Facility Evaluation Report

LPA Hiratsuka conducted this announced prelicensing. LPA met with Facility Representative Benita Velenzuela Lopez. Applicant Jagdeep Bal, could not be present during the visit but appointed Benita Velenzuela Lopez to represent him. Facility Representative is the administrator for two of Applicant's other facilities.

This facility has a fire clearance for three ambulatory and one non-ambulatory residents. There are four private resident rooms. None of the rooms have exits to the outside. The largest room has a full private bathroom. There is one full common bathroom. There is a laundry room with an exit to the outside behind the kitchen. There are locked cabinets for medications and records. The backyard is very large. There is a fence that divides the backyard into two spaces. There is a door to the garage from inside the facilty.

LPA is waiving component III orientation due to Facility Applicant and Facility Representative owning and operating other facilities.

This facility meets all requirements. LPA is going to submit this report to the application specialist.