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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005680
Report Date: 03/24/2025
Date Signed: 03/24/2025 10:34:30 AM

Document Has Been Signed on 03/24/2025 10:34 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:IMMACULATE CARE HOMEFACILITY NUMBER:
347005680
ADMINISTRATOR/
DIRECTOR:
MUIRURI, MARYIMMACULATEFACILITY TYPE:
740
ADDRESS:8892 MONTEREY OAKS DRIVETELEPHONE:
(916) 236-7339
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 6CENSUS: 2DATE:
03/24/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Maryimmaculate MuiruriTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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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.
NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Vincent Moleski
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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