Facility Evaluation Report

LPA Hiratsuka, conducted this unannounced annual visit. LPA toured the facility with Caregiver Glenn Sahetapy. Caregiver Racquel Bereciarte, was also present. Administrator Gurdip Judge, arrived during visit but had to leave after a short time. This facility has four private resident rooms and one shared room. There is a caregiver room that leads to the garage. The main entrance opens to a small foyer. There is a hallway on the right that leads to shared resident room that has an exit to the outside as well as a full bathroom and a common half bathroom. To the left of the main entrance is a hallway that leads to the rest of the resident rooms as well as the kitchen. There is a large room across the main entrance that is a sitting and dining area as well as a doorway on the left that leads to the main sitting area and kitchen. There is also a dining table in the kitchen area. There is a sliding glass door that is blocked by a couch in the sitting area across the main entrance because that sliding door is not considered an exit to the outside. There is a gate on the same side as the garage. The front yard has a small fenced in area that has two gates leading to the front door. Both gates are unlocked. There is a locked cabinet in the kitchen for medications and sharp knives.

-two resident medication records were reviewed

The following shall be updated and submitted to Community Care Licensing by 09/25/2023:

-LIC 500 facility personnel or staff schedule

-LIC 308 designation of administrative responsibility