Immaculate Home at Withers

Type of visit: Required - 1 Year

On 08/03/2026 at 1:45 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to conduct a 1-Year Required inspection. LPA met with Caregiver Gerald Caluag explained the purpose of the visit. Administrator, Norberto Geronimo, was notified by phone call of visit, and arrived at 2:30 PM. LPA toured the facility with caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of eight (8) total bedrooms which two (2) rooms are occupied by staff and four (4) bathrooms which one (1) is designated for staff use. No bodies of water were observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 0102/2026. Emergency Disaster Plan was posted and last updated 05/26/2026. First aid kit was observed to be complete. Earthquake and fire drills last conducted on 06/30/2026 and are done quarterly. LPA reviewed five (5) resident files, and five (5) staff files; all are found to be complete. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 3, 2026

Type of visit: Required - 1 Year

On 07/09/2025 at 10:00 AM, Licensing Program Analysts (LPAs) David and Andrew Christy arrived unannounced to conduct a 1-Year Required inspection. LPAs met with Caregiver, Renato Pundanera, and explained the purpose of the visit. Norberto Geronimo, Administrator was notified by phone call of visit. LPAs toured the facility with caregiver including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of eight (8) total bedrooms which two (2) rooms are occupied by staff and four (4) bathrooms which one (1) is designated for staff use. No bodies of water were observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 140 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/18/2024. Emergency Disaster Plan was posted. First aid kit was observed to be complete. Earthquake and fire drill last conducted on 06/28/2025. LPAs reviewed six (6) resident files, and five (5) staff files; all are found to be complete. LPAs observed the following deficiencies: At 10:22 AM, LPAs measured the hot water in the shared bathroom at 140 degrees Fahrenheit. Continued on LIC809C. Continued form LIC809 The deficiency was observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Jul 9, 2025

Allegation investigated: Facility Staff are not assisting with toileting Facility Staff are restricting meals

On 2/11/2025 at 2:00PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to deliver findings for the above allegations. LPA explained the purpose of the visit with Administrator Norberto Geronimo. On the allegation: Facility Staff are not assisting with toileting Interviews with staff indicated that R1 was receiving assistance with toileting. S1 stated that they did provide a commode in the resident’s room for nighttime to reduce the risk of falling and staff assisted with toileting and changing during the day. On the allegation: Facility Staff are restricting meal LPAs interviewed Administrator, and clients. Based on interviews it was stated that the facility provides residents with snacks. If ambulatory residents may go to the kitchen to get one of the many snack options and if a resident is non-ambulatory, they may request a snack from the staff. Continued on 9099-C... Unsubstantiated ... Continued from 9099 Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 11, 2025 · control 15-AS-20241203144934

Type of visit: Required - 1 Year

On 8/07/2024 at 10:15AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Maricel Gorremans Caregiver, and explained the purpose of the visit. Norberto Geronimo, Administrator arrived at 11:30AM. The Administrator currently holds a certificate (#7003393740) that expired on 04/15/2026 and is waiting on his renewed certificate to be mailed. The facility’s fire clearance was approved for five (5) non-ambulatory and one (1) bedridden residents. LPA toured the facility with Caregiver and Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of eight (8) total bedrooms which two (2) rooms are occupied by staff and four (4) bathrooms which one (1) is designated for staff use. No bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.1 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/07/2023. Emergency Disaster Plan was posted. First aid kit was observed to be complete. Earthquake and fire drill last conducted on 06/28/2024. CONTINUE ON LIC809C. CONTINUE FROM LIC809 LPA reviewed five (5) resident files and three (3) staff files all complete. LPA observed the following deficiencies: · At 1:55pm LPA observed washing machine, 2 ladders, 3 commodes, shovel and planting pots located on the side of the home in the backyard. LPA requested the following documents to be submitted to CCLD by 08/14/2024. · Resident Roster · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 pages) · Liability Insurance The deficiency was observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights providedthe state’s words, verbatim · CDSS document, Aug 7, 2024