Facility Evaluation Report

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.