Facility Evaluation Report

LPA Hiratsuka conducted this unannounced annual visit. LPA toured the facility.

This facility currently has five residents. LPA toured the facility and the backyard.

Three staff and three resident records were reviewed.

LPA observed a lot of trash on the side of the house with the gate. The trash does not impede the walkway and LPA is not issuing a citation because right now it does not impede the walkway, but it does need to be removed.

The following was observed and citations issued:

-The perishable food supply is not enough for three meals a day for two days for five residents. The refrigerator and freezer were almost empty. LPA was informed today is shopping day. Regulations require a two day perishable food supply to be maintained.

-The nonperishable food supply is not enough to maintain three meals a day for seven days for five residents. The regulations require the nonperishable food supply to be maintained for three meals a day for seven days for the amount of residents in the facility.

-LPA observed R1 leave the facility property. LPA reviewed R1's physician's report (LIC 602) and it states the resident is not able to leave the facility unassisted.

-LPA observed locks on the freezer and refrigerator that were not being used during visit. LPA asked the caregivers and they stated they use the locks at night. The facility does not have a waiver from Community Care Licensing Division allowing the locks.

Deficiencies cited from Title 22 Regulations and or the California Health and Safety Code. Failure to correct shall result in civil penalties. appeal rights left