Annacare2

Type of visit: Required - 1 Year

On 05/22/2026, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Administrator Annalisa Blancaflor who was informed of the purpose of the visit. The facility has a fire clearance to serve six non-ambulatory elderly residents of which one may be bedridden. The facility also has an approved hospice waiver for three and LPA was informed two residents are currently receiving hospice services at the facility. LPA toured the facility with administrator and observed the facility is made up of a one-story home with six resident bedrooms, three bathrooms, a kitchen, two dining areas, two living rooms, a laundry room, and attached garage. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. Indoor and outdoor pathways were free of obstruction. The facility met requirements for a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen cabinet. Administrator tested one (1) of the smoke alarms/carbon monoxide detectors and LPA heard them to be operational. LPA also observed two charged fire extinguishers mounted near the kitchen last serviced on 06/26/2025. The facility's certificate of liability insurance expires on 04/13/2027. The administrator certificate for Blancaflor expires on 09/09/2027. Staff present have a criminal record clearance and valid first aid/CPR certification. Long Term Care Ombudsman's contact information, residents' personal rights, complaint procedures and facility sketch are visibly posted near the front entrance. LPA reviewed Staff 1's (S1's) employee file and the Health Screening Report - Facility Personnel (LIC 503) is blank. Administrator reported they have repeatedly asked S1 to submit a completed LIC 503, but S1 continues to refuse. Resident files reviewed had the Department's required records. LPA reviewed the California Secretary of State business entity records for the licensee Annacare2 LLC, and observed the entity status reflected as 'Suspended - FTB' with an inactive date of 04/01/2025. As a result the facility will be cited. The facility's licensing fees are current. LPA reviewed the facility's telephone and mobile numbers, email address, and mailing addresses on file. Administrator confirmed that all the information remains current and that there have been no changes to the licensee entity or corporate structure. Administrator reported an interest in modifying the licensee's corporate structure and acknowledged that Community Care Licensing (CCL) will be timely notified of changes and that a change of ownership application will be submitted if required. During the tour, LPA observed the facility has an inground pool in the backyard that is gated. LPA observed that the gate's door latch was in the open position with the lack hook disengaged and no locking mechanism in place to secure the gate. After LPA informed the administrator that the gate latch was unlocked, administrator closed the latch mechanism. However, LPA also observed a lock lying on the ground inside of the gate, with the locking mechanism detached from the latch hardware. Administrator reported that she has repeatedly instructed the pool maintenance staff to ensure the gate is properly secured and locked after servicing the pool, but sometimes the staff forgets to properly secure it. LPA asked administrator what action, if any, staff are taking to ensure that the pool is properly secured after it is serviced, but LPA did not receive a response. LPA then observed administrator retrieve the lock from the ground and struggle to align and insert the locking mechanism into the lock. Administrator then reported that the locking hardware was broken and she would go to the store to purchase a new lock. When asked, administrator reported that some of the residents have the capacity to use their walker to ambulate around the house and into the backyard on their own. A deficiency will be issued for this. During the tour, LPA observed the facility's visitation policy posted on the facility's front door entrance and on a living room wall. Administrator reported this visitation policy was implemented during the Covid-19 pandemic and the facility no longer follows this policy despite the posted signs. The visitation policy requests visitors to submit a negative Covid-19 result, present a Covid-19 vaccination card, inform staff if they are unvaccinated, avoid coming in groups and inform the administrator of the intention to the visit the resident. The visitation policy also notes only 1 person is allowed once a week or once every 2 weeks for a duration of 15 minutes per visit. LPA reviewed the house rules listed in the admission agreement which require resident guests to abide by facility's visitor policies. During the visit, administrator removed the visitor policy postings and reported they would update the signs to reflect the current visitor policy which is compliant with Title 22, the Health and Safety Code, and residents' personal rights. A technical advisory will be issued for this. No additional deficiencies were cited during today's visit. LPA offered to refer the facility to the Department's Technical Support program but administrator declined explaining she would review CCL's website instead. An exit interview was conducted an a copy of this report, LIC 809-D, Confidential Names list (LIC 811), Appeal Rights and Title 22 regulation section 87412 'Personnel Records' were reviewed and provided to Administrator Blancaflor.the state’s words, verbatim · CDSS document, May 22, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 10/15/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to deliver an amended Deficiencies page pertaining to complaint control number 18-AS-20250821141624. LPA met with Caregiver Milanie Encinas and explained the purpose of the visit. An exit interview was conducted where a copy of this report was reviewed and provided to Milanie Encinas, caregiver.the state’s words, verbatim · CDSS document, Oct 15, 2025

Allegation investigated: Facility staff failed to provide resident's records to authorized party.

On 08/25/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation for the allegation noted above. LPA met with Administrator Annalisa Blancaflor, and explained the elements of the allegation. The allegation was investigated and, the investigation consisted of interviews and records review. On 08/21/25 Community Care Licensing received a complaint alleging that the facility staff failed to provide Resident's #1 (R1) records to authorized party. Per an interview with administrator Annalisa Blancaflor who confirmed that she was aware of the initial request that was received via written letter and then received a follow up phone call. Blancaflor could not recall the dates. Blancaflor stated that she made a request to be provided with ample time to produce the records, but there was no date agreed upon. During today's visit Blancaflor provided LPA with a copy of the written request that was dated 08/13/25, but was sent via FedEx and received on 08/15/25. Per a records review of the written request it states "not to exceed two business days, at a cost not to exceed the community standards for photocopies". The letter provides further Substantiated instructions for facility staff to contact the office to make arrangements to arrange the photocopying of R1s file, within two working days. Based on interviews and and records review the allegation of facility staff failed to provide resident's records to authorized representative is substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Due to this being the second time that the facility is being cited for the same deficiency, within a 12 month period, an immediate civil penalty of $1000 is being assessed. An exit interview was conducted and a copy of this report, 9099C, 9099D, LIC421IM, and appeal rights were reviewed and provided to Annalisa Blancaflor, Administrator.the state’s words, verbatim · CDSS document, Aug 25, 2025 · control 18-AS-20250821141624

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(c)(1) · Plan of correction due date: Aug 25, 2025

Resident Records (c) All information and records obtained from or regarding residents shall be confidential. (1) The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents. The licensee and all employees shall reveal or make available confidential information only upon the resident's written consent or that of his designated representative. This requirement is not met as evidenced by: the licensee did not provide R1s records, which posed a potential health, safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 25, 2025

Plan of correction: There is no POC due at this time. R1s file was provided to LPA during today's visit (8/25/25) by adminstrator Blancaflor.

Allegation investigated: Licensee failed to provide resident's records to authorized party.

On 06/16/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation for the allegation noted above. LPA met with Administrator Annalisa Blancaflor, and explained the elements of the allegation. The allegation was investigated and, the investigation consisted of observations, interviews and records review. On 06/13/25 Community Care Licensing received a complaint alleging that the Licensee failed to provide Resident's #1 (R1) records to authorized party. It was further alleged that there were ten (10) attempts made to obtain R1s records. The initial request was made on 04/30/25, and subsequent request on 05/09/25, 05/22/25, 05/23/25, 05/27/25, 05/28/25, 5/30/25, 06/03/25, 06/04/25 and 06/06/25. Per an interview with administrator Annalisa Blancaflor who confirmed that she was aware of the multiple requests, however Blancaflor did not comply. Due to never having a request from an authorized representative, and being unsure of what to do. LPA reminded Blancaflor to contact the department or review the evaluator manual should she require further guidance. Based on interviews the allegation of licensee failed to provide resident Substantiated records to authorized party is substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. An exit interview was conducted and a copy of this report, 9099C, 9099D, appeal rights were reviewed and provided to Annalisa Blancaflor, Administrator.the state’s words, verbatim · CDSS document, Jun 16, 2025 · control 18-AS-20250613080344

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(c)(1) · Plan of correction due date: Jun 30, 2025

Resident Records (c) All information and records obtained from or regarding residents shall be confidential. (1) The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents. The licensee and all employees shall reveal or make available confidential information only upon the resident's written consent or that of his designated representative. This requirement is not met as evidenced by: the licensee did not provide R1s records, which posed a potential health, safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 16, 2025

Plan of correction: There is no POC due at this time. R1s file was surrendered when requested. Per the administrator R1s full file was copied and provided to LPA during today's (6/16/25) visit.

Type of visit: Required - 1 Year

On 5/8/2024, Licensing Program Analyst (LPA), Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Caregiver, Milani Encinas who was informed of the purpose of the visit. Administrator, Annalisa Blancaflor was contacted over-the-phone and informed of LPA's visit. The facility has a fire clearance for six (6) non-ambulatory elderly residents, of which one (1) may be bedridden. The facility also has an approved hospice waver for three (3) residents and LPA was informed none of the current residents are on hospice. During today's visit, there was five (5) residents and one (1) staff present. LPA toured the facility with Caregiver Encinas. All outdoor pathways were free of obstructions. Outdoor shaded seating area is available for the residents to sit and relax. The facility has an in-ground pool that has an appropriate gate and is secured with a master lock to make it inaccessible for the residents in care. LPA observed residents watching television in the living room. Resident bedrooms have the required bedding, furniture and lighting. Bathrooms are clean and have grab bars near the showers. The facility has a hallway closet filled with clean towels, blankets, and linen, available in different colors for the residents in care. LPA toured the kitchen and observed the facility has a 2-day supply of perishable foods and 7-day supply of non-perishable foods, which are stored in a safe and healthful manner. Cleaning solutions and disinfectants are secured in a locked cabinet in the laundry room. Caregiver Encinas tested the smoke alarms/carbon monoxide detectors and LPA found them to be operational. LPA also observed charged fire extinguishers mounted throughout the facility. Medication is secured in a locked kitchen cabinet. The facility has two (2) living rooms. LPA observed living rooms to be clean and furniture in good condition. LPA reviewed random resident files and observed that residents with a dementia diagnosis had updated physician reports. Residents' personal rights, Long-Term Care Ombudsman's contact information and grievance procedures are posted near the front entrance. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted an a copy of this report was reviewed and provided to Caregiver Encinas.the state’s words, verbatim · CDSS document, May 8, 2024

Allegation investigated: Facility is operating over the capacity.

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced visit to initiate and deliver findings regarding the allegation listed above. LPA was granted entry and met with caregiver Milanie Encinas, who was Informed of the purpose of the visit. LPA toured the facility, conducted interviews, and collected pertinent documents regarding the allegation listed above. Regarding the allegation “Facility is operating over the capacity”, upon arrival LPA asked staff the number of residents currently residing in the facility. Staff One (S1) stated there were currently seven (7) residents. Record Review reveals the facility is licensed for a capacity of 6 and during LPA’s tour of the facility LPA observed a total of 7 residents. It was reported Resident One (R1) is the owner of the home and is treated like a resident but R1 is a non-paying resident. Record Review revealed R1 has a resident file with a signed admissions agreement that states R1 is “non-payment”. Substantiated During the visit, LPA observed staff providing care and supervision to R1 and the six (6) residents residing at the facility. Therefore based on LPA’s observations, record review, and interviews, the allegation “Facility is operating over the capacity” has been deemed SUBSTANTIATED at this time. A finding that the complaint is SUBSTANTIATED means that the allegation is valid. The facility was cited civil penalties per Title 22 division 6 chapter 8 section 87204(a) Limitations - Capacity and Ambulatory Status. An exit interview was conducted, and a copy of this report was given to Encinas along with the LIC 9099-D, LIC 421IM, LIC 811, and appeal rights.the state’s words, verbatim · CDSS document, Feb 9, 2024 · control 18-AS-20240202081314

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87204(a) · Plan of correction due date: Feb 16, 2024

Limitations - Capacity and Ambulatory Status: (a) A licensee shall not operate a facility beyond the conditions and limitations ...including specification of the maximum number of persons who may receive services at any one time...This requirement was not being met as evidenced by: The facility is licensed for a capacity of 6 residents, however during the visit on 02/09/2024, 7 residents were observed to be residing at the home. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Feb 9, 2024

Plan of correction: Licensee shall relocate the resident the facility is not licensed to provide care and supervision due to over capacity.Proof of resident relocation shall be submitted to the Department no later than and of POC date 02/16/2024