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.

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

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.