • Class 4Emergency Environmental ControlCorrected Dec 3, 2018
  7. Standard
    10 deficiencies cited
    • Class 3Admissions - Health AssessmentCorrected Apr 25, 2017
    • Class 3Medication - Assistance with Self-adminCorrected Feb 24, 2017
    • Class 3Medication - AdministrationCorrected Feb 24, 2017
    • Class 3Staffing Standards - StaffCorrected Feb 4, 2017
    • Class 3Training - Staff In-serviceCorrected Mar 17, 2017
    • Class 3Training - HIV/AidsCorrected Mar 17, 2017
    • Class 3Training - Do Not Resuscitate OrdersCorrected Apr 25, 2017
    • Class 3Food Service - Dietary StandardsCorrected Jan 26, 2017
    • Class 3Records - ResidentCorrected Mar 8, 2017
    • Class 4Background Screening; Prohibited OffensesCorrected Jan 26, 2017
  8. Standard
    15 deficiencies cited
    • Class 3Resident Care - Rights & Facility ProceduresCorrected Jun 1, 2015
    • Class 3Medication - Assistance with Self-adminCorrected Jun 1, 2015
    • Class 3Medication - RecordsCorrected Jun 1, 2015
    • Class 3Staffing Standards - AdministratorsCorrected Jun 1, 2015
    • Class 3Staffing Standards - StaffCorrected Jun 1, 2015
    • Class 3Training - Staff In-serviceCorrected Jun 1, 2015
    • Class 3Training - HIV/AidsCorrected Jun 1, 2015
    • Class 3Training - Nutrition & Food ServiceCorrected Jun 1, 2015
    • Class 3Training - Documentation & MonitoringCorrected Jun 1, 2015
    • Class 3Food Service - Dietary StandardsCorrected Jun 1, 2015
    • Class 3Physical Plant - Safe Living Environ/OtherCorrected Jun 1, 2015
    • Class 3Records - StaffCorrected Jun 1, 2015
    • Class 3Records - ResidentCorrected Jun 1, 2015
    • Class 3Resident ContractsCorrected Jun 1, 2015
    • Class 4Background Screening; Prohibited OffensesCorrected Jun 1, 2015
  9. Standard
    3 deficiencies cited
    • Class 3Medication - Assistance with Self-adminCorrected Jun 14, 2013
    • Class 3Medication - Labeling and OrdersCorrected Jun 14, 2013
    • Class 3Records - StaffCorrected Jun 14, 2013

Legal actions on file

Formal actions the state took. Actions may predate the current owner.

ActionReasonInitiatedFine
Change of ownership occurredNot statedNov 30, 2016-
FineSurveyMar 31, 2015$500

What this home reports offering

Self-reported to the state by the facility. Confirm anything that matters to you.

Activities

  • Arts and Crafts
  • Dancing
  • Games/Cards
  • Music Programs
  • Other
  • Social Events/Outings

Consumer Information

  • Bed Hold Policy

Religious Affiliations

  • Other

Special Programs and Services

  • Massage Therapy/Spa
  • Other
  • Pet Therapy

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