Facility Evaluation Report

LPA Hiratsuka conducted this unannounced annual visit. LPA toured with Administrator Edward Gadia.

This facility has six private resident rooms and two caregiver rooms. The backyard has a wood desk that is well maintained. There is an ample supply of perishable and nonperishable food supply. There is a locked cabinet for medications.

-LIC 200 application for a community care facility or residential care facility for the elderly license to change the fire clearance from five non-ambulatory to six non-ambulatory residents as well as an updated facility sketch. LPA shall submit a new fire clearance to the fire department.

-The LIC 200 also has the updated licensee mailing address to this address.

The following shall be updated and submitted to Community Care Licensing Division by April 17, 2024:

-LIC 308 designation of administrative responsibility

-LIC 500 facility personnel or staff schedule