Facility Evaluation Report

LPA Hiratsuka, conducted this unannounced annual visit. This facility has six private resident rooms. One private room is to the right of the main entrance. The rest of the resident rooms and two common bathrooms are located to the left of the facility down a hallway. The entrance of the facility leads to an open floor plan that has the kitchen, dining, and sitting area. There is a locked storage closet for medications and records in the kitchen area. There locked laundry room and caregiver room in a nook area in the kitchen. The garage is only accessible from the outside and is used for storage. The backyard was inspected. There is a gate on both sides of the facility.

The following shall be updated and submitted to Community Care Licensing by the end of the month:

-LIC 500 facility personnel or staff schedule

-LIC 308 designation of administrative responsibility