Facility Evaluation Report

LPA Hiratsuka conducted this unannounced annual visit.

This facility has a fire clearance for three ambulatory residents only. There are three private resident rooms. One resident room has a full private bathroom and there is one full common bathroom. There is a staff room and bathroom. There are a couple of common areas. There is an ample supply of perishable and nonperishable food.

The following shall be updated and submitted to Licensing by June 1 2024:

-LIC 500- facility personnel or staff schedule

-LIC 308- designation of administrative responsibility. (who is in charge when administrator is not present.)