Immaculate Care Home

Type of visit: Required - 1 Year

On 03/20/2026 at 12:30 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA Hughes met with caregiver Balbino and explained the purpose of the visit, LPA called the facility designated administrator to inform that CCLD was present in the facility, however their voicemail was full. The current census is 2 with 1 facility staff present. This facility is a single story building licensed to serve (6) non-ambulatory residents. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 117.7 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the entry way and was last serviced on 03/09/2026. LPA observed the facility has a public telephone in the staff room and the facility has the required posters posted. Facility thermostat was observed at 74 degrees Fahrenheit. LPA observed toxins located in the kitchen cabinet kept locked and inaccessible to residents. LPA observed sharp knives kept locked in the kitchen and inaccessible to residents. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 2 out of 2 residents medications and the Centrally Stored Medication Destruction Record (CSMDR) was complete. The first aid kit was checked and contained the required components. LPA requested resident and staff files for review. LPA reviewed 2 out of 2 resident files and they were complete. LPA requested 3 out of 3 staff files for review, and observed the files incomplete, as facility staff were missing records. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 03/24/2026 (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is not in compliance with Title 22 Regulations, and the deficiencies can be found on the LIC 809-D page. An exit interview was conducted and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility. A copy of this report will be emailed to the licensee.the state’s words, verbatim · CDSS document, Mar 20, 2026

Type of visit: POC

Licensing Program Analysts (LPAs) Vincent Moleski and Sommer Hayes arrived unannounced to conduct a case management visit. LPAs Moleski and Hayes met with facility administrator Maryimmaculate Muiruri and explained the purpose of the visit. LPA Moleski visited this facility on 3/13/25 to conduct an annual inspection. During the course of that inspection, LPA Moleski issued three Type A citations which required immediate correction. Due dates for those three citations were set for 3/14/25. As of 3/24/25, LPA Moleski received no plans of corrections regarding these citations, as agreed upon with the licensee. During this visit, Muiruri provided LPA Moleski an invoice showing that the facility fire extinguisher had been serviced as of 3/14/25, within the due date previously agreed upon for a fire clearance violation. LPA Moleski cleared this citation during this visit. On 3/13/25, LPA Moleski issued Type A citations per 22 CCR Sections 87465(h)(5) and 87628(a). During that visit, staff agreed to provide LPA Moleski with written acknowledgments of the requirements of these sections by the due date of 3/14/25. To this date, LPA Moleski has not received these acknowledgements. LPA Moleski is hereby assessing civil penalties for failure to correct these two citations. Civil penalties are assessed in the amount of $100 per day per citation, totaling $1000 per citation, or $2000. An exit interview was held with Muiruri. Appeal rights and a copy of this report were left with Muiruri.the state’s words, verbatim · CDSS document, Mar 24, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Vincent Moleski and Administrative Assistant Nicholas Morisi arrived unannounced to conduct an annual inspection. LPA Moleski met with staff member Balbino Garcia and explained the purpose of the visit. LPA Moleski reviewed Garcia's staff file. LPA Moleski asked for files for both of the clients currently in care, and for a staff file for Maryimmaculate Muiruri, the licensee. Garcia said that, as far as he was aware, files were not made for either client, both of whom moved in about six months ago. Garcia could not locate Muiruri's file. LPA Moleski called Muiruri and left a voicemail for her. Garcia said that Muiruri had not been working at this facility much recently. LPA Moleski asked to see records of emergency disaster drills. Garcia said they had not been conducted. Garcia said one resident, R2, had a stage two wound on their heel. LPA Moleski asked to see R2's home health care plan, or visit notes from home health nurses. Garcia did not have either of these available. While speaking with R2, R2 said that they had diabetes, and that Garcia performed blood glucose testing for R2. Garcia admitted that he had occasionally performed blood glucose testing for R2. LPA Moleski asked to see centrally stored medication records for R1-R2. Garcia provided a centrally stored medication record for R1 from July 2024, when R1 moved in. Garcia said no additional centrally stored medication records were available. LPA Moleski observed that R2's medication, which was stored in a locked storage area, was kept in a seven-day dispenser, rather than in its originally received container. LPA Moleski toured the facility with Garcia and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 69 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 119 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. [continued on 809-C] LPA Moleski observed first aid supplies and carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked closet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski observed a fire extinguisher which had not been serviced within the last year, as required. LPA Moleski interviewed one staff member (S1) and two residents (R1-R2). This facility is hereby cited per 22 CCR Sections 87202(a), 87465(h)(5), 87412(a), 87465(a)(6), 87506(a), 87631(a)(3)(B), and 87628(a), and Health and Safety Code Section 1569.695(c). An exit interview was held with Garcia. Appeal rights and a copy of this report were left with Garcia.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct an annual inspection. LPA Moleski met with staff member Balbino Garcia and explained the purpose of the visit. LPA Moleski reviewed three resident files (R1-R3) and one staff file (S1). LPA Moleski observed a blank LIC 602 (physician's report) in R3's file. Garcia was unable to produce a completed LIC 602 for R3. LPA Moleski reviewed a handwritten incident report in R1's file. The incident report, dated 3/29/24, was not received by CCLD. Both R1's and R3's files contained blank preplacement appraisals. LPA Moleski toured the facility with Garcia and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 74 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 111 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA Moleski observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and carbon monoxide/smoke detectors. LPA Moleski observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA Moleski observed a locked cabinet for the storage of medication. LPA Moleski observed locked cabinets for the storage of cleaning solutions and knives. LPA Moleski interviewed two residents (R1-R2). This facility is being cited per 22 CCR Sections 87211(a)(1), 87458(a) and 87457(c). An exit interview was conducted. Appeal rights and a copy of this report were left with Garcia.the state’s words, verbatim · CDSS document, Apr 18, 2024