Facility Evaluation Report

LPA Hiratsuka conducted this unannounced annual visit.

This facility has four private resident rooms and one staff room. One resident room has a private half bathroom. There is one full common bathroom. The common areas are on the right of the facility. There is a wood deck and ramps in the backyard. The ramp and decks are well maintained. LPA toured the resident rooms and common areas and did not observe any issues.

Two resident and staff files were reviewed.

The following shall be updated and submitted to Community Care Licensing Division by May 3, 2024:

-LIC 308 designation of administrative responsibility

-LIC 500 facility personnel or staff schedule

-plan for incidental and medical care for residents