ANNACARE2 LLC

Official classification

Type B

Official code

87205(b)

Regulation authority

CCR

What the official deficiency says

87205 Accountability of Licensee Governing Body (b) If the licensee is a corporation or an association, the governing body shall be active, and functioning in order to assure accountability. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above due to the California Secretary of State business entity records for the licensee, Annacare2 LLC entity status reflected as 'Suspended - FTB' with an inactive date of 04/01/2025, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/22/2026 Plan of Correction Licensee reported they will resolve their issues with the California Franchise Tax Board and provide proof of cleared suspension to reflect an active status that is in 'Good Standing'. POC due to LPA by close of business on 06/22/2026.

Official classification

Type B

Official code

87307(e)(2)(A)

Regulation authority

CCR

What the official deficiency says

(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (2) Fishponds, wading pools, hot tubs, swimming pools, or similar larger bodies of water. (A) The licensee shall ensure that the bodies of water specified above are inaccessible through fencing, covering, or other means when not in active use by residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview the licensee did not comply with the section cited above due not securing the facility's in-ground pool located in the backyard which poses a potential safety to persons in care.

Official plan of correction

POC Due Date: 06/05/2026 Plan of Correction During the visit, administrator left the facility to purchase a new lock for the pool gate. Upon administrator's return, LPA observed the new lock had been installed on the pool gate. LPA tested the gate and confirmed the pool area was properly secured. Administrator reported they will also add a sign to remind the facility's pool maintance staff to properly secure the gate after servicing it. Administrator reported they will also check the pool to ensure that it is properly secured after it is serviced. Proof of sign posted will be submitted to LPA by close of business on 06/05/2026.

Official classification

Type B

Official code

87412(a)(11)

Regulation authority

CCR

What the official deficiency says

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above due to not having a health screening on file for Staff 1 (S1), which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 06/05/2026 Plan of Correction Administrator reported they will require S1 to submit a completed health screening and provide a copy of the completed health screening to LPA by close of business on 06/05/2026.

Official classification

Type B

Official code

87506(c)(1)

Regulation authority

CCR

What the official deficiency says

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.

Official 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.

Deadline recorded: Aug 25, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87506(c)(1)

Regulation authority

CCR

What the official deficiency says

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.

Official 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.

Deadline recorded: Jun 30, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87204(a)

Regulation authority

CCR

What the official deficiency says

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.

Official 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

Deadline recorded: Feb 16, 2024. A deadline is not proof that correction was completed.