Facility Evaluation Report

LPA Hiratsuka conducted this unannounced annual visit.

This facility has a fire clearance for five non-ambulatory and one bedridden resident. There are four private resident rooms and one shared resident room. There are two caregiver rooms. There is a laundry room. The resident rooms and common areas were toured and no issues found.

Two staff files and two resident files were reviewed.

The following was observed during today's visit:

-the facility sketch submitted to Community Care Licensing Division with the application in 2014, does not match the floor plan. It does not have one of the staff rooms, has an extra staff room, and the layout appears to be flipped. LPA discussed the facility sketch with Co-Licensee Manjit Minhas and he stated he will submit a new one.

The following shall be updated and submitted to Community Care Licensing Division by May 15, 2024:

-LIC 308 designation of administrative responsibility

-LIC 500 facility personnel or staff schedule